• 제목/요약/키워드: PreS1

검색결과 3,695건 처리시간 0.04초

Juxtaductal stenosis가 동반된 PA/VSD환자에서 체폐단락술 부위에 따른 폐동맥 크기의 변화 (Pulmonary Arterial Growth Pattern after Shunt Operation in Patients of Pulmonary Atresia with Ventricular Septal Defect Associated with Juxtaductal Stenosis)

  • 이교준;박영환;최재영;조범구
    • Journal of Chest Surgery
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    • 제31권9호
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    • pp.861-866
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    • 1998
  • 심실중격결손이 동반된 폐동맥폐쇄(PA/VSD)는 폐동맥의 형태 및 공급원이 매우 다양하고, 폐동맥의 발육부전 과 협착 및 폐동맥지 연결이상 유무가 교정수술시의 문제점으로 대두되고 있으므로, 저자들은 동맥관인접협 착(juxtaductal stenosis)이 동반되어 있는 환자들을 대상으로 체폐단락술전후 폐동맥 크기의 변화를 비교하 여, 수술방법 및 시기를 결정하는데 도움이 되고자 본 연구를 하였다. 1991년 7월부터 1996년 7월까지 연세대 학교 심장혈관센터에서 심실중격결손이 있는 폐동맥폐쇄환자중 동맥관인접협착이 동반되어 체폐단락술을 시행 한 59례가 있었으며, 수술전후의 심도자술 및 심혈관조영술을 시행한 29례를 대상으로 하였다. 우측(10례, Group I) 및 좌측단락술(19례, Group II)에서 단락술전후의 하행대동맥, 양측폐동맥 및 동맥관인접협착 부위의 직경을 측정하여, 수술부위에 따른 수술전후 변화를 비교하였다. 두 군에서, 하행대동맥직경에 대한 동측 폐동 맥직경의 비(ratio)가 수술전 0.78$\pm$0.31에서 수술후 1.01$\pm$0.26로, 또한 수술전 0.67$\pm$0.18에서 수술후 0.84$\pm$ 0.27로 각각 유의하게 증가하였으며, 편측 폐동맥직경의 비는 수술전 0.92$\pm$0.28에서 수술후 1.05$\pm$0.15로, 또한 수술전 0.94$\pm$0.27에서 수술후 1.08$\pm$0.37로 각각 증가하였으나 통계학적으로 유의하지는 않았다. 동맥관 인접협착 부위의 변화는 수술전 0.43$\pm$0.27에서 수술후 0.39$\pm$0.25로, 또한 수술전 0.32$\pm$0.10에서 수술후 0.30$\pm$0.16로 감소하는 경향을 보였으나 통계학적으로 유의하지 않았으며, 2례의 경우에서는 수술후 단절된 소견을 보였다. 체폐단락술을 통한 폐동맥혈류의 확보는 폐혈관 성장에 좋은 효과가 있으므로 폐혈류 감소 및 폐동맥 발육부전환자에서 추천되는 치료법이나 심실중격결손을 동반한 폐동맥폐쇄의 경우에는 동맥관인접협착의 변화가 중요한 것으로 생각된다. 본 연구 결과에서는 체폐단락술을 시행한 동측의 폐동맥이 성장함을 확인할 수 있었고, 동맥관인접협착은 악화될 가능성이 있는 것으로 생각되었다. 또한, 좌측 체폐단락술을 시행하여, 2례의 좌측 폐동맥의 단절을 경험하였다. 그러므로, 체폐단락술을 시행한 경우에는, 보다 철저한 술후 추적 및 검사가 요구되며, 동맥관인접협착이 동반된 측의 폐동맥에 단락술을 시행한 경우에는 조기에 완전 교정술을 고려하여야 할 것으로 사료된다.

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목표 신항만의 터미널 운영시스템에 따른 CY 소요면적 산정에 관한 연구 (Estimation of the CY Area Required for Each Container Handling System in Mokpo New Port)

  • 금종수
    • 한국항만학회지
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    • 제12권1호
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    • pp.35-46
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    • 1998
  • 우리나라 서남권역의 거점 항만으로서 역할을 해온 목포항은 황해경제권의 중심에 위치하여 대중국 교역 및 TCR과의 연결에 유리한 지리적 이점을 갖고 있다. 또한 세계경제의 성장축이 환태평지역으로 이동할 것으로 예상되고, 황해경제권의 부상에 따라 이 지역의 역내교역 컨테이너 물동량의 증가가 예상되며, 주변 공단의 조성과 활성화가 가시화될 때 목포항의 역할과 기능이 크게 부각될 것으로 전망된다. 이러한 목포항 주변 환경의 변화에 따라 정부에서는 목포신외항 1단계 사업으로 2001년까지 30,000 DWT급 선박이 접안할 수 있는 컨테이너부두 1선석과 다목적부두 1선석을 건설하고 있다. 컨테이너 터미널 개장 초기에는 1선석만을 컨테이너 터미널로 사용하나 장기적으로는 2선석 모두 컨테이너 물동량을 처리할 예정이다. 본 연구는 2001년에 개장되는 목포신외항의 컨테이너 터미널 운영시스템에 따른 적정한 CY 소요면적을 산정하는 데 그 목적이 있다. 컨테이너 터미널의 계획 및 설계 단계에서 고려하여야 할 중요한 항목 중의 하나는 터미널 운영시스템의 선정에 따라서 터미널의 소요면적이 크게 달라진다는 점이다. 컨테이너 터미널의 CY 소요면적은 예상되는 컨테이너의 장치수요량과 장치기간에 의하여 크게 영향을 받게 되며, 또한 CY에서 사용되는 컨테이너 취급장비에 따라서 적재단수가 다르기 때문에 어떠한 운영시스템을 선정하는가에 따라서 CY 소요면적은 크게 다르게 된다. 따라서, 본 연구에서는 CY 소요면적 산정에 영향을 미치는 주요한 요소들을 고려하여 2001년에 개장되는 목표신외항 컨테이너 터미널에 있어서 2001-2016년까지의 기간동안 각 컨테이너 터미널 운영시스템에 따른 CY 소요면적을 산정하였다. 그리고 목포신항만의 터미널 운영시스템별 CY 소요면적을 결론 부분에 요약하였다.되므로, 조사료(粗飼料)의 사료가치(飼料價値)를 평가(評價)함에 있어서는 급여수준(給與水準)과 소화율(消化率)과의 관계를 주의깊게 고려해야 할 것이다. 생산(生産)할 수 있다고 사료(思料)된다.향이 없었으나 골목 $m^3$당 접종량(接種量) 4.0kg구가 1.63g로 가장 큰 것으로 나타났다.과(結果)를 종합(綜合)해 보면 전호(前胡)의 용도별(用途別) 적정(適正) 재식거리(栽植距離)는 채소형(菜蔬型) $30\times20cm$, 약재형(藥材型) $60\times30cm$, 채소(菜蔬) 약재(藥材) 복합형(複合型) $45\times20cm$에서 지하부(地下部) 생육(生育)이 양호(良好)하면서 생엽(生葉) 및 건근(乾根) 수량(收量)이 증수(增收)되는 경향(傾向)을 보였다.퇴비(堆肥) 등(等) 유기질(有機質) 비료(肥料) 시용(施用)이 효고적(效果的)이었다.DS-PAGE법(法)으로 단백질(蛋白質) 양상을 등숙시기별(等熟時期別)로 조사(調査)한 결과(結果) 두 계통간(系統間) 질적(質的)인 차이(差異)는 보이지 않았으나 시기별(時期別)로는 양적차이(量的差異)를 나타냈다.間)에는 부(負)(-)의 상관(相關)이 있다.($P{\leq}0.01%$). 5. NEL 및 starch value 환경온도(環境溫度)가 상승(上昇)됨에 따라 감소(減少)된다. 4 엽기(葉期) sorghum식물(植物)의 환경온도(環境溫度)를 달리 하였을 때 NEL가치(價値)는 각각(各各) 4.87MJ($30/25^{\circ}C$), 5.46MJ($25/20^{\circ}C$) 및 5.81MJ/kg($18/8^{\circ}C$)로 변(變)하여 고온(高溫)에서

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도입주체에 따른 인터넷경로의 도입효과 (The Impact of the Internet Channel Introduction Depending on the Ownership of the Internet Channel)

  • 유원상
    • 마케팅과학연구
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    • 제19권1호
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    • pp.37-46
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    • 2009
  • The Census Bureau of the Department of Commerce announced in May 2008 that U.S. retail e-commerce sales for 2006 reached $ 107 billion, up from $ 87 billion in 2005 - an increase of 22 percent. From 2001 to 2006, retail e-sales increased at an average annual growth rate of 25.4 percent. The explosive growth of E-Commerce has caused profound changes in marketing channel relationships and structures in many industries. Despite the great potential implications for both academicians and practitioners, there still exists a great deal of uncertainty about the impact of the Internet channel introduction on distribution channel management. The purpose of this study is to investigate how the ownership of the new Internet channel affects the existing channel members and consumers. To explore the above research questions, this study conducts well-controlled mathematical experiments to isolate the impact of the Internet channel by comparing before and after the Internet channel entry. The model consists of a monopolist manufacturer selling its product through a channel system including one independent physical store before the entry of an Internet store. The addition of the Internet store to this channel system results in a mixed channel comprised of two different types of channels. The new Internet store can be launched by the independent physical store such as Bestbuy. In this case, the physical retailer coordinates the two types of stores to maximize the joint profits from the two stores. The Internet store also can be introduced by an independent Internet retailer such as Amazon. In this case, a retail level competition occurs between the two types of stores. Although the manufacturer sells only one product, consumers view each product-outlet pair as a unique offering. Thus, the introduction of the Internet channel provides two product offerings for consumers. The channel structures analyzed in this study are illustrated in Fig.1. It is assumed that the manufacturer plays as a Stackelberg leader maximizing its own profits with the foresight of the independent retailer's optimal responses as typically assumed in previous analytical channel studies. As a Stackelberg follower, the independent physical retailer or independent Internet retailer maximizes its own profits, conditional on the manufacturer's wholesale price. The price competition between two the independent retailers is assumed to be a Bertrand Nash game. For simplicity, the marginal cost is set at zero, as typically assumed in this type of study. In order to explore the research questions above, this study develops a game theoretic model that possesses the following three key characteristics. First, the model explicitly captures the fact that an Internet channel and a physical store exist in two independent dimensions (one in physical space and the other in cyber space). This enables this model to demonstrate that the effect of adding an Internet store is different from that of adding another physical store. Second, the model reflects the fact that consumers are heterogeneous in their preferences for using a physical store and for using an Internet channel. Third, the model captures the vertical strategic interactions between an upstream manufacturer and a downstream retailer, making it possible to analyze the channel structure issues discussed in this paper. Although numerous previous models capture this vertical dimension of marketing channels, none simultaneously incorporates the three characteristics reflected in this model. The analysis results are summarized in Table 1. When the new Internet channel is introduced by the existing physical retailer and the retailer coordinates both types of stores to maximize the joint profits from the both stores, retail prices increase due to a combination of the coordination of the retail prices and the wider market coverage. The quantity sold does not significantly increase despite the wider market coverage, because the excessively high retail prices alleviate the market coverage effect to a degree. Interestingly, the coordinated total retail profits are lower than the combined retail profits of two competing independent retailers. This implies that when a physical retailer opens an Internet channel, the retailers could be better off managing the two channels separately rather than coordinating them, unless they have the foresight of the manufacturer's pricing behavior. It is also found that the introduction of an Internet channel affects the power balance of the channel. The retail competition is strong when an independent Internet store joins a channel with an independent physical retailer. This implies that each retailer in this structure has weak channel power. Due to intense retail competition, the manufacturer uses its channel power to increase its wholesale price to extract more profits from the total channel profit. However, the retailers cannot increase retail prices accordingly because of the intense retail level competition, leading to lower channel power. In this case, consumer welfare increases due to the wider market coverage and lower retail prices caused by the retail competition. The model employed for this study is not designed to capture all the characteristics of the Internet channel. The theoretical model in this study can also be applied for any stores that are not geographically constrained such as TV home shopping or catalog sales via mail. The reasons the model in this study is names as "Internet" are as follows: first, the most representative example of the stores that are not geographically constrained is the Internet. Second, catalog sales usually determine the target markets using the pre-specified mailing lists. In this aspect, the model used in this study is closer to the Internet than catalog sales. However, it would be a desirable future research direction to mathematically and theoretically distinguish the core differences among the stores that are not geographically constrained. The model is simplified by a set of assumptions to obtain mathematical traceability. First, this study assumes the price is the only strategic tool for competition. In the real world, however, various marketing variables can be used for competition. Therefore, a more realistic model can be designed if a model incorporates other various marketing variables such as service levels or operation costs. Second, this study assumes the market with one monopoly manufacturer. Therefore, the results from this study should be carefully interpreted considering this limitation. Future research could extend this limitation by introducing manufacturer level competition. Finally, some of the results are drawn from the assumption that the monopoly manufacturer is the Stackelberg leader. Although this is a standard assumption among game theoretic studies of this kind, we could gain deeper understanding and generalize our findings beyond this assumption if the model is analyzed by different game rules.

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계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로- (The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery)

  • 이소우
    • 대한간호학회지
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    • 제12권2호
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향 (Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants)

  • 정경화
    • Child Health Nursing Research
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    • 제5권1호
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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만성 폐질환 환자에서의 호흡재활치료의 효과 (The Effect of Pulmonary Rehabilitation in Patients with Chronic Lung Disease)

  • 최강현;박영주;조원경;임채만;이상도;고윤석;김우성;김동순;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제43권5호
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    • pp.736-745
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    • 1996
  • 배경: 호흡재활치료는 만성 폐질환 환자들의 폐기능을 호전시키지는 못하나 운동허용능(exercise tolerance)을 호전시키는 것으로 알려져 있다. 그러나 이러한 운동허용능이 증가하는 것이 유산소운동 능력 (aerobic exercise capacity)이 중가하기 때문인지는 논란이 있으며, 아직 국내에서 는 호흡재활치료에 대한 보고가 없었다. 방법: 14명의 만성 폐질환 환자(만성폐쇄성폐질환 11명, 유육종증 1명, 기관지확장증 1명, 특발성 폐섬유화증 1명, 평균 연령 $57{\pm}4$세, 남자 12명, 여자 2명)를 대상으로 6 주간의 호흡재활치료를 시행하여 치료 전후의 폐기능과 운동허용능의 변화를 관찰하였다. 결과: 1) 대상 환자의 호흡재활치료 전 평균 노력성 폐활량(FVC), 1초간 노력성호기량($FEV_1$) 및 노력성 호기중간 기류량($FEF_{25-75%}$)은 각각 예측치의 $71.5{\pm}6.4%$, $40.6{\pm}3.4%$$19.3{\pm}3.8%$ 였으며, 총 폐용량(TLC), 기능적잔기용량(FRC) 및 잔기량(RV)은 각각 $130.3{\pm}9.3%$, $157.3{\pm}13.2%$$211.1{\pm}23.9%$이었고, 확산능(diffusing capacity) 및 최대 환기량(MVV)은 각각 $59.1{\pm}1.1%$$48.6{\pm}6.2%$이었다. 이들 각 폐기능의 지표들은 호흡재활치료 전후 유의한 변화는 없었다. 2) 자전거운동력측정계 (bicycle ergometer)를 이용한 운동부하 검사상 최대 운동량(maximum work rate)은 치료전 $57.7{\pm}4.9$ watts 에서 치료후 $64.8{\pm}6.0$ watts로(P=0.036), 최대산소섭취량($VO_2$ max)은 $0.81{\pm}0.07$ L/mm에서 $0.96{\mu}0.08$ L/mm로 (P=0.004), 무산소역치 (anaerobic threshold)는 $0.60{\pm}0.06$ L/mm 에서 $0.76{\mu}0.06$ L/min로(P=0.009) 호흡재활치료후 유의하게 증가하였다. 가스교환은 호흡재활치료 전후에 변화가 없었다. 3) 지구력시험 (endurance test)상 운동일(work)이 상지는 $4.5{\pm}0.7$ joule 에서 $14.8{\pm}2.4$ joule로 (P<0.001), 하지는 $25.4{\pm}5.7$ joule에서 $42.6{\pm}7.7$로 (P<0.001) 모두 재활치료 후 유의하게 증가하였다. 6분 보행거리는 $392{\pm}35$ 미터 에서 $459{\pm}33$ 미터로(P<0.001) 치료 후 연장되었고, 최대 흡기압도 $68.5{\pm}5.4$ $CmH_2O$에서 $80.4{\pm}6.4$ $CmH_2O$로 증가하였다(P<0.001). 결론: 만성 폐질환 환자에서 6주간의 호흡재활치료는 폐기능 및 가스교환을 호전시키지는 못하였지만 운동허용능(exercise tolerance)을 호전시키는 것으로 사료되었다.

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Origin of limestone conglomerates in the Choson Supergroup(Cambro-Ordovician), mid-east Korea

  • Kwon Y.K.;Chough S.K.;Choi D.K.;Lee D.J.
    • 한국석유지질학회:학술대회논문집
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    • 한국석유지질학회 2001년도 제8차 학술발표회 발표논문집
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    • pp.63-65
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    • 2001
  • The Chosen Supergroup (Cambro-Ordovician), mid-east Korea consists mainly of shallow marine carbonates and contains a variety of limestone conglomerates. These conglomerates largely comprise oligomictic, rounded lime-mudstone clasts of various size and shape (equant, oval, discoidal, tabular, and irregular) and dolomitic shale matrices. Most clasts are characterized by jigsaw-fit (mosaic), disorganized, or edgewise fabric and autoclastic lithology. Each conglomerate layer is commonly interbedded with limestone-dolomitic shale couplets and occasionally underlain by fractured limestone layer, capped by calcareous shale. According to composition, characteristic sedimentary structures, and fabric, limestone conglomerates in the Hwajol, Tumugol, Makkol, and Mungok formations of Chosen Supergroup can be classified into 4 types: (1) disorganized polymictic conglomerate (Cd), (2) horizontally stratified polymictic conglomerate (Cs), (3) mosaic conglomerate (Cm), and (4) disorganized/edgewise oligomictic conglomerate (Cd/e). These conglomerates are either depositional (Cd and Cs) or diagenetic (Cm and Cd/e) in origin. Depositional conglomerates are interpreted as storm deposits, tidal channel fills, or transgressive lag deposits. On the other hand, diagenetic conglomerates are not deposited by normal sedimentary processes, but formed by post-depositional diagenetic processes. Diagenetic conglomerates in the Chosen Supergroup are characterized by autoclastic and oligomictic lithology of lime-mudstone clasts, jigsaw-fit (mosaic) fabric, edgewise fabric, and a gradual transition from the underlying bed (Table 1). Autoclastic and oligomictic lithologies may be indicative of subsurface brecciation (fragmentation). Consolidation of lime-mudstone clasts pre-requisite for brecciation may result from dissolution and reprecipitation of CaCO3 by degradation of organic matter during burial. Jigsaw-fit fabric has been considered as evidence for in situ fragmentation. The edgewise fabric is most likely formed by expulsion of pore fluid during compaction. The lower boundary of intraformational conglomerates of depositional origin is commonly sharp and erosional. In contrast, diagenetic conglomerate layers mostly show a gradual transition from the underlying unit, which is indicative of progressive fragmentation upward (Fig. 1). The underlying fractured limestone layer also shows evidence for in situ fragmentation such as jigsaw-fit fabric and the same lithology as the overlying conglomerate layer (Fig, 1). Evidence from the conglomerate beds in the Chosen Supergroup suggests that diagenetic conglomerates are formed by in situ subsurface fragmentation of limestone layers and rounding of the fragments. In situ subsurface fragmentation may be primarily due to compaction, dewatering (upward-moving pore fluids), and dissolution, accompanying volume reduction. This process commonly occurs under the conditions of (1) alternating layers of carbonate-rich and carbonate-poor sediments and (B) early differential cementation of carbonate-rich layers. Differential cementation commonly takes place between alternating beds of carbonate-rich and clay-rich layers, because high carbonate content promotes cementation, whereas clay inhibits cementation. After deposition of alternating beds and differential cementation, with progressive burial, upward-moving pore fluid may raise pore-pressure in the upper part of limestone layers, due to commonly overlying impermeable shale layers (or beds). The high pore-pressure may reinforce propagation of fragmentation and cause upward-expulsion of pore fluid which probably produces edgewise fabric of tabular clasts. The fluidized flow then extends laterally, causing reorientation and further rounding of clasts. This process is analogous to that of autobrecciation, which can be analogously termed autoconglomeration. This is a fragmentation and rounding process whereby earlier semiconsolidated portions of limestone are incorporated into still fluid portions. The rounding may be due mainly to immiscibility and surface tension of lime-mud. The progressive rounding of the fragmented clasts probably results from grain attrition by fluidized flow. A synthetic study of limestone conglomerate beds in the Chosen Supergroup suggests that very small percent of the conglomerate layers are of depositional origin, whereas the rest, more than $80\%$, are of diagenetic origin. The common occurrence of diagenetic conglomerates warrants further study on limestone conglomerates elsewhere in the world.

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구조적 대응체 분석법에 의한 골격성 II급 부정교합 환자의 악교정 수술전후의 비교 (A Comparison of pre and post-surgical characteristics in skeletal Class III malocclusion patients using counterpart analysis)

  • 손병화;경승현;김범수
    • 대한치과교정학회지
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    • 제34권1호
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    • pp.93-107
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    • 2004
  • Enlow의 구조적 대응체 분석법은 다수의 평균에 의한 정상치와 비교하는 분석법과는 달리 개개인에서 두 개안면의 구성양상이 발달되어온 해부학적, 발육학적 특징의 복합체를 설명하는 방법이다. 본 연구에서는 악교정 수술을 시행한 골격성 III급 부정교합 환자 80명(남자 40명, 여자 40명)을 대상으로 구조적 대응체 분석법을 이용하여 수술 전후를 비교하고, 정상교합자와 비교하여 다음과 같은 결과를 얻었다. 1. 수술에 의해서 주로 하악지 전후방 길이(B3)가 감소되어 상하악의 전후방적 부조화가 해소되었다. 2. 수술에 의해서 하악지의 배열(R3, R4)이 후방으로 재배열되었으며 교합평면(R5)은 후하방으로 회전되었다. 3. 수술후와 정상교합자의 비교결과 수술후에 골격성 III급 양상은 해소되었으나 두개저수준(R1, R2)에서는 차이를 보이고 있다. 4. 수술방법에 따른 비교결과 양악수술은 상악골의 길이(A4), 하악지의 배열(R3, R4), 교합평면의 각도(R5)에서 하악수술과 차이를 보였으나 두 그룹간의 차이는 크지 않았다. 한국인 골격성 III급 부정교합자의 특징을 살펴본 지난 연구에서 골격적 원인은 두개저의 후상방회전, 상악골의 후방위치, 하악지의 전방경사, 하악골체부의 길이증가였는데 본 연구 결과 실제 수술에서 개선되는 요소는 주로 하악지의 전후방 길이 감소, 상악골의 전진이기 때문에 상대적인 개선으로 골격성 III급 양상이 해소되었다고 볼 수 있다. 이러한 결과는 실제적인 수술부위가 상악골과 하악골의 일부에 국한되기 때문이다.

가이드 수술용 템플릿을 위한 5축 정밀가공공정의 정확성에 관한 연구 (Accuracy of 5-axis precision milling for guided surgical template)

  • 박지만;이태경;정제교;김용;박은진;한종현;곽재영;김성균;허성주
    • 대한치과보철학회지
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    • 제48권4호
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    • pp.294-300
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    • 2010
  • 연구 목적: 컴퓨터-가이드 임플란트 수술은 전통적인 방법에 비해 여러 가지 장점을 가진다. 본 연구의 목적은 가이드 수술용 템플릿 제작을 위한 좌표동기화 5축 정밀가 공공정의 정확도를 범용 CAD 소프트웨어를 통해 역설계공학의 방법으로 평가하는 것이다. 연구 재료 및 방법: 악궁 형태의 모형에 거타퍼쳐 스타핑을 매식한 10 개의 모형을 만들고 상부에 실리콘 인상재를 이용하여 인공치은을 덮어 스타핑의 위치를 보이지 않게 가렸다. 모형의 하면에 동기화를 위한 좌표동기화 형상을 만든 뒤 Cone beam CT에서 3차원 영상을 얻었다. 임플란트 계획 소프트웨어의 CT 이미지 상에서 매식된 스타핑과 동일한 방향으로 스타핑의 1/2 깊이까지 가상의 시술계획을 하고, 스타핑의 방향벡터와 저지점 (1/2지점) 데이터를 석고모형의 영상으로 좌표동기화 하였다. 이후 모형하면의 좌표동기화 형상을 이용하여 가공기기상의 좌표로 좌표변환을 통해 가공좌표동기화를 하였다. 5축 밀링머신의 좌표동기화판에 모형을 고정한 후, 동기화된 가공데이터에 의거하여 스타핑과 동일한 직경의 드릴로 계획된 벡터와 깊이로 정확히 가공 하였다. 모델에 정확히 안착되는 인상트레이를 CT 장비에 미리 고정한 상태에서, 인상트레이에 모델을 적합하여 이미지를 획득한 뒤 3차원 재구성하는 방법으로 영상을 중첩하여 비교 분석하였다. SolidWorks (Dassault Systems, Concord, USA) 범용 CAD 상에 영상을 불러들여 역설계공학의 방법으로 실린더 상부, 하부의 중점에서의 위치편차와 각도편차를 조사하였다. 통계는 SPSS (release 14.0, SPSS Inc., Chicago, USA)를 이용하여 각 편차 사이의 상관관계를 분석하였다 ($\alpha$ = 0.05). 결과: 위치 편차로 인하여 모든 드릴 보어 (bore)에서 상부 1/2에 잔존하는 거타퍼쳐의 일부를 관찰할 수 있었다. 실험 모형상에서 계획된 이미지와 드릴링 후CT에서 역설계를 거친 이미지 사이의 위치편차는 상부에서 0.31 (0.15 - 0.42) mm, 하부에서 0.36 (0.24 - 0.51) mm, 각도편차는 1.62 (0.54 - 2.27)$^{\circ}$이었다. 실린더 상부와 하부 위치 편차는 양의 상관관계를 가졌다 (Pearson Correlation Coeffocient = 0.904, P= .013). 결론: 좌표동기화 5축 정밀가공 공정은 가이드 수술용 템플릿을 제작하는 데에 적합한 정확도를 가진다.

연안어장 준설퇴적물을 이용한 Cochlodinium polykrikoides 제거 (Removal of Cochlodinium polykrikoides using the Dredged Sediment from a Coastal Fishery)

  • 선영철;김명진;송영채;고성정;황응주;조규태
    • 대한환경공학회지
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    • 제32권1호
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    • pp.53-60
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    • 2010
  • 본 연구에서는 연안어장 준설퇴적물을 이용하여 적조생물인 Cochlodinium polykrikoides을 제거하는 실험을 수행하였다. 최적의 적조제거 조건을 도출하기 위해 준설퇴적물의 투입량 및 입자크기, 열처리, 첨가제 종류 및 함량, 적조 분포 깊이 등의 인자를 조절하였다. 준설퇴적물의 적정 투입량은 6~10 g/L 정도였으며, 이를 살포했을 때 제거율은 60분 후 73~93%이었다. 실제 바다에 투입시 단위면적당(1 $m^2$) 건조한 준설퇴적물 기준으로 6~10 $kg/m^3$를 살포하는 것이 필요하다. 준설퇴적물의 입자크기가 작을수록 적조제거율이 증가했다. 입자크기가 <100 ${\mu}m$일 때 제거율이 93%로 100 ${\mu}m$ ${\mu}m$ 입자의 경우(51%)보다 훨씬 높았다. 준설퇴적물의 90% 이상이 100 ${\mu}m$ 이하의 크기를 차지하므로 준설퇴적물을 별다른 처리없이 살포했을 때 상당한 효과를 거두리라고 본다. 준설퇴적물에 첨가제(CaO)를 넣어서 적조제거에 높은 효율(99%)을 얻었다. 첨가제의 적정량은 5~10%이지만 pH 상승을 고려해서 가능한 소량 투입하는 것이 적합하다. 적조 분포 깊이가 깊을수록 제거효율은 증가했다. 깊이가 5 cm 일 때 제거효율이 83%이었고 50 cm 깊이에서는 93%이었다. 바다에서 적조가 발생하는 깊이는 3 m 이내이고, Cochlodinium polykrikoides 대부분이 1 m 이내의 깊이에 존재한다. 이 실험결과를 통해 실제 바다에 준설퇴적물을 적용하면 더 높은 적조 제거효율을 얻을 수 있으리라고 기대한다. 연안어장 준설퇴적물(<100 ${\mu}m$) 10 g/L을 투입하여 적조를 최대 93%까지 제거할 수 있었으며, 이 결과는 황토를 이용한 결과(90~97%)와 비슷했다. 본 연구결과는 연안어장 준설퇴적물 살포법이 기존의 황토살포법을 대체할 수 있을 정도로 처리효율이 뛰어남을 보여주었다.