• Tuberculosis and Respiratory Diseases
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• 제44권6호
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• pp.1296-1307
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• 1997

연구배경 : Erdosteine은 만성 기관지염 급성 악화시는 물론 만성 폐색성 기관지염 치료제로 개발된 Thiol 유도체로서 점액조절작용, 항산화작용이 있으며, 특히 위장관 부작용이 거의 없다. 본 연구에서는 현재 유효성 및 안전성이 입증되어 임상에서 많이 처방되고 있는 Ambroxol과의 비교임상연구를 통해 급성 및 만성 기관지염 환자에서 Erdosteine의 임상적 유용성을 알아보고자 하였다. 방 법 : 본 연구는 무작위 이중맹검 비교시험으로서 전향적 연구방법으로 수행되었다. 급 만성 기관지염으로 다량의 객담배출 혹은 객담배출곤란을 주증상으로 하는 80명을 무작위로 할당하여 Erdosteine 투여군에는 1일 2회, 1회 300mg, Ambroxol 투여군에는 1일 2회, 1회 30mg을 총 7일간 투여하였다. 1차 효과평가기준으로는 객담배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도, 호흡곤란을 포함한 자각증상이 평가되었고, 2차 효과평가기준으로는 동맥혈가스검사, 폐기능검사가 평가되었다. 안전성은 부작용과 임상병리검사로 평가하였다. 총 80명의 환자 중 61명(Erdosteine군 : 31명, Ambroxol군 : 30명)이 본 연구를 종료하였고 19명은 중도 탈락되었다. 결과의 분석은 paired t-test, ANOVA test, multivariate t2-test, Repeated measures analysis of covariance, two sample t-test, Loglinear-Logit model analysis, Fisher's exact test를 이 용하여 유의성을 검정하였다. 결 과 : 1) 두 군간의 환자배정에 있어서 인구학적, 임상적 특징은 차이가 없었다. 2) 동맥혈가스검사, 폐기능검사에서는 두 군간의 차이는 없었고, 자각증상에서는 Erdosteine군은 객담 배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도, 호흡곤란에서, Ambroxol군은 객담배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도에서 유의하게 호전을 보였다. 통계적으로 유의하지 않았으나 Erdosteine군이 Ambroxol군에 비해 더 유의하게 호전되는 경향을 보였다($\alpha$=0.05). 3) 혈액학적검사, 혈액화학적검사 및 소변검사에서는 각 군 모두 임상적으로 의미있는 변화는 없었고 두 군간의 차이도 없었으며, 자각증상에서는 Ambroxol군에서만 4명이 연구 종료시까지 부작용이 소실되지 않았고 2명은 연구를 중단하였으나 두 군간의 차이는 없었다. 4) 각 약제의 최종효과평가에서 Erdosteine군은 31명 중 아주좋은효과 11명, 좋은효과 12명, 경도효과 6명, 무효과 2명, 악화 0명이었고 Ambroxol군은 30명 중 아주좋은효과 6명, 좋은효과 14명, 경도 효과 5명, 무효과 4명, 악화 1명이었으며 Erdosteine군이 Ambroxol군에 비해 증상이 개선될 확률이 약 2.5배만큼 높았다 (p<0.05). 결 론 : Erdosteine은 급성 및 만성 기관지염 환자의 치료에 있어 그 효과와 안전성에 있어서 우수한 약물이라고 할 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제49권6호
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• pp.752-759
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• 2000

연구배경 : 폐기능 검사는 민족과 인종 그리고 거주지역뿐만 아니라 연령에 따라서도 차이가 있는 것으로 알려져 있다. 그러나 대부분의 검사실에서 검사기기에 내장된 평균적 표준치를 기준으로 삼고 있는 실정이어서 노령인구에 대한 폐기능검사 표준을 조사할 필요가 있었다. 이에 건강한 노인을 대상으로 폐기능검사를 시행하여 연령증가에 따른 폐기능의 변화를 확인하고 이를 토대로 표준치를 제시하고자 하였다. 방법 : 65세 이상의 남녀 각 100명을 대상으로 폐기능검사를 시행하였다. 측정된 FVC, $FEV_1을 Windows용 SPSS 8.0 version을 이용하여 연령 및 사용하여 다중회기분석을 시행하였다. 노인들의 연령과 키를 현재까지 많이 쓰이고 있는 다중선형회기식으로 분석하여 저자들의 다중선형회기식과의 차이를 분석하였다. 결과 : 대상 200예 중 남자노인의 평균연령은 $71.5{\pm}5.1$세였고, 평균신장은 $163.5{\pm}6.20$cm 였다. 이들의 평균 FVC는 $3.42{\pm}0.48{\ell}$, 평균 $FEV_1$은 $2.71{\pm}0.39{\ell}$였다. 여자노인의 평균연령은 $72.0{\pm}5.1$세였고， 평균 신장은 $149.1{\pm}5.93$cm 였다. 이들의 평균 FVC는 $2.22{\pm}0.42{\ell}$ 였고, 평균 $FEV_1$은 $1.83{\pm}0.33{\ell}$였다. 단변수 분석에서 선형적 연관성을 보인 연령과 신장을 독립변수로 한 다중회귀식을 계산하였고 이를 기존의 다종선형회기식과 비교한 결과 $FEV_1$은 Morris등의 다중선형회기식에 의한 예측치가 실측치보다 낮게 예측되어 유의한 차이가 있었다(p<0.01). 결론 : 65세 이상의 정상노인에서 폐기능 검사를 시행한 결과 연령의 증가에 따라 폐기능이 통계적으로 의미있게 감소함을 확인하였다. 또한 이들의 폐기능 실측치를 다종선형회귀식을 도출하여 기존에 보고된 식들과 비교한 결과 기존의 다중선형회귀식이 한국노인의 표준을 대변할 수 없음을 증명하였다. 저자들의 다중선형회귀식은 노인 연령균에서 오차가 적어 한국노인의 폐기능을 예측하는데 유용할 것으로 기대되었다.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.14-23
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• 2000

연구배경: 폐암은 근치적 폐절제술이 가장 효과적인 치료법이지만 폐암 환자들은 흔히 고령이면서 흡연으로 인한 폐 기능저하가 동반된 경우가 많고 정상 폐조직을 광범위하게 절제하게 되므로 다른 수술보다 수술후 사망률 및 폐합병증이 더욱 문제시되고 있다. 이에 저자들은 폐기능이 저하된 폐암환자에서 폐절제술후 사망 및 합병증과 관련된 수술전 인자를 일아보고자 본 연구를 시행하였다. 방 법: 1995년 10월부터 1997년 8월까지 삼성서울병원에서 폐절제술을 시행받는 환자중에 $FEV_1$ 이 2L 이하이거나 예측치의 60% 이하인 환자를 대상으로 전향적 연구를 시행하였고 수술후 최종진단이 폐암이 아니거나 폐절제가 시행되지 않았던 환자는 최종대상에서 제외하였다. 수술 전에 대상환자의 성별, 연령, 체중 감소의 정도, 동반질환, 폐쇄성 폐렴여부를 조사하였고, 헤마토크릿, 혈청알부민, 심전도, 안정시동맥혈가스, $FEV_1$, DLco를 비롯한 폐활량검사, 운동부하 폐 기능검사를 시행하였으며 폐관류주사를 이용하여 수술후 폐기능예측지표를 산출하였다. 수술시 집도의, 폐절제술범위, 수술시간, 수술후 병기, 수술후 중환자실 체류시간을 기록하였고 사망 및 합병증은 수술후 30 일내의 사망, 폐렴이나 호흡부전 등과 같은 폐합병증, 48시간 이상의 중환자실 입원, 심장계 합병증, 농흉, 출혈, 반회후두신경손상 등 기타 합병증으로 분류하여 수술 후 발생여부를 확인하였다. 결 과: 최종 대상환자는 36명이었고 연령은 44-82세로 중앙값은 65세였으며 $FEV_1$은 $1.78\pm0.06L$이었다. 수술은 14예가 엽절제술, 8예가 이엽절제술, 14예가 전폐절제술을 시행 받았다. 수술후 사망이 2예에서 있었고 폐합병증이 10예, 48 시간이상의 중환자실 입원이 12예, 심장합병증이 3예, 기타 합병증이 4예에서 각각 발생하였으며 사망과 관련된 수술전 인자로는 혈청 알부민, DLco, 체중감소정도, ppo-DLco, ppo-DLco%, Wmax, 폐절제 정도, ppo-$VO_2$max등 이었고(p<0.05), ppo-$VO_2$max가 10ml/kg/min 이하인 환자 2명은 모두 사망한 반면 10ml/kg/min 이상인 환자에서는 사망이 없었다(p<0.01). 수술 후폐합병증은 체중감소정도, 호흡곤란정도, DLco, ppo-DLco, Wmax, MVV와 밀접한 관련이 있었다(p<0.05). 그러나 다변량분석에 의해 사망과 관련하여 유의한 지표는 없었으며 폐합병증과 관련하여 유의한 지표는 MVV(p<0.05) 였다. 결 론: 폐기능이 저하된 폐암환자의 수술후 사망 및 폐합병증과 관련하여 유용한 예견지표는 체중감소 정도, 호흡곤란 정도, 폐절제범위 등 폐기능검사와 관련되지 않은 지표들이 중요한 예견지표였고 운동부하폐기능검사지표들은 수술후 사망 및 합병증을 예측하는데 유용한 정보를 제공할 것으로 생각되며, 특히 ppo-$VO_2$max가 10ml/kg/min 이하인 환자는 수술후 사망률이 높을 것으로 추정된다.

• 대한치과보철학회지
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• 제46권2호
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• pp.148-156
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• 2008

자가부식 접착제는 사용하기 쉽고, 술식 민감성이 적은 장점이 있으나 특히 산도가 약한 자가부식 접착제의 법랑질에 대한 결합력은 논란이 되고 있다. 본 연구에서는 2단계 자가부식 접착제인 Clearfil SE Bond (Kuraray, Okayama, Japan)의 연마 법랑질에 대한 미세인장 결합강도를 측정하여 3단계 산부식수세 접착제인 Scotchbond Multi-Purpose (3M ESPE, St. Paul, MN, USA) 및 1단계 자가부식 접착제인 iBond (Heraeus Kulzer Gmbh, Hanau, Germany)의 결합강도와 비교하고자 하였고, 2단계 자가부식 접착제에 산부식 전처리를 시행하는 것이 법랑질에 대한 결합강도를 높일 수 있는지 알아 보고자 하였다. 실험군은 2단계 자가부식 접착제인 Clearfil SE Bond만 사용한 비산부식 군과 35% 인산 (Scotchbond Etchant, 3M ESPE)으로 산부식 후 Clearfil SE Bond를 사용한 산부식 군, 그리고 1단계 자가부식 접착제인 iBond를 사용한 군으로 나누었다. 대조군은 3단계 산부식수세 접착제인 Scotchbond Multi-Purpose를 사용한 군으로 정하였다. Bovine 전치의 순면을 십자가형으로 4등분하여 각 군으로 무작위로 배분하였다. 각 치아의 순면을 800-grit 실리콘 카바이드 지로 연마한 후 삭제된 법랑질면에 제조사의 설명서에 따라 각 군의 접착제를 적용하고 Light-Core (Bisco)로 적층 충전하였다. 시편은 $37i{\acute{E}}$, 증류수에 일주일 동안 보관한 후 low speed precicion diamond saw (TOPMENT Metsaw-LS, R&B, Daejeon, Korea)를 이용하여 약 $0.8{\times}0.8mm$ 단면이 되도록 시편을 절단하여 미세시편을 제작하였다. 일주일마다 증류수를 교환하면서 한 달, 세 달 동안 $37i{\acute{E}}$, 증류수에 미세시 편을 보관한 후 각각의 미세인장결합강도를 측정하였다. 미세인장결합강도 (MPa)는 파절 시에 가해진 힘 (N)을 접착면적 ($mm^2$)으로 나누어 계산하였다. 접착계면에서의 파절 양상은 실물현미경 (Microscope-B nocular, Nikon)을 이용하여 분류하였다. 미세인장결합강도에 대한 통계분석은 one-way ANOVA를 이용하여 유의수준 5%에서 검정하였고, 사후감정은 Least Significant Difference 방법을 이용하였다. 중합 후 1개월 뒤 측정된 각각의 접착제의 평균 미세인장결합강도는 유의수준 5%에서 모든 접착제 간에 유의한 차이가 없었다. 3개월 뒤 측정된 각각의 접착제의 평균 미세인장결합강도는 유의수준 5%에서 iBond 와 Clearfil SE Bond 비산부식 군과 Scotchbond Multi- Purpose 간에는 각각 유의한 차이가 없었다. 본 연구에서는 2단계 자가부식 접착제인 Clearfil SE Bond의 연마 법랑질에 대한 미세인장결합강도가 3단계 산부식수세 접착제인 Scotchbond Multi-Purpose 와 비교하여 유의한 차이가 없었으며 (P>0.05), 3개월 후의 결과에서 Clearfil SE Bond 비산부식 군의 미세인장결합강도가 Clearfil SE Bond 산부식 군보다 유의하게 낮았다 (P<0.05). 즉 35% 인산으로 산부식 전처리를 시행한결과 Clearfil SE Bond 의 법랑질에 대한 결합강도가 증가하였다.

• 사상체질의학회지
• /
• 제10권2호
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• pp.351-429
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• 1998

The Purpose of Study 1. Inspection of clinical application on TCD to CVA 2. Objective Comparement and analysis about treatment effect of Western-Medicine, Korean Medicine, Cooperative consultation of Korean and Western medicice for CVA The Subject of Study We intended for the eighty six patient of CVA who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. I to 1998. 7. 31 1. View of CT, MRI : the patient of Cb infarction 2. Attack Time : The patient who coming hospital falling ill within the early one week The method of study 1. Treat four group of Korean medicine, Constitution medicine, Western medicine, cooperative consultation of Korean medicine and Western medicine. 2. Application of TCD Check the result for three times, immediatly after the attack, two months later, four months later 3. Comparative analysis of each treatment effect by clinical symptoms and pathologic examination 4. The Judgement of the patient The Result From 8/1/1997 to 7/31/1998, We have the following result by clinical analysis intended for CVA 86 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. 1 to 1998. 7. 31 in 1. Analysis according to Age The first stage of thirties, forties, seventies is heavier than forties, fifties in improvement and Index of improvement of symptom 2. Analysis according to sex We have no special relation in an average of symptom and improvement, Index improvement 3. Analysis according to Family History We have the better result in first stage and improvement, index improvement when no family history. 4. Analysis according to Past History We have no special relation in past history like hypertension, DM, heart problem 5. Analysis devided two group, above group and under group on the basis of the average in first stage of all patient. We have the better result when the first stage is light, that the first score of barthel index and CNS is high. 6. Analysis of the effect of treatment about Korean medical treatment, Western medical treatment, cooperative treatment. In this study, the highest group of rate of treatment at four contrast groups (Korean medicine, Constitution medicine, Western medicine, cooperative treatment according to dyagnosis and range of treatment was the patient group of doing dyagnosis and method of treatment based on constitution medicine theory. This is that of doing demostation, A-Tx, po-herb-medication according to dyagnosis and treat method of constitution of Lee Je-ma In case of left, the case of dyagnosis any disease according to doctor view but, normal in TCDwas 22-beginning of attack, 20- two weeks later, 11 case-four weeks later in case of right, 15-beginning of attack, 12-two weeks later, 9 case four weeks later. So left vessel compares to right vessel is more interference, in fact more than a 1/2 of the patients of MCA disease can't do dyagnosis. In rate of imparement, the state of pacient improved but there isn't the improved case of result in TCD. 7. In TCD dyagnosis, between the case of inconsus the doctor view specially MCA in brain blood vessel is in large numbers and in total 86's patient, impossible case of dyagnosis according to interferiance of temporal is 21 case. 7. Result study about application of Kreaan medical treatment 1) The impossible patient of observation MCA blood vescular for interference temporal bone happened in large numbers. 2) There is the case having difference result to CT,MRI, MRA result. 3) Because individual difference is large, excluding to ananalogy of symptom. This is normal numerical value that has possibility of being checked as abnormal numerical value 4) there are a lot of cases that the speed of normal part is as similarly measured as that of abnormal part. It means that we cannot judge the disease by this measure 5) It is rare that this measure represent degree of improvement in patient's condition of disease. When we observe patient's condition become better, but we have no case that the result of TCD test better. 6) The result could be appear differently by the technique of the tester or by the experience of the tester 7) In the TCD test, abnormal symptoms is checked at 0 week, but at 2th week, normal symptoms is checked, again at 4th week abnormal is checked. According to the above result, CVA diagnosis is difficult only with TCD, as it appear in diagnosis error check which is suggested in the problem connected to project, for the aged persons who have the worst hardening of part of the cranium (1998. 5. 26 77 of 83 patients is 50s) there is a lot of cases that the measurement is impossible by TCD and the correction of measurement numerical value is decreased, as the age of cerebral infarction is high, TCD is inappropriate to diagnosis equipment through this study.

• 동굴
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• 제68호
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• pp.23-73
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• 2005

Purpose of study; The purpose of this study is specifically classified as two parts. The one is to attempt the chronological annals of Quaternary topographic surface through the study over the formation process of alluvial surfaces in our country, setting forth the alluvial surfaces lower-parts of Han River area, as the basic deposit, and comparing it to the marginal landform surfaces. The other is to attempt the classification of micro morphology based on the and condition premising the land use as a link for the regional development in the lower-parts of Han river area. Reasons why selected the Lower-parts of Han river area as study objects: 1. The change of river course in this area is very serve both in vertical and horizontal sides. With a situation it is very easy to know about the old geography related to the formation process of topography. 2. The component materials of gravel, sand, silt and clay are deposited in this area. Making it the available data, it is possible to consider about not oかy the formation process of topography but alsoon the development history to some extent. 3. The earthen vessel, a fossil shell fish, bone, cnarcoal and sea-weed are included in the alluvial deposition in this area. These can be also valuable data related to the chronological annals. 4. The bottom set conglometate beds is also included in the alluvial deposits. This can be also valuable data related to the research of geomorphological development. 5. Around of this area the medium landform surface, lower landform surface, pediment and basin, are existed, and these enable the comparison between the erosion surfaces and the alluvial surfaces. Approach : 1. Referring to the change of river beds, I have calculated the vertical and horizontal differences comparing the topographic map published in 1916 with that published in 1966 and through the field work 2. In classifying the landform, I have applied the method of micro morphological classification in accordance with the synthetic index based upon the land conditions, and furthermore used the classification method comparing the topographic map published in 1916 and in that of 1966. 3. I have accorded this classification with the classification by mapping through appliying the method of classification in the development history for the field work making the component materials as the available data. 4. I have used the component materials, which were picked up form the outcrop of 10 places and bored at 5 places, as the available data. 5. I have referred to Hydrological survey data of the ministry of Construction (since 1916) on the overflow of Han-river, and used geologic map of Seoul metropolitan area. Survey Data, and general map published in 1916 by the Japanese Army Survbey Dept., and map published in 1966 by the Construction Research Laboratory and ROK Army Survey Dept., respectively. Conclusion: 1. Classification of Morphology: I have added the historical consideration for development, making the component materials and fossil as the data, to the typical consideration in accordance with the map of summit level, reliefe and slope distribution. In connection with the erosion surface, I have divided into three classification such as high, medium and low-,level landform surfaces which were classified as high and low level landform surfaces in past. furthermore I have divided the low level landform surface two parts, namely upper-parts(200-300m) and bellow-parts(${\pm}100m$). Accordingly, we can recognize the three-parts of erosion surface including the medium level landform surface (500-600m) in this area. (see table 22). In condition with the alluvial surfaces I have classified as two landform surfaces (old and new) which was regarded as one face in past. Meamwhile, under the premise of land use, the synthetic, micro morphological classification based upon the land condition is as per the draw No. 19-1. This is the quite new method of classification which was at first attempted in this country. 2. I have learned that the change of river was most severe at seeing the river meandering rate from Dangjung-ni to Nanjido. As you seee the table and the vertical and horizontal change of river beds is justly proportionable to the river meandering rate. 3. It can be learned at seeing the analysis of component materials of alluvial deposits that the component from each other by areas, however, in the deposits relationship upper stream, and between upper parts and below parts I couldn't always find out the regular ones. 4. Having earthern vessel, shell bone, fossil charcoal and and seaweeds includen in the component materials such as gravel, clay, sand and silt in Dukso and Songpa deposits area. I have become to attempt the compilation of chronicle as yon see in the table 22. 5. In according to hearing of basemen excavation, the bottom set conglomerate beds of Dukso beds of Dukso-beds is 7m and Songpa-beds is 10m. In according to information of dredger it is approx. 20m in the down stream. 6. Making these two beds as the standard beds, I have compared it to other beds. 7 The coarse sand beds which is covering the clay-beds of Dukso-beds and Nanjidobeds is shown the existence of so-called erosion period which formed the gap among the alluvial deposits of stratum. The former has been proved by the sorting, bedding and roundness which was supplied by the main stream and later by the branch stream, respectively. 8. If the clay-beds of Dukeo-bed and Songpa-bed is called as being transgressive overlap, by the Eustatic movement after glacial age, the bottom set conglomerate beds shall be called as being regressive overlap at the holocene. This has the closest relationship with the basin formation movement of Seoul besides the Eustatic movement. 9. The silt-beds which is the main component of deposits of flood plain, is regarded as being deposited at the Holocene in the comb ceramic and plain pottery ages. This has the closest relationship with the change of river course and river beds.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.6-7
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• 1981

근래 국민 생활이 향상되고 독, 극약물에 대한 규제가 강화되었을 뿐 아니라 사회 인식도 개선됨으로서 부식성 약물을 오연하는 경우는 점차 감소하고 있다. 그러나 물질 문명의 발달과 이를 뒤따르지 못하는 정서 생활의 부조화로 인하여 자살을 기도하고저 연하하는 경우는 아직도 적지않게 발생하고 있으며 또한 연하하는 부식제의 종류도 급격한 산업의 발달과 공업화로 인하여 다양해지고 있다. 식도 부식증에 관하여는 각종 산성(Pitkin, 1935 Carmody, 1930) 및 알카리성(Tree, 1942, Tucker, 1951) 부식제에 대한 연구 보고가 있었으며 이에 따른 협착증에 대해서는 Salzer(1920), Bokey(1924) 등이 조기 확장법을 주장한 이후 Spain(1950)에 의해 Cortison의 투여 효과가 소개되었고 또한 항생제의 동시투여로 그 치료 면에서 괄목할만한 발전을 하여 왔다. 그러나 이러한 치료 방법들에 못지않게 조기 식도경 검사를 시행하여 그 결과에 따라서 치료 방향을 결정하는 것은 매우 중요한 점으로 이 러한 시도가 최근의 추세라고 하겠다. 이에 저자들은 1971년부터 1981년 3월까지만 10년 3개월간 연세대학교 부속병원 이비인후과에서 입원 가료한 부식성 식도염 환자 96명에 대한 역학적 조사를 시행하여 아래와 같은 결과를 얻었기에 보고하는 바이다. 1) 성별 빈도는 남자와 여자의 비가 1대 1.7이며 연령 분포는 21세에서 30세가 38명 (39.6%)으로 가장 많았다. 2) 약물을 먹은 동기는 자살 목적이 80명 (83.3%), 사고의 경우는 10세미만이 9명 (56.3%)으로 가장 많았었다. 3) 약물은 빙초산 41명 (41.8%), 가성소다 20명 (20.4%), 염산 17명 (17.3%)의 순이었으며 연도별 빈도를 볼때 가성소다의 경우는 감소하였으나 산성부식제 특히 빙초산의 급격한 증가를 나타내었다. 4) 위세척을 한 경우는 57명 (59.4%)으로 대부분이조기 도착한 경우였다. 5) 대부분에서 Nasogastic tuhe를 삽입하였으며 (83.3%), 삽입하지 않은 16명 (16.7%)은 늦게 내원이 10명, 삽입 실패 4명, 기타 2명이었다. 6) 기관절개술이 요구된 경우는 호흡기장애가 있었던 17명 (17.7%)이었으며 분비물의 축적이 6명 (35.3%), 상기도폐쇄가 11명 (64.7%)이었다. 7) 조기 식도경 검사를 시행한 11명 (11.5%)중 48시간이내가 6명 (54.5%)으로 가장 많았다. 조기 식도경검사 결과 ; 점막에 중증도의 궤양이 8명 (72.7%)으로 대부분을 차지하였고 점막의 종창과 부식 정도가 비교적 경하였던 6명 (54.5%)은 입원 가료가 필요하지 않아서 곧 경구 음식 투여를 시작하였으나 입원 가료가 필요했던 중(重)증의 경우 그 입원 일수는 평균 4주간 이었다. 8) 본 병원에 처음 내원하여 치료를 받은 22명중 Nasogastric tube를 넣은 기간은 평균 11.6일 이었으나 최근에는 tube를 삽입하여둔 기간은 대체로 입원기간과 일치하며 이는 조기 식도경 검사를 시행하여 병변의 정도에 따라 결정하였다. 9) 대부분의 경우에서 Steroid를 투여하였으며 투여하지 않거나 투여가 지연된 경우는 47명 (48.9%)으로서 내용별 분류를 보면 (1) 약물의 종류로 인한 경우(산성, 미상) 12명, (2) 경(輕)하다고 인정된 경우 9명, (3) 늦게 내원한 경우 11명, (4) 비적응증(심한 감염, 합병증, 임신등)이 7명, (5) 기타(사망, 기록미비)가 8명이었다. 10) 협착으로 인한 확장 치료(Bougienage)를 요한 경우가 7명, 급식위루술(feeding gastrostomy)을 시행한 경우가 6명, 그 외에 수술적 치료를 요한 경우가 4명이었다. 11) 입원가료중 합병증이 생긴 경우는 27명 (28.1%)이었으며 심폐합병증, 심한출혈, 식도및 위장 천공, 신부전증의 순으로 빈도를 나타내었으며 사망 및 빈사상태에 회원이 8명이었다. 12) 식도 협착증이 있었던 경우는 13명 (56.5%)이었으며 협착 부위 및 빈도는 (1) 식도의 중간 부위 협착이 5명, (2) 식도의 상부 협착이 3명, (3) 하부 협착이 3명, (4) 전반적인 협착이 1명이였으며, (5) 하인두 및 유문협착이 1명이었다.

• 한국지능시스템학회:학술대회논문집
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• 한국퍼지및지능시스템학회 1993년도 Fifth International Fuzzy Systems Association World Congress 93
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• pp.1051-1054
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• 1993

The International Atomic Energy Agency's Statute in Article III.A.5 allows it“to establish and administer safeguards designed to ensure that special fissionable and other materials, services, equipment, facilities and information made available by the Agency or at its request or under its supervision or control are not used in such a way as to further any military purpose; and to apply safeguards, at the request of the parties, to any bilateral or multilateral arrangement, or at the request of a State, to any of that State's activities in the field of atomic energy”. Safeguards are essentially a technical means of verifying the fulfilment of political obligations undertaken by States and given a legal force in international agreements relating to the peaceful uses of nuclear energy. The main political objectives are: to assure the international community that States are complying with their non-proliferation and other peaceful undertakings; and to deter (a) the diversion of afeguarded nuclear materials to the production of nuclear explosives or for military purposes and (b) the misuse of safeguarded facilities with the aim of producing unsafeguarded nuclear material. It is clear that no international safeguards system can physically prevent diversion. The IAEA safeguards system is basically a verification measure designed to provide assurance in those cases in which diversion has not occurred. Verification is accomplished by two basic means: material accountancy and containment and surveillance measures. Nuclear material accountancy is the fundamental IAEA safeguards mechanism, while containment and surveillance serve as important complementary measures. Material accountancy refers to a collection of measurements and other determinations which enable the State and the Agency to maintain a current picture of the location and movement of nuclear material into and out of material balance areas, i. e. areas where all material entering or leaving is measurab e. A containment measure is one that is designed by taking advantage of structural characteristics, such as containers, tanks or pipes, etc. To establish the physical integrity of an area or item by preventing the undetected movement of nuclear material or equipment. Such measures involve the application of tamper-indicating or surveillance devices. Surveillance refers to both human and instrumental observation aimed at indicating the movement of nuclear material. The verification process consists of three over-lapping elements: (a) Provision by the State of information such as - design information describing nuclear installations; - accounting reports listing nuclear material inventories, receipts and shipments; - documents amplifying and clarifying reports, as applicable; - notification of international transfers of nuclear material. (b) Collection by the IAEA of information through inspection activities such as - verification of design information - examination of records and repo ts - measurement of nuclear material - examination of containment and surveillance measures - follow-up activities in case of unusual findings. (c) Evaluation of the information provided by the State and of that collected by inspectors to determine the completeness, accuracy and validity of the information provided by the State and to resolve any anomalies and discrepancies. To design an effective verification system, one must identify possible ways and means by which nuclear material could be diverted from peaceful uses, including means to conceal such diversions. These theoretical ways and means, which have become known as diversion strategies, are used as one of the basic inputs for the development of safeguards procedures, equipment and instrumentation. For analysis of implementation strategy purposes, it is assumed that non-compliance cannot be excluded a priori and that consequently there is a low but non-zero probability that a diversion could be attempted in all safeguards ituations. An important element of diversion strategies is the identification of various possible diversion paths; the amount, type and location of nuclear material involved, the physical route and conversion of the material that may take place, rate of removal and concealment methods, as appropriate. With regard to the physical route and conversion of nuclear material the following main categories may be considered: - unreported removal of nuclear material from an installation or during transit - unreported introduction of nuclear material into an installation - unreported transfer of nuclear material from one material balance area to another - unreported production of nuclear material, e. g. enrichment of uranium or production of plutonium - undeclared uses of the material within the installation. With respect to the amount of nuclear material that might be diverted in a given time (the diversion rate), the continuum between the following two limiting cases is cons dered: - one significant quantity or more in a short time, often known as abrupt diversion; and - one significant quantity or more per year, for example, by accumulation of smaller amounts each time to add up to a significant quantity over a period of one year, often called protracted diversion. Concealment methods may include: - restriction of access of inspectors - falsification of records, reports and other material balance areas - replacement of nuclear material, e. g. use of dummy objects - falsification of measurements or of their evaluation - interference with IAEA installed equipment.As a result of diversion and its concealment or other actions, anomalies will occur. All reasonable diversion routes, scenarios/strategies and concealment methods have to be taken into account in designing safeguards implementation strategies so as to provide sufficient opportunities for the IAEA to observe such anomalies. The safeguards approach for each facility will make a different use of these procedures, equipment and instrumentation according to the various diversion strategies which could be applicable to that facility and according to the detection and inspection goals which are applied. Postulated pathways sets of scenarios comprise those elements of diversion strategies which might be carried out at a facility or across a State's fuel cycle with declared or undeclared activities. All such factors, however, contain a degree of fuzziness that need a human judgment to make the ultimate conclusion that all material is being used for peaceful purposes. Safeguards has been traditionally based on verification of declared material and facilities using material accountancy as a fundamental measure. The strength of material accountancy is based on the fact that it allows to detect any diversion independent of the diversion route taken. Material accountancy detects a diversion after it actually happened and thus is powerless to physically prevent it and can only deter by the risk of early detection any contemplation by State authorities to carry out a diversion. Recently the IAEA has been faced with new challenges. To deal with these, various measures are being reconsidered to strengthen the safeguards system such as enhanced assessment of the completeness of the State's initial declaration of nuclear material and installations under its jurisdiction enhanced monitoring and analysis of open information and analysis of open information that may indicate inconsistencies with the State's safeguards obligations. Precise information vital for such enhanced assessments and analyses is normally not available or, if available, difficult and expensive collection of information would be necessary. Above all, realistic appraisal of truth needs sound human judgment.

• 한국지능시스템학회:학술대회논문집
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• 한국퍼지및지능시스템학회 1993년도 Fifth International Fuzzy Systems Association World Congress 93
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• pp.1041-1043
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• 1993

Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)＋dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

• 한국문헌정보학회지
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• 제17권
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• pp.11-47
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• 1989

This study intends to examine the background and the procedure of the carving of the tablets of the second edition of Dae-Jang-Mock­Lock(재조대장목록). the time and the route of the moving of the tablets. into Haein-sa, and the contents and the system of it. This study is mainly based on the second edition of Dae-Jang-Mock-Lock. But the other closely related materials such as restored first. edition of the Dae- Jang-Mock-Lock, Koryo Sin-Jo-Dae-Jang-Byeol-Lock (고려신조대장교정별록). Kae-Won-Seok-Kyo-Lock (개원석교록). Sok-Kae­Won-Seok-Kyo-Lock (속개원석교록). Jeong-Won-Sin-Jeong-Seok-Kyo­Lock(정원신정석교록), Sok-Jeong-Won-Seok-Kyo-Lock(속정원석교록), Dea-Jung-Sang-Bu-Beob-Bo-Lock(대중상부법보록), and Kyeong-Woo-Sin-Su-Beob-Bo-Lock(경우신수법보록), are also analysed and closely examined. The results of this study can be summarized as follows: 1. The second edition of Tripitaka Koreana(고려대장경) was carved for the purpose of defending the country from Mongolia with the power of Buddhism, after the tablets of the first edition in Buin-sa(부이사) was destroyed by fire. 2. In 1236. Dae-Jang-Do-Gam(대장도감) was established, and the preparation for the recarving of the tablets such as comparison between the content, of the first edition of Tripitalk Koreana, Gal-Bo-Chik-Pan-Dae­Jang-Kyeong and Kitan Dae- Jang-Kyeong, transcription of the original copy and the preparation of the wood, etc. was started. 3. In 1237 after the announcement of Dae-Jang-Gyeong-Gak-Pan-Gun­Sin-Gi-Go-Mun(대장경핵판군신석고문), the carving was started on a full scale. And seven years later (1243), Bun-Sa-Dae-Jang-Do-Gam(분사대장도감) was established in the area of the South to expand and hasten the work. And a large number of the tablets were carved in there. 4. It took 16 years to carve the main text and the supplements of the second edition of Tripitaka Koreana, the main text being carved from 1237 to 1248 and the supplement from 1244 to 1251. 5. It can be supposed that the tablets of the second edition of Tripitaka Koreana, stored in Seon-Won-Sa(선원사), Kang-Wha(강화), for about 140 years, was moved to Ji-Cheon-Sa(지천사), Yong-San(용산), and to Hae-In-Sa(해인사) again, through the west and the south sea and Jang-Gyeong-Po(장경포), Go-Ryeong(고령), in the autumn of the same year. 6. The second edition of Tripitaka Koreana was carved mainly based on the first edition, comparing with Gae-Bo-Chik-Pan-Dae-Jang-Kyeong(개보판대장경) and Kitan Dae-Jang-Kyeong(계단대장경). And the second edition of Dae-Jang-Mock-Lock also compiled mainly based on the first edition with the reference to Kae-Won-Seok-Kyo-Lock and Sok-Jeong-Won-Seok-Kyo-Lock. 7. Comparing with the first edition of Dae-Jang-Mock-Lock, in the second edition 7 items of 9 volumes of Kitan text such as Weol-Deung­Sam-Mae-Gyeong-Ron(월증삼매경론) are added and 3 items of 60 volumes such as Dae-Jong-Ji-Hyeon-Mun-Ron(대종지현문논) are substituted into others from Cheon chest(천함) to Kaeng chest(경함), and 92 items of 601 volumes such as Beob-Won-Ju-Rim-Jeon(법원주임전) are added after Kaeng chest. And 4 items of 50 volumes such as Yuk-Ja-Sin-Ju-Wang-Kyeong(육자신주왕경) are ommitted in the second edition. 8. Comparing with Kae-Won-Seok-Kyo-Lock, Cheon chest to Young chest (영함) of the second edition is compiled according to Ib-Jang-Lock(입장록) of Kae-Won-Seok-Kyo-Lock. But 15 items of 43 vol­umes such as Bul-Seol-Ban-Ju-Sam-Mae-Kyeong(불설반주삼매경) are ;added and 7 items of 35 volumes such as Dae-Bang-Deung-Dae-Jib-Il­Jang-Kyeong(대방등대집일장경) are ommitted. 9. Comparing with Sok-Jeong-Won-Seok-Kyo-Lock, 3 items of the 47 volumes (or 49 volumes) are ommitted and 4 items of 96 volumes are ;added in Caek chest(책함) to Mil chest(밀함) of the second edition. But the items are arranged in the same order. 10. Comparing with Dae- Jung-Sang-Bo-Beob-Bo-Lock, the arrangement of the second edition is entirely different from it. But 170 items of 329 volumes are also included in Doo chest(두함) to Kyeong chest(경함) of the second edition, and 53 items of 125 volumes in Jun chest(존함) to Jeong chest(정함). And 10 items of 108 volumes in the last part of Dae-Jung-Sang-Bo-Beob-Bo-Lock are ommitted and 3 items of 131 volumes such as Beob-Won-Ju-Rim-Jeon(법원주임전) are added in the second edition. 11. Comparing with Kyeong-Woo-Sin-Su-Beob-Bo-Lock, all of the items (21 items of 161 volumes) are included in the second edition without ;any classificatory system. And 22 items of 172 volumes in the Seong­Hyeon-Jib-Jeon(성현집전) part such as Myo-Gak-Bi-Cheon(묘각비전) are ommitted. 12. The last part of the second edition, Joo chest(주함) to Dong chest (동함), includes 14 items of 237 volumes. But these items cannot be found in any other former Buddhist catalog. So it might be supposed as the Kitan texts. 13. Besides including almost all items in Kae-Won-Seok-Kyo-Lock and all items in Sok-Jeong-Won-Seok-Kyo-Lock, Dae-Jung-Sang-Bo­Beob-Bo-Lock, and Kyeong-Woo-Sin-Su-Beob-Bo-Lock, the second edition of Dae-Jang-Mock-Lock includes more items, at least 20 items of about 300 volumes of Kitan Tripitaka and 15 items of 43 volumes of traditional Korean Tripitake that cannot be found any others. Therefore, Tripitaka Koreana can be said as a comprehensive Tripitaka covering all items of Tripitakas translated in Chinese character.