• The Korean Journal of Pain
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• 제22권2호
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• pp.151-157
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• 2009

Background: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. Methods: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe ($DT^{pre}$, $DT^{post}$, $^{\circ}C$), and the DTnet were calculated as follows. $DT^{net}$ = $DT^{post}$ - $DT^{pre}$. Results: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the $DT^{post}$ ($6.1{\pm}1.2^{\circ}C$, P = 0.021), and the DTnet ($6.0{\pm}1.0^{\circ}C$, p = 0.023), as compared to group C. Conclusions: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.

• 안보군사학연구
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• 통권5호
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• pp.1-45
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• 2007

Reserved forces of ROKA are in charge of replacement of TOE in the wartime and mission of rear area operation. But there is institutional inertia in the law and organization oriented to fill human resources rather than take mission. We need to prepare for the investment and arrangement of reserved forces as military power that would be replaced standing forces. In this portion, to reinforce reserve forces elite, First, efficient mobilization regulations and systems are suggested. I covered a maintenance of relevant mobilization ordinances which need to legislated and approved by national assembly for wartime and development of mobilization system which might lose the appropriate time for mobilization due to complicated declaration procedures and measures to overcome the panic at the initial stage of the war and organization and employment of nationwide transportation system and mobilization center. To ensure efficient resource management and mobilization of reserve forces with a number of approximately 3 million, there's a necessity of organization for integration and conciliation. To make it real, I suggested establishing and employing the mobilization center, on first phase, employ the mobilization center focusing on homeland divisions, on second phase, it is advisable to convert to national level mobilization system and develop to central mobilization center focusing on national emergency planning committee. During peacetime, in conjunction with Mobilization Cell, mobilization center can conduct resource survey and integrate and manage mobilization resources and take charge of mobilization training of subordinate units, and during wartime, in conjunction with mobilization coordination team and Cell, can ensure the execution of mobilization. Second, Future oriented reserve forces management system such as service system of reserve forces and support system of homeland defense operations. Current service and trainings of reserve forces by the year have very low connection, as it is very complex to manage the resources and trainings, and service and training lack the equity, re-establishment of service system is required. Also in an aspect of CSS and cultivation support for reserve forces, as the scope and limitation of responsibility between the armed forces and autonomous organization is obscure, conditions to conduct actual-fighting exercises are limited. Concentrated budgetting is extremely difficult because reserve forces training fields are scattered nationwide, and facilities and equipments are rapidly getting older. To improve all these, I suggest the organization of homeland defense battalion with a unit of "City-Gun-District" and supporting the local reserve forces. Conduct unit replacement or personal replacement for those who have finished their 1 or 2 years and homeland defense operation duty for those with 3-5 years for consistency and simplification. Third, I suggest Future oriented Reserved Training(FRT) and Training Center oriented training management to establish a reliable reserve training. Reserves carry out expansion of unit, conventional combat mission, homeland defense and logistics support during wartime, and actual-fighting exercise, and disaster relief, peace keeping activities. Despite diverse activities and roles, their training condition still stays definitely poor. For these reasons, Modernization of weapons and facilities through gradual replacement and procurement is essential to enhance mobilization support system.

• 전자공학회논문지SC
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• 제44권4호통권316호
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• pp.15-20
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• 2007

현재, 우리나라 당뇨병의 유병률은 빠른 속도로 증가하고 있으며 당뇨병의 유병기간이 길수록 각종 합병증이 발생하여 더욱 심각한 증상을 나타내는데, 그 중 비만 및 고혈당, 당대사장애로 인한 당뇨병성 혈관합병증과 말초 혈관 경화증이 많이 발병하고 있는 실정이다. 따라서 본 연구에서는 광혈류량 측정법(Photoplethysmography)으로 손가락 및 발가락에서 얻어진 맥파의 2차 미분분석을 통해 연령이 비슷한 정상인 50명과 당뇨병으로 확진된 50명의 말초 혈관 탄성도를 객관적으로 비교하고자 하였다. PPG 파형의 2차 미분 분석에 사용되는 평가 인자는 a, b, c, d, e 이고, b/a는 혈관의 탄성도를 의미하며 탄성도가 떨어질수록 b/a의 절대 값은 감소하게 된다. 정상인 50명의 PPG 2차 미분 b/a값은 $-1.09{\pm}0.14$, 당뇨병 환자 50명의 PPG 2차 미분 b/a값은 $-0.81{\pm}0.09$로 정상인에 비해 당뇨병 환장의 말초혈관 탄성도가 감소하였으며, Independent t-test 검정 결과 통계적으로 유의한 차이를 보였다(p<0.05). 본 연구에서는 PPG 파형의 2차 미분 분석을 통하여 정상인과 혈관합병증 발병율이 높은 당뇨병 환자의 말초혈관 탄성도를 비교하였으며, 향후 비침습적이고 간단한 방법으로 당뇨병 환자의 말초혈관 탄성도와 혈관 경화정도를 객관적으로 평가하고 진단함으로써 당뇨병 환자들의 심혈관계질환 사전예방과 치료효과 판정에 도움을 줄 것으로 기대한다.

• 벤처창업연구
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• 제3권1호
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• pp.29-55
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• 2008

창업교육의 일환으로 인터넷 창업교육이 공공과 민간영역에서 다양하게 진행되고 있지만 수요자의 다양한 욕구를 충족시키고 창업성공에 이르게 하는 데는 부족함이 있다. 본 연구는 인터넷 창업교육의 현황을 고찰한 뒤, 전자상거래지원센터에서 진행 중인 인터넷 창업교육 실태조사를 통해 교육생 만족도 및 교육내용에 중요도와 실제 교육반영도 조사를 통해 창업교육의 문제점과 발전방안을 모색해 보고자 한다. 본 연구결과는 다음과 같다. 첫째, 교육생들의 연령, 학력, 교육동기와 창업교육 경험유무에 따라 교육만족도가 다르게 나타나, 이들의 요구에 기반한 다양한 형태의 맞춤식 교육이 요구된다. 둘째, 현재 진행되고 있는 기술적 요소에 대한 교육과 더불어 창업 리더십, 사업수행능력 등 인적 요소, 사업추진환경과 사업아이템 등 사업환경적 요소에 대한 교육 보강이 요구된다. 셋째, 창업 후 사후지원과 컨설팅, 수료생 커뮤니티 구축, 수료생간 아이템 연계 지원, 상호네트워킹, 멘토링 등 교육 후 관리의 중요성이 부각되었다. 본 논문은 이러한 조사분석을 통해 인터넷 창업의 성공적 지원을 위한 교육진행과 사후연계체제 구축을 통해 창업교육의 고도화 및 내실화 방안을 제시하고 있다.

• Strategy21
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• 통권37호
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• pp.104-143
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• 2015

China's new grand strategy, the "One Belt, One Road Initiative" (also Belt Road Initiative, or BRI) has two primary components: Chinese President Xi Jinping announced the "Silk Road Economic Belt" in September 2013 during a visit to Kazakhstan, and the "21^st Century Maritime Silk Route Economic Belt" in a speech to the Indonesian parliament the following month. The BRI is intended to supply China with energy and new markets, and also to integrate the countries of Central Asia, the Association of Southeast Asia Nations (ASEAN), and the Indian Ocean Region - though not Northeast Asia - into the "Chinese Dream". The project will be supported by the Asian Infrastructure Investment Bank (AIIB), due to open in 2016 with 57 founding members from all around the world, and China has already promised US$ 50 billion in seed funding. China's vision includes networks of energy pipelines, railways, sea port facilities and logistics hubs; these will have obvious commercial benefits, but also huge geopolitical significance. China seems to have two distinct aims: externally, to restore its historical sphere of influence; and internally, to cope with income inequalities by creating middle-class jobs through enhanced trade and the broader development of its economy. In South Korea, opinion on the BRI is sharply polarized. Economic and industrial interests, including Korea Railroad Corporation (KORAIL), support South Korean involvement in the BRI and closer economic interactions with China. They see how the BRI fits nicely with President Park Geun-hye's Eurasia Initiative, and anticipate significant commercial benefits for South Korea from better connections to energy-rich Russia and the consumer markets of Europe and Central Asia. They welcome the prospect of reduced trade barriers between China and South Korea, and of improved transport infrastructure, and perceive the political risks as manageable. But some ardently pro-US pundits worry that the political risks of the BRI are too high. They cast doubt on the feasibility of implementing the BRI, and warn that although it has been portrayed primarily in economic terms, it actually reveals a crucial Chinese geopolitical strategy. They are fearful of China's growing regional dominance, and worried that the BRI is ultimately a means to supplant the prevailing US-led regional security structure and restore the Middle Kingdom order, with China as the only power that matters in the region. According to this view, once China has complete control of the regional logistics hubs and sea ports, this will severely limit the autonomy of China's neighbors, including South Korea, who will have to toe the Chinese line, both economically and politically, or risk their own peace and prosperity.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.699-702
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• 2011

Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.396-399
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• 2010

Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• Journal of Chest Surgery
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• 제40권2호
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• pp.136-139
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• 2007

양측성 슬와동맥 포착증후군은 주로 젊은 남자에게서 슬와동맥과 비복근, 섬유대, 슬와근과의 비정상적인 주행관계에 의한 혈류장애로 허혈성 파행을 유발하는 드문 말초 혈관질환이다. 58세 남자환자가 내원 1개월 전부터 시작된 좌측 하지의 허혈성 파행, 냉감, 3번 발가락 괴사로 입원하였다. 발목-상완 지수 감소 소견을 보여 대퇴동맥 혈관조영술을 시행하였고 좌측 하지 천부 대퇴동맥 원 위부 이하 부위 완전폐쇄소견 보였다. 심전도상 심방세동 보여서 슬와동맥 혈전증을 의심하고 유로키나제 혈전용해술을 시행하기로 결정하였다. 혈전용해술 후 좌측 슬와동맥 포착증후군이 진단되었고 해부학적 확진을 위하여 자기공명촬영를 시행하였다. 슬와동맥이 비복근 내측으로 주행하는 제1형으로 진단되었고, 슬와동맥류를 완전 제거하고 반대측 대복제정맥를 이용하여 대치술을 시행하였다. 경미한 우측 슬와동맥류는 수술하지 않고 관찰 중에 있으며 현재까지 합병증 없이 개통성이 유지되고 있다. 이에 심하게 이환된 하지는 수술적 치료를 시행하고, 경미하게 이환된 하지는 보존적 치료로 좋은 결과를 얻었기에 보고하는 바이다.

• 한국지반공학회논문집
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• 제36권5호
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• pp.25-34
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• 2020

최근 현장타설말뚝의 네킹 결함을 평가하기 위한 비파괴평가기법으로 전자기파를 적용하는 연구가 활발히 진행되고 있다. 하지만, 전자기파의 전파는 주변 매질의 함수비에 큰 영향을 받는다. 본 연구에서는 서로 다른 함수비의 모래 지반에 설치되어 있는 현장타설말뚝에 발생한 네킹 결함을 전자기파를 이용하여 평가할 수 있는 방법을 실내실험을 통해 고찰하고자 한다. 실내실험을 위해 네킹 결함이 있는 직경 600mm, 길이 1m의 모형 말뚝을 제작하였으며, 건조된 모래와 함수비가 10%, 20%, 30%인 모래에 설치된 조건에서 실험을 수행하였다. 전자기파의 전파를 위해 철근망에 전선을 설치하여 전송선로를 구성하였다. 전자기파의 송신과 수신을 위해 time domain reflectometer를 사용하였다. 실험결과, 모형 말뚝의 두부와 선단부뿐만 아니라 네킹 결함부에서도 전자기파의 반사 신호가 뚜렷이 나타났다. 모래의 함수비가 증가할수록 네킹 결함부에서 반사되는 전자기파 신호의 최대 진폭이 감소하였으며, 모형 말뚝 선단에서 반사된 전자기파의 속도는 네킹 결함 내의 모래의 함수비가 증가할수록 감소하였다. 하지만, 전자기파의 도달시간과 속도를 이용하여 산정된 네킹 결함의 위치와 실제 네킹 결함의 위치가 거의 같았다. 본 연구는 전자기파가 모래 지반에 설치된 현장타설말뚝의 네킹 결함을 평가하는데 유용하게 활용될 수 있음을 보여준다.