• Archives of Plastic Surgery
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• 제39권3호
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• pp.209-215
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• 2012

Background : Among all facial fractures, nasal bone fractures are the most common, and they have been reduced by closed reduction (CR) for a long time. But several authors have reported suboptimal results when using CR, and the best method of nasal bone reduction is still being debated. We have found that indirect open reduction (IOR) through an endonasal incisional approach is a useful method for more accurate reduction of the nasal bone. Methods : A retrospective chart review was performed of 356 patients who underwent reduction of a nasal bone fracture in our department from January, 2006, to July, 2011. We treated 263 patients with IOR. We assessed patients' and doctors' satisfaction with surgical outcomes after IOR or CR. We evaluated the frequency of nasal bleeding owing to mucosal injury, and followed the surgical outcomes of patients who had simultaneous dorsal augmentation rhinoplasty. Results : According to the analysis of the satisfaction scores, both patients and doctors were significantly more satisfied in the IOR group than the CR group (P<0.05). Mucosal injury with nasal bleeding occurred much less in the IOR group (5.3%) than the CR group (12.9%). Dorsal augmentation rhinoplasty with IOR was performed simultaneously in 34 cases. Most of them (31/34) showed satisfaction with the outcomes. Conclusions : IOR enables surgeons to manipulate the bony fragment directly through the endonasal incisional approach. However, we propose that CR is the proper technique for patients under 16 and for those with comminuted nasal bone fractures because submucosal dissection in IOR can damage the growth or circulation of nasal bone.

• 기록학연구
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• 제5호
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• pp.179-208
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• 2002

In this paper, I explained the dominating/dominated relationship of Japan and Colonized Korea by analysing the management system of official documents. I examined the theory and practices of the classification used by the office of the Governor-General for preserving official documents whose production and circulation ended. In summary, first, the office of the Governor-General and its municipal authorities classified and filed documents according to the nature and regulations on apportionment for the organizations. The apportionment of the central and local organs was not fixed through the colonial period and changed chronologically. The organization and apportionment of the central and local organs reflected the changes in the colonial policies. As a result, even in the same organs, the composition of documents had differences at different times. The essential way of classifying documents in the colonial period was to sort out official documents which should be preserved serially and successively according to each function of the colonial authorities. The filing of documents was taken place in the form of the direct reflection of organizing and apportioning of the function among several branches of the office of the Governor-General and other governmental organs. However, for the reason that filing documents was guided at the level of the organs, each organ's members responsible for documents hardly composed the filing unit as a sub-category of the organ itself. Second, Japan constructed the infrastructure of colonial rule through the management system of official documents. After Kabo Reform, the management system of official documents had the same principles as those of the Japan proper. The office of the Governor-General not only adopted several regulations on the management of official documents, but also controlled the arrangement and the situation of document managing in the local governmental organizations with the constant censorship. The management system of documents was fundamentally based on the reality of colonial rule and neglected many principles of archival science. For example, the office of Governor-General labelled many policy documents as classified and burnt them only because of the administrative and managerial purposes. Those practices were inherited in the document management system of post-colonial Korea and resulted in scrapping of official documents in large quantities because the system produced too many "classified documents".

• 대한통합의학회지
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• 제10권3호
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• 한국기후변화학회지
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• 제1권1호
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• pp.59-73
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• 2010

현재 미래 기후변화에 따른 수자원을 전망하고, 이에 대한 적응 전략을 수립하는 연구의 가장 중요한 핵심은 바로 '불확실성'이다. 이 때문에 각 연구마다 상이한 결과를 나타내고 있으나, 이러한 불확실성을 줄이는 연구는 국내에서는 매우 미진한 상태이다. 이러한 불확실성의 근본 원인은 배출 시나리오, GCM(General Circulation Model), 상세화 기법, 강우-유출 모형 등을 각 연구마다 다르게 사용했기 때문이다. 본 연구에서는 IPCC 기후 시나리오 중 A, B 배출 시나리오를 바탕으로 생산되는 51개의 GCM 시나리오를 다운로드 받아 2001년부터 2008년까지 월평균 온도와 강수량에 대하여 한반도를 대상으로 분석하였다. 비교 결과, 온도 전망은 실측과 비슷한 경향성을 보였으나, 강수량은 홍수기를 모의하지 못하는 것으로 나타났다. 한반도에 적합한 GCM 시나리오를 선정하기 위해 효율성 계수, PDF, Relative Entropy를 이용한 방법을 적용하였다. 세 방법으로 선정된 시나리오 중 공통된 4개의 GCM 시나리오, 즉 CGCM2.3.2(MRI-M, B1), MIROC3.2medress(NIES, B1), CGCM2.3.2(MRI-M, A2), CGCM2.3.2(MRI-M, A1B)를 최종 선정하였다. 2040년 강수 전망에 있어서도 GCM 시나리오마다 최대 27.36%부터 최소 12.49%까지 서로 다른 증가 전망을 나타냈다. 선택된 GCM 시나리오는 한반도 지역이 대상이나 이수기의 모의결과에서 이질성(heterogeneity)을 나타내고 있어, 본 연구의 결과로 하나의 GCM 시나리오만으로 미래 기후를 전망한다는 것이 얼마나 위험한지 알 수 있다. 따라서 본 연구에서 정량적으로 제시된 GCM 시나리오들이 미래 한반도 이수기 물 공급과 가뭄 재해 정책 수립에 우선적으로 활용해야 함을 제시하였다.

• Journal of Chest Surgery
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• 제35권4호
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• pp.303-306
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• 2002

심한 Ebstein기형이 있으면서 신생아시기에 증상이 있는 경우, 심한 심비대를 보이며 이로인해 폐발달의 장애가 생기고 기능적 폐동맥판폐쇄를 보이며, 동맥관의존 폐혈류를 보인다. 지금까지 이런 경우 양심실성교정은 실망적이었으며 근래에 와서 Fontan술식을 목표로 하는 Stames술식으로 좋은 결과를 보고하고 있다. 본원에서는 생후 4일째 심한 심비대와 함께 해부학적 폐동맥판폐쇄가 동반된 Ebstein기형의 환아에서 심방화된 우심실을 수직적 주름성형술, 삼첨판막륜성형술, 우심실유출로재건, 심방중격결손부분폐쇄, 우심방축소술로 양심실고정술을 시행하였다. 술후 환아는 심홉곽비의 현저한 감소와 심초음파검사상 경도의 삼첨판폐쇄부전을 보이며 10개월째 건강한 상태로 외래추적관찰중이다.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.127-130
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• 2009

Purpose: In an amputated auricle, a microvascular anastomosis is the best treatment of choice. But, the neartotally amputated auricle which is connected by very narrow tissue pedicle to the head, can survive by simple attachment without a microvascular anastomosis owing to the rich vascular network through the superficial temporal artery and posterior auricular artery. In cases of venous congestion resulting from a lack of vein anastomosis, medical leeches (Hirudo medicinalis) can solve the problem. We are reporting the case of a 6-year-old boy who had a neartotally amputated auricle with successful results by simple closure and medical leech treatment without a microvascular anastomosis. Methods: A 6-year-old male patient had an left auricular injury by an escalator accident. The left auricle was neartotally amputated from the temporal head with connection only by very narrow skin and subcutaneous pedicle (about 1 cm in width) at the helical root of upper and anterior part of auricle. Marginal bleeding from the avulsed auricle was noted and the arterial blood was supplied from a branch of upper auricular branch of the superficial temporal artery. The auricle was repaired by simple closure including cartilage and skin without any vascular anastomosis. After simple closure, the auricle showed good circulation with pink color. But on the 2nd day after the operation, there was a venous congestion with severe swelling, which resulted in a purplish colored auricle. The venous congestion disappeared after using medical leeches by the 5th day after the operation. Results: The repaired auricle showed aesthetically and functionally satisfactory result with normal development at the 9 months follow-up check after the operation. Conclusion: In cases of neartotally amputated auricles of children or crushing injury in which microsurgery is difficult, we can try simple closure with the use of medical leeches in treating a of venous congestion for a successful result.

• Journal of Chest Surgery
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• 제43권3호
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• pp.304-307
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• 2010

대동맥 축착증 및 심한 대동맥 협착을 가진 생후 5일의 환자가 대동맥 협착을 해결하려는 중재적 시술 도중 유도 카테터에 의한 우측 경동맥 손상으로 인한 출혈 및 심낭 내 탐폰으로 인한 심정지가 발생하여 심폐소생술 후 체외막성산화기 보조를 받았다. 환자의 체중은 2.4 kg이었다. 1일 후 수술적 완전 교정술을 시행하였으나, 수술 직후 심한 심기능 저하로 인하여 양심실 보조 장치로 순환 보조를 하였고, 3일 후 양심실 보조 장치 이탈에 성공하였다. 이후 환자는 일반적인 치료 후 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제40권3호
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• pp.220-224
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• 2007

소아에서 체외막 산소화 장치는 중증호흡부전, 약물에 반응하지 않는 심부전, 패혈증, 폐동맥고혈압에서 뿐만 아니라 심장이식의 가교로서도 기계적인 심폐보조를 제공한다. 그렇지만 소아에서 부정맥에 의해 생긴 저심박출증에 대해 체외막 산소화 장치를 이용하여 심장보조를 시행한 증례는 많지 않다. 본 저자들은 부분 양심실 교정을 받은 엡스타인 기형에서 심실성 부정맥 때문에 순환 부전에 빠진 15세 여자 환자를 체외막 산소화 장치를 이용하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제13권2호
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• pp.27-36
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• 2007

Recently, hospital patients experience anxiety, confusion, and stress about wayfinding as the spacial layout and treatment circulatory system of hospitals have become complicated due to their oversized and complex structure. As part of finding a solution to the problem, this study seeks to examine what are the essential elements of the wayfinding planning of O.P.D. in general hospitals, to develop the model of wayfinding, and to suggest the methods of improving the wayfinding system. The research methods of this study adopted were literature review in wayfinding cognition, plan analysis of ten general hospitals, space analysis of these hospitals through space syntax, analysis of the system of visual-perceptual information through a field study, and analysis of surveys and follow-up surveys conducted to support the results. Based on these results, the proposals for finding decision points, providing the information, and developing a model planning are listed as follows. 1) The comprehensive understanding of O.P.D. spacial layout and the visual-perceptual information system is necessary to find the essential elements of wayfinding. 2) The decision points are found through the full understanding of spacial functions, circulation systems, and facility configuration, considering the spacial layout, the bound of the visual-perceptual information system, and the circulatory system. Furthermore, the information decision points could be confined by space syntax. 3) The checklist and color compound & color codes, developed through the planning of signage system and color system could be applied to the methods of providing the information. 4) The planning of wayfinding system according to the whole process of practices for outpatients was mentioned above. The system of visual-perceptual information developed through the process of this study should be integrated in the spacial layout of the whole O.P.D.

• 대한교통학회:학술대회논문집
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• 대한교통학회 1995년도 한-중 국제학술회의 발표논문
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• pp.51-59
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• 1995

본문재이달성진해금후도시객운교통적발전응주족우대용량、쾌원환유궤지공신적기출 진,종분석,해기유철로추뉴선재성시범권내적력장포국화현실공능유충,탐계료철로추뉴선재학보상항대외대교통주요공능적전제하,위괄응본해도시교통발전적수요,여하통과알 잠개조,재객경,밀집、류향매녕、원정교장적지구,장부분기유지면철로선개조성고가유궤 성시쾌속전혹,절실퇴해승차난적모순,촉진도시교통향현대화방향발전작출핵만.