• 제목/요약/키워드: local control

검색결과 3,862건 처리시간 0.039초

CBRN 위협에 대비한 사후관리체계 강화방안 (A Study on Strengthening Consequence Management System Against CBRN Threats)

  • 권혁신;곽민수;김관헌
    • 대한토목학회논문집
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    • 제40권4호
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    • pp.429-435
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    • 2020
  • 북한은 2017년 6차 핵실험 이후 스스로 핵 무력의 완성을 선언하였다. 한반도 비핵화를 위한 국내외의 노력에도 불구하고 그 해결전망은 밝지 않다. 북한의 WMD위협을 억제하기 위한 정치·외교적 노력과 함께 유사시 예상되는 '재앙적 상황'에 대비한 사후관리 능력의 강화가 요구된다. 이에 따라 본 연구는 CBRN 위협에 대비한 사후관리 강화방안을 제시하기 위해 수행되었다. 연구모델은 국가 차원의 재난관리 계획발전모델 중 미 국토안보부가 채택하여 활용 중인 THIRA 프로세스를 일부 보완하여 활용하였다. 한국의 사후관리 체계는 재난에 대비한 위험관리와 위기관리를 포괄한다. 이 체계는 전·평시 CBRN의 확산 또는 사용의 억제, 위협의 대응, 예상피해 최소화 등을 목적으로 민·관·군 통합방위작전의 형태로 수행된다. 예방단계에는 CBRN의 개념과 사후관리 절차를 국가관리체계 속에 반영, 통합경보체계의 보완, 대피시설의 준비 그리고 통합훈련체계의 구축 등이 요구된다. 대비단계에는 관련 법규와 매뉴얼의 정비, 정부 조직의 정비와 수행절차의 발전, 통합대응이 가능한 현장 지원체계의 구축, 그리고 주기적인 훈련 등이 필수적이다. 대응단계에는 응급처치와 구호를 위한 의료지원체계의 정상가동, 제염시설의 설치 및 운영, 그리고 피해평가 및 통제지침의 발전이 중요하다. 복구단계에서는 안정화 평가 기준 및 절차의 발전, 피해복구에 필요한 자원의 확보 및 운용, 그리고 지역방위군과 향토예비군, 민방위가 연계된 지역피해복구 역량 강화가 필요하다.

세대간의 웰빙인식정도와 웰빙관련 실천행동의 비교 (Comparison of Awareness and Practice on Well-being Life and Related Behaviors According to Generations)

  • 김혜경;김진희
    • 대한지역사회영양학회지
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    • 제12권4호
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    • pp.426-439
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    • 2007
  • The purpose of this study was to investigate the awareness and practice on well-being life and well-being related behaviors, and the various factors affecting well-being related behaviors such as purchasing food materials, food habits, eating out and daily routine activities. A survey was conducted by questionnaire and on a 5-point Likert scale. The subjects of this study were composed of 221 students and their 102 parents who were over 40 years residing in the Ulsan area. The results of this study are summarized as follows: Almost half of the subjects (47.4%) responded that they have good health conditions; to keep a good health condition, 41.2% of the subjects were exercising regularly and 20.4% of them kept diet control. In regard to the meaning of well-being, 66.6% of the subjects thought it is the lifestyle for physical and mental richness (children: 70.6%, parents: 57.8%). 30.3% of the subjects answered that the most important part of well-being was food related. The importance order was mental richness, food related things, physical health for children, and for the parents, it was food related things, physical health, mental richness. Most of population (45.8%) answered that they have a willingness for the pursuit of a well-being life. Among the well-being related behaviors, 69.7% of subjects have purchased items (children: 61.5%, parents: 87.3%). 37.2% of the subjects have acquired information from TV. The average well-being practice score was $61.01{\pm}10.36$. Children's scores were significantly lower than the parent's scores (p < 0.001). And the average practice score of 'purchasing food materials,' 'eating out,' 'food habits,' 'daily routine activities' were $15.3{\pm}3.3,\;15.5{\pm}3.1,\;16.8{\pm}3.3$ and $13.4{\pm}3.5$, respectively. Among five types of purchasing food materials, 'purchasing domestic agricultural food' was greatest ($3.64{\pm}0.91$) and 'purchasing of organic or low agricultural chemical food products' was lowest ($3.15{\pm}0.91$). In regard to food habits, 'eating rice and bread made of mixed grains' was greatest ($3.46{\pm}1.12$) and 'eating uncooked food or zen food' was lowest ($2.46{\pm}0.99$). The practice scores were significantly affected by gender (p < 0.05), monthly income (p < 0.01), educational level (p < 0.01), presence of disease (p < 0.05), subjective health condition (p < 0.05), well-being awareness (p < 0.001) and concern with well-being (p < 0.001). Well-being awareness scores and well-being practice scores are related positively. Therefore various programs in well-being education should be necessary in order to boost the authentic perceptions of well-being and well-being oriented behaviors in any socioeconomic situation, such as different generations; industrial companies producing well-being goods for consumer's needs and satisfaction; and government and local community create various conditions for well-being oriented behavior.

1990년대 유압굴삭기 조형 분석에 관한 연구 (Design Analysis of Hydraulic Excavator since 1990)

  • 윤진필;문무경
    • 디자인학연구
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    • 제13권4호
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    • pp.233-242
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    • 2000
  • 1990년대는 유압굴삭기의 전통적 조형이 새롭게 모색 및 재해석되는 시기로 판단되었으며, 이는 2가지 방향으로 정리될 수 있다. 하나는 유압굴삭기의 전통적 이미지에 관한 부정적 해석에서 기인한 '탈(post-heavy equipment)중기적' 경향이며, 다른 하나는 고유성 유지와 개선이라는 긍정적 해석에서 기인한 '후기(late-)중기적' 경향이다. 이는 동일한 현상을 다양하게 바라볼 수 있는 패러다임과 관련하는 것으로 사료된다. 이 시기에 개발 및 시판된 8개 연구대상 모델 중 유압굴삭기의 조형 경향은, 일본 색채디자인연구소에서 개발한 이미지스케일 3상한에서 2상한으로 변화였으며, 예외적으로 코벨코는 1상한까지 이동하는 경향이 있었다. 이는 탈중기적 이미지를 디자인 전략으로 채택하고 있는 코벨코만의 경우였다. 아울러, 인적(入的)공간으로서의 캐빈의 변화는 장비 전체의 변화에서보다 좀더 1상한으로 이동하고 있는데, 이는 물적(物的)공간과 시각적 차별화를 위한 것으로 사료되었다.

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방사선 치료에 내성이 유도된 두경부 편평세포암에 대한 종양살상 헤르페스 바이러스의 유전자 치료 효과 (Therapeutic Effect of Oncolytic Herpes Simplex Virus on Induced Radioresistant Head and Neck Squamous Cell Carcinoma)

  • 김세헌;최은창;이진석;천제영;변형권;송기재;김광문
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.130-136
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    • 2006
  • Introduction : The sensitivity of tumor cells to radiotherapy is a critical determinant of local control and potential cure in advanced head and neck squamous cell carcinoma(HNSCC). The emergence of radioresistant tumor cells is an obstacle to cancer therapy. Most radioresistant cells have a higher proportion of cells in the Sphase of the cell cycle and a lower apoptotic fraction than radiosensitive cells. HSV replication is increased in cells that have higher S-phase fractions. NV1066 is an oncolytic herpes simplex virus type-1 mutant. We hypothesized that NV1066 replication and cytotoxicity are increased in radioresistant cells. The purpose of this study is to evaluate the antitumor efficacy of NV1066 to treat radioresistant HNSCC. Methods : Radioresistant cells were selected by treating five HNSCC cell lines with repeated conventional fractionated doses of radiation(2Gy/day), using a Cs-137 irradiator, up to a cumulative dose of 70Gy. Clonogenic cell survival and S-phase fractions were compared between radioresistant and parental radiosensitive cells. The two cell populations were then treated with NV1066 to examine viral replication, by the viral plaque assay and viral cytotoxicity. Results : Fractionated irradiation resulted in the selection of radioresistant cells. Radioresistant cells had a higher S-phase fraction(42.9%) compared to parental cells(26.2%). NV1066 replication in radioresistant cells was 7.4 times higher than in parental cells(p<0.01). Treatment with NV1066 resulted in increased cytotoxicity of 24.5% in radioresistant cells compared to parental cells(p<0.05). Conclusion : NV1066 showed increased viral replication and cytotoxicity in radioresistant HNSCC cell lines. These findings suggest a potential clinical application for this oncolytic viral therapy as treatment for radioresistant head and neck cancers.

Bio-Conjugated Polycaprolactone Membranes: A Novel Wound Dressing

  • Cai, Elijah Zhengyang;Teo, Erin Yiling;Jing, Lim;Koh, Yun Pei;Qian, Tan Si;Wen, Feng;Lee, James Wai Kit;Hing, Eileen Chor Hoong;Yap, Yan Lin;Lee, Hanjing;Lee, Chuen Neng;Teoh, Swee-Hin;Lim, Jane;Lim, Thiam Chye
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.638-646
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    • 2014
  • Background The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. Methods 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two $3.0{\times}3.0cm$ full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. Results Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): $8.33cm^2$, $4.90cm^2$, $3.12cm^2$, $1.84cm^2$; Mepitel (n=6): $10.29cm^2$, $5.53cm^2$, $3.63cm^2$, $2.02cm^2$; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. Conclusions BPM is comparable to Mepitel as a safe and efficacious wound dressing.

Spatiotemporal Trends of Malaria in Relation to Economic Development and Cross-Border Movement along the China-Myanmar Border in Yunnan Province

  • Zhao, Xiaotao;Thanapongtharm, Weerapong;Lawawirojwong, Siam;Wei, Chun;Tang, Yerong;Zhou, Yaowu;Sun, Xiaodong;Sattabongkot, Jestumon;Kaewkungwal, Jaranit
    • Parasites, Hosts and Diseases
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    • 제58권3호
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    • pp.267-278
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    • 2020
  • The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

불산제조업체에서 발생한 불산화상에 관한 조사연구 (A Study on Occupational Hydrofluoric Acid Burns in a Hydrofluoric Acid Manufacturing Factory)

  • 임현술;정해관;김지용
    • Journal of Preventive Medicine and Public Health
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    • 제26권4호
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    • pp.587-598
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    • 1993
  • Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. Hydrofluoric acid burns are occurring with ever-increasing frequency due to the wide use of this acid in industries. Hydrofluoric acid burns are characterized by severe progressive tissue destruction and excruciating pain due to the unique properties of the freely dissolvable fluoride ion. The authors reviewed medical records of 32 cases (36 spells) of hydrofluoric acid burns which occurred in a hydrofluoric acid manufacturing factory from Sep. 1, 1990 to June 30, 1993. The results are as follows; 1. Eleven measurements of air concentrations of hydrofluoric acid by detection tube method from 1990 to 1992 were all below TLV (Department of Labor, R.O. K). 2. There were 19 cases (22 spells) of hydrofluoric acid burns which occurred during the study period among regular employees. The overall incidence density of hydrofluoric acid was 17.8 cases (20.6 spells) per 100 person-year. Incidence density was 19.0 cases (22.0 spells) per 100 person-year among male workers and there were no female cases. Incidence density was 32.9 cases (38.3 spells) per 100 person-year among production workers and 1.9 cases (1.9 spells) per 100 person-years among management workers with the difference being statistically significant (P<0.01). 3. Of 32 cases (36 spells) of hydrofluoric acid burns among workers who were regularly employed or temporarily employed, 26 spells (81.2%) were between age 20 to 39. In 15 spells(41.7%) burns occurred between 12:00 and 17:59 with 16 spells(44.3%) having arrived at hospital within 2 hours after the accident. 4. Of 36 spells, the main cause of hydrofluoric acid burns were by splashes (8 spells, 22.2 %). The most frequent site of burns were fingers and pain was the most frequent symptom. Thirty spells (83.3%) of the hydrofluoric acid burns were treated with local injection of antidote (calcium gluconate). Complete recovery without scarring were observed in most of the cases (34 out of 36 cases, 94.4%). The study results suggest that to prevent hydrofluoric acid burns, environmental control and the wearing of hydrofluoric acid resistant protective clothes and gloves are important. It is also stressed that establishment of an emergency management and a transfer system for hydrofluoric acid burn victims is necessary.

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원격조정 고선량 근접 치료 (Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES)

  • 박수경;장혜숙;최은경;이병용;김재성
    • Radiation Oncology Journal
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    • 제10권2호
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    • pp.267-275
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    • 1992
  • 원격조정 고선량 근접치료는 새로운 각광받는 테크놀로지이다. 이에, 저자들은 3년간의 서울중앙병원의 590횟수, 116 환자를 대상으로 고선량 근접치료의 그 시술과 임상적 결과를 평가해 보고자 한다 자궁경부암 58 환자와 비인두강암 26 환자의 관내 방사선치료 471 횟수, 식도암 12 환자, 내 기관지암 11 환자, 클라스킨 종양 1 환자의 관내 방사선치료 79 횟수와 유방암 4 환자, 육종 1 환자, 요도암 1 환자의 조직내 방사선치료 40 횟수가 1989년 9월에서 1992년 8월 사이에 시행되어졌다. 추적 관찰 기간은 1 개월에서 35개월이었고, 그 중간 기간은 7개월이었다. 조직내 방사선치료를 제외한 모든 시술은 국소 마취로 시행하였고, 모든 환자에서 급성 합병증은 생기지 않았다. 또한, 6 환자를 제외하고는 모두 계획 선량대로 치료를 마칠 수가 있었다. 자궁경부암 58 환자에서, 비인두강암 26 환자 중 20 환자에서 완전 관해가 일어났으며, 증상 완화 목적으로 치료한 15 환자에서 $80{\%}$의 환자에서 소기의 목적을 이룰 수 있었다. 이 논문에서 원격조정 고선량 근접치료의 자세한 시술과 그에 따른 결과를 설명할 것이다. 이 치료의 생물학적인 효과와 적당한 선량/선량 횟수/분할치료를 평가하기 위해, 우리는 더욱 긴 추적 관찰을 시행하여야 하며, 이 새로운 근접치료 시술이 저선량 근접치로 시술보다 효과적이고 외래 환자로 통근 치료가 가능하며, 안전한 치료 방법이라고 생각하고 있다.

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Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

  • Kim, Hyun Ju;Rhee, Woo Joong;Choi, Seo Hee;Nam, Eun Ji;Kim, Sang Wun;Kim, Sunghoon;Kim, Young Tae;Kim, Gwi Eon;Kim, Yong Bae
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.126-133
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    • 2015
  • Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

  • Kim, Yi-Jun;Lee, Kyung-Ja;Park, Kyung Ran;Kim, Jiyoung;Jung, Wonguen;Lee, Rena;Kim, Seung Cheol;Moon, Hye Sung;Ju, Woong;Kim, Yun Hwan;Lee, Jihae
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.109-116
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    • 2015
  • Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Materials and Methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.