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충남지역 밤나무 재배 임가의 경영 효율성 분석 (Management Efficiency of Chestnut-Cultivating Households in Chungnam Province)

  • 원현규;전준헌;유병일;이성연;이정민;지동현
    • 한국산림과학회지
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    • 제102권3호
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    • pp.390-397
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    • 2013
  • 본 연구는 비모수추정 방법인 자료포락 기법을 이용하여 청양, 공주, 부여 등 충남지역의 밤나무 재배임가를 대상으로 경영효율성을 평가하였다. 분석자료는 2012년 3월부터 10월까지 실시한 '|밤나무 경영에 관한 실태조사'결과 중에서 20개 임가의 투입요소(관리비, 수확비, 재료비, 간접비, 재배면적)와 산출요소(조수입액)를 대상으로 하였다. 그리고 DEA 기법중 CCR 모형과 BCC 모형을 이용하여 기술효율성, 순수기술효율성, 규모효율성을 분석하였고 비효율성 임가의 개선방안도 제시하였다. 추가적으로 DEA 분석결과의 검증을 위하여 기술효율성과 표준진단표 결과를 비교하였다. 연구결과, 기술효율성은 평균값이 0.667로 전체적으로 비효율적으로 분석되었고 그 원인은 순수기술효율성이 평균 0.944, 규모효율성이 평균 0.703으로 나타나 재배기술적인 측면에서는 순수기술효율성이 높았지만 규모의 효율성에서는 비효율성이 존재하였다. 효율성이 1인 임가는 기술효율성 6개, 순수기술효율성 13개, 규모효율성이 6개 임가로 나타났고, 3개 모두 1인 임가는 6개로 나타났다. 표준진단표 점수와 비교한 결과 80점이상 고득점을 기록한 임가는 5개로 나타났고 이 중 기술효율성이 1로 분석된 임가는 3개로 나타났다. 또한 기술효율성과 표준진단표의 최저점수와 최고점수를 기록한 임가도 동일하게 나타났다. 이것은 DEA를 이용한 경영 효율성 평가가 표준진단표와 함께 현장에 적용 가능하다는 것을 나타낸다.

사막화방지(沙漠化防止) 및 방사기술개발(防沙技術開發)에 관한 연구(硏究)(I) - 중국(中國)의 사막화현황(沙漠化現況) 및 방지대책(防止對策) - (Studies on the Desertification Combating and Sand Industry Development(I) - Present Status and Countermeasures for the Combating Desertification in China -)

  • 우보명;이경준;전기성;김경훈;최형태;이승현;이병권;김소연;이상호;전정일
    • 한국환경복원기술학회지
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    • 제3권3호
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    • pp.45-76
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    • 2000
  • The purposes of this study were to investigate and understand the present status of various types of "deserts", such as sand desert, gravel desert, rock desert, earth desert, salt desert, desert, rocky desert, gobi desert, sandy desert, clay desert, etc., and the general countermeasures for the combating "desertification" "desertization", and to develop the technologies on the revegetation and restoration for the combating desertification in China. The methods of this study were mainly composed of field surveys on the several experimental sites and research institutes related to combating desertification in China, and examinations on the various technologies for the combating desertification at the Daxing Experimental Station of Beijing Forestry University. The conclusion from this study may be summarized as follows; 1. Status and tendency of desertification in China : China is one of the countries seriously threatened by desertification. Desertification affected areas in China are mainly distributed in arid, semi-arid and dry sub-humid areas in China, covering the most regions of the Northeast China (eastern region of Inner-Mongolia), the northern part of the North China (middle and western region of Inner-Mongolia, Shaanxi, Ningsha, Gansu) and the western part of the Northwest China (Xinzang, Qinghai, Xizang). The total area affected by desertification in China is approximately 2.622 million $km^2$. It covers 27.3% of the total territory of China. Until recently, it is estimated that the annual spreading ratio of desertification in China is 2,460 $km^2$. Therefore, desertification is mostly serious problems facing to the Chinese people. 2. The causes and environmental effect of desertification : The desertification in China is mainly caused by compound factors, including natural condition and human activities. In China, the desertification is started by the decrease of precipitation, continuous dry and drought, strong wind, wind and water erosion, land degradation and loss of natural vegetation caused by climate variation, and accelerated by the human activities, such as over-cultivating, over-grazing, over-cutting of woods, irrational use of water resources. Because desertification has affected the geographical features, soil nutrients contents, salinity, vegetation coverage and the functions of ecosystem, the environmental deteriorations in the desertification affected areas are very seriously. 3. The fundamental strategies of combating desertification in China are the increase of education and awareness of people through various mass media, the revision of laws to guarantee operation of Desertification Combating Law and to improve many relating laws and regulations, the application of advanced technologies and training of experts, the establishment of discriminative policies, and increasing arrangement of budget-investment, and so on. China, as a signed country in UNCCD, has made efforts for the combating desertification. Korea is also signed country in UNCCD, so we should play an important role in the desertification combating projects of China for the northest asia and global environmental conservation as well as environmental conservation of Korea.

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조기 영아기에 시행된 복합 심기형 환자들에서의 변형 Blalock-Taussig 단락술 (Modified Blalock-Taussig Shunt for the Patients with Complex Congenital Heart Defects in Early Infancy)

  • 임홍국;김웅한;황성욱;이철;김종환;이창하
    • Journal of Chest Surgery
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    • 제38권5호
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    • pp.335-348
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    • 2005
  • 배경: 조기 영아기에 변형 Blalock-Taussig 단락술을 시행받은 복합 심기형 환자들을 대상으로 술 전상태, 술 후 경과, 사망률과 사망원인을 고찰하였다. 대상 및 방법: 2000년 1월부터 2003년 11월까지 조기 영아기에 변형 Blalock-Taussig 단락술을 시행받은 복합 심기형 환자 58명을 연구 대상으로 하였다. 수술 당시 환자들의 평균 연령은 $23.1\pm16.2$일($5\~1$일)이었고, 평균 체중은 $3.4\pm0.7\;kg\;(2.1\~4.3kg)$이었다. 진단은 심실중격결손을 동반한 폐동맥 폐쇄가 12예($20.7\%$), 심실중격이 온전한 폐동맥 폐쇄가 17예($29.3\%$), 단심실이 18예($31.0\%$), 좌측심장형성부전이 11예($19.0\%$)였다. 4예의 총폐정맥연결이상증이 단심실에 동반되었다. 결과: 조기 사망은 11예($19.0\%$)로, 사인은 저심박출증 9예, 부정맥 1예, 다장기부전이 1예였다. 만기 사망은 5예($10.9\%$)로, 사인은 폐렴 2예, 저산소증 1예, 패혈증이 1예였다. 단락술 후 사망에 관여하는 유의한 인자는 술 전 폐동맥 고혈압, 술 전 대사성산증, 술 중 심폐우회술의 이용, 좌측심장형성부전과 총폐정맥연결이상증이었다. 술 후 48시간 동안 24명($41.4\%$)의 환자에서 혈역학적인 불안정성을 보였다. 단락폐쇄에 의한 재수술이 6예, 폐혈류과다에 의한 단락분리술이 1예에서 시행되었다. 걸론: 조기 영아기에 변형 Blalock-Taussig 단락술을 시행받은 복합 심기형 환자들은 고위험군을 제외하면 생존률 및 술 후 경과 측면에서 만족할 만한 결과를 보였다. 수술 직후 많은 환자들에서 혈역학적인 불안정성 시기가 있으므로, 지속적인 집중 관찰 및 치료가 필요하다. 고위험군에 대해서는 단락술 후의 혈역학적 변화에 대한 이해를 바탕으로 한 적극적인 술 후 관리가 필요하다.

비디오 흉강경을 이용한 농흉수술의 임상분석 (Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema)

  • 오상기;송상윤;윤지형;나국주;공강은;박송란;김상형
    • Journal of Chest Surgery
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    • 제43권2호
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    • pp.139-143
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    • 2010
  • 배경: 농흉은 진단법과 항생제의 발달에도 불구하고 흔히 접하게 되는 질환이며, 내원시에 다양한 증상과 형태를 보여 각기 다른 치료법이 적용된다. 최근 흉강경을 이용한 흉부수술이 증가하면서 농흉에 대한 수술 적응증과 방법이 변하고 있어 본 교실에서는 비암성 다발성 흉수와 섬유농성 농흉 및 기질화된 농흉에 대한 비디오 흉강경을 이용한 수술의 임상 분석을 통해 그 유용성을 알아보고자 한다. 대상 및 방법: 2005년 1월부터 2009년 5월까지 암성 질환, 급성혈종, 단순 흉수에 의한 흉막조직 검사를 제외한 다발성 흉수 및 농흉을 주소로 내원한 환자 중 술 전 비수술적 배액법이나 약물치료로 호전이 되지 않아 흉강경 수술을 적용하였던 36명의 환자를 대상으로 술 전 임상 자료와 더불어 수술 방법, 시간, 술후 임상 요소들을 분석하였다. 결과: 수술은 전례에서 흉강경 수술법을 적용하였다. 그 중 1예에서 기술적인 어려움으로 개흉술로 전환하였다. 수술시간은 평균 $90{\pm}38.5$ (30∼200)분 이었고 수술 시에 평가한 American Thoracic Society (ATS) 농흉 단계는 1단계가 1명, 2단계가 24명, 3단계가 11명이었다. 술 후 흉관 거치 기간은 $11.9{\pm}5.8$ (3~24)일이었다. 1명을 제외한 모든 환자에서 호전되었으나 한명은 농흉이 지속되어 재수술을 통해 개방창을 형성하였다. 퇴원시 흉부단순촬영상 늑횡격막각이 소실된 경우가 22예, 흉막 비후 소견이 보이는 경우가 20예, 이 두 가지 모두 보이는 경우가 17예, 두 가지 모두 보이지 않는 경우 11예였으나 추적관찰시에 실시한 흉부단순촬영상 각기 9예, 7예, 4예, 24예로 1예를 제외한 전례에서 호전 소견을 보였다. 결론: 이상의 소견으로 볼 때 다발성 흉수와 농흉에 대하여 비디오 흉강경 수술은 만족할 만한 성적을 보여주었으며 ATS 농흉 단계 1,2단계뿐 아니라 3단계에서도 선택적으로 비디오 흉강경 수술을 적응할 수 있다고 하겠다.

두부 손상환자 가족의 간호요구에 대한 연구 (A Study on Needs of the Families of Head Injury Patients)

  • 조규영;박형숙
    • 기본간호학회지
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    • 제6권3호
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    • pp.414-433
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    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

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연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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국소침범한 갑상선암의 임상적 고찰 (Clinical Studies on Locally Invasive Thyroid Cancer)

  • 김영민;이창윤;양경헌;노영수;박영민;임현준
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.236-243
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    • 1998
  • 1991년부터 1997년월까지 7년간 한림대학교 이비인후과학교실에서 국소침범한 갑상선암으로 치료를 받은 10명의 환자들을 후향적으로 검토하여 다음과 같은 결과를 얻었다. 1) 성별 분포는 남녀비는 1:2.3이었으며 연령별 분포는 60대 이상이 7명으로 노인에 호발함을 알 수 있었다. 2) 임상승상은 애성이 5례(50%)로 가장 많았으며 무증상이면서 경부종괴로 온 경우가 3례 그외에 연하곤란, 호흡곤란 객혈 등이었다. 3) 침범된 구조는 기관 7례, 반회후두신경과 종격동임파절이 각각 5례, 경부식도 3례, 경동맥 3례, 기관주위임파절 3례, 하인두 1례, 미주신경 1례 순이었다. 4) 침범된 구조물들에 대한 수술로는 기관 수상절제술 및 단단문합술이 1례. 기관 수상절제와 윤상기관성형술 1례, 기관 창절제술 및 일차봉합술 1례. 기관 창절제술 및 흉쇄유돌근-근막피판재건술 1례, 기관 면도식절제술 1례, 식도 부분절제술 2례, 식도 면도식절제술 1례, 편측 윤상후두절제술 1례, 윤상연골 부분절제술 및 흉쇄유돌근-근골막피판재건술 1례, 갑상연골 면도식절제술 1례, 반회후두신경절제술이 2례, 미주신경절제술 1례, 경동맥절제술 및 $Gortex^{\circledR}$를 이용한 재건술 2례, 경동맥 면도식절제술 1례 등이었다. 이상에서 국소침범한 갑상선암은 대부분의 경우 가능한 완전절제를 시도하였으나 광범위 절제 후 재건술의 어려움이 있었으며 또한 대부분이 노인 환자로서 전신상태에 따른 예후가 불량한 경우가 있었다. 따라서 각 환자의 나이와 침범 정도에 따른 개별적인 술식으로 치료방법을 선택하는 것이 중요할 것으로 사료된다.하다고 생각된다. 6) 횡문근육종과 골육종의 경우 3례중 2례에서 광범위한 수술적 제거후 방사선치료를 병행하였으며, 현재 무병생존 중이고, 1례는 화학요법과 방사선치료의 병합요법을 시행하였으나 실패하였다. 육종의 경우 광범위한 수술적 절제가 가장 좋은 치료로 사료되며, 미세잔존암이 남아있는 경우는 방사선 치료의 병합이 필요하리라 생각된다.\beta$4-tyrosine phosphorylation site (Clone M)을 얻었다. 암 세포의 부착 및 침투 능력의 기능적 연구로 모노 클로날 항체와 fibronectin, laminin, Matrigel을 단백질 기질로 사용하였으며 결과 비교를 위하여 pRc/CMV 벡터만 주입시켰던 클로운과 방광암 세포주를 $\beta$4 integrin 음성 대조군으로 또한 이 Integrin의 높은 발현을 보이는 두경부 편평상피암 세포주를 양성 대조군으로 이용하였다. 결과 : 세포부착능력에 있어서 온전한 $\beta$4 cytoplasmic domain이 존재하는 클로운이 laminin에 강한 부착능력을 보였으나 fibronectin의 부착정도는 $\beta$4 integrin의 표현정도와 관계없이 모든 클로운에서 비슷하였다. Matrigel을 투과하는 암세포 침윤 능력에서는 $\beta$4 integrin의 표현이 존재하는 클로운들이 투과 능력이 높았으나 세포외 리간드가 없는 control membrane을 사용하였을 때와 비교하여 투과능력의 차이를 보이지 않았다. 결론 : 유전자 주입(transfection) 방법으로

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수산화칼슘이 손상치수조직 및 치근조직의 치유에 미치는 영향에 관한 연구 (AN EXPERIMENTAL STUDY ON THE EFFECT OF Ca(OH)2 UPON THE HEALING PROCESS OF THE PULP AND PERIAPICAL TISSUE IN THE DOGS' TEETH)

  • 임성상;김영해;이정식;이명종;윤수한;권혁춘;엄정문
    • Restorative Dentistry and Endodontics
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    • 제8권1호
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    • pp.123-131
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    • 1982
  • The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

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폐관류 검사를 이용한 폐절제술 후 심폐운동기능의 예측 (Prediction of Post-operative Cardiopulmonary Function By Perfusion Scan)

  • 류정선;이지영;서동범;조재화;이홍렬;윤용한;김광호
    • Tuberculosis and Respiratory Diseases
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    • 제50권4호
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    • pp.401-408
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    • 2001
  • 연구배경 : 폐 절제술이 술후 운동능력의 변화에 어떤 영향을 주는지 잘 알려져 있지 않으나 폐 관류 검사를 이용하여 술후 운동능력을 예측하고자 하는 몇몇 연구들이 있었다. 그러나 이들 연구들은 검사시점 및 대상환자의 선정 등에 문제가 있음이 지적되고 있다. 본 연구에서 폐암 환자에서 술후 운동능력을 예측하는데 술전 폐관류 검사의 유용성 및 술전 후의 폐기능의 변화가 운동능력의 변화와 상관관계가 있는지를 알아보고자 하였다. 방 법 : 술전 1주 이내에 폐기능 검사, 심폐 운동부하 검사, technetium 99m labelled macroaggregated albumin (99mTc-MAA)을 이용한 폐 관류 겸사 및 체중, 체질량 지수를 측정하였다. 폐관류 검사를 이용한 술후 검사의 예측치는 preoperative values measured$\pm$[% perfusion remained/(% perfusion resected+% perfusion remained)]를 이용하여 구하였다. 폐관류 검사를 이용한 술후 검사치의 예측도를 알기 위하여 술후 실측된 검사치와 폐관류 검사로 예측한 검사치의 비[postoperative value measured/postoperative value predicted)$\pm$100%]를 구하였다. 또한 환자의 술전 후 각각의 실측된 검사치 간의 차이를 비교하기 위하여[(preoperative value measured-postoperative value measured)/preoperative value measured]$\pm$100%를 측정하였다. 결 과 : 대상군에서 술전 및 술후 6개월에 측정한 체중 및 체질량 지수의 차이가 없었다. 술후 실측된 $VO_{2max}$는 폐관류 검사에 의하여 예측된 $VO_{2max}$의 112%이었으며, $WR_{max}$는 119% 이었다. 그러나 술후 실측된 심폐 운동부하 검사치는 폐관류 검사에 의하여 예측된 심폐 운동부하 검사치와 각각 $r_s$, 값이 0.794와 0.932로 유의한 상관관계를 보였다. 심폐 운동부하 검사치에서는 전폐절제술 환7-r군에서 술후 실측된 $VO_{2max}$$WR_{max}$는 예측된 각각의 검사치의 121.05%, 136.51%이었으며, 엽절제술 환자군에서는 각각 107.94%와 111.59%이었다. 심폐 운동부하 검사치의 감소는 엽절제술 환자군에서 $VO_{2max}$$WR_{max}$가 각각 7.69%와 3.73%이었고 전폐절제술 환자군에서는 15.71%와 7.14% 었다. 술전 후 $FEV_1$, FVC 및 TLC의 변화는 술전 후 $VO_{2max}$$WR_{max}$의 변화와 유의한 상관관계를 보였다. 결 론 : 술전 폐관류 검사는 술후 운동능력을 예측하는데 유용하다고 판단된다. 그러나 술전 폐관류 검사는 술후 운동능력을 낮게 평가하는 경향을 보였다.

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${\ll}$황제내경(黃帝內經)${\gg}$ 의 심(心)의 개념(槪念)과 장상(藏象)에 대한 연구(硏究)

  • 이용범;방정균
    • 대한한의학원전학회지
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    • 제13권1호
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    • pp.269-303
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    • 2000
  • The xin(心) has various meanings in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ but they sometimes contradict each other. This thesis divided the xin into the meaning and the Zang-xiang(藏象), and then analyzed the xin's notion in detail. The concept of the xin in ${\ll}$Huangdineijing(黃帝內經)${\gg}$ is sorted out into : the notion of space, yin-yang five elements(陰陽五行) and shen(神) The xin is the upper part of body and it possesses the character of yang(陽). So the concept of the breast has originated from this character and it rightly belonged to the top. The xin is assigned to fire among five elements, 'chang(長)', which has the energy of moving forward, noon at a day when yang-qi(陽氣) is properous and shows 'gu(鉤)' & 'keo(矩)' in pulse condition. The xin possesses the character, 'Taiyang of the yang(陽中之太陽)' along with the notion of space combined with five elements. That is, the notion of upper space means 'of the yang(陽中)', and, fire in five elements means 'yang'. This is similar to '=(Taiyang)' of Sasang(四象) at ${\ll}$the Book of Changes(周易)${\gg}$ Since the xin puts shen(神) in order, actions of spirit have effect on the xin. And it depends whether the sense of vitality is broad or narrow. The xin related with broad sense of spirit is 'monarch of the organs(君主之官)'. Therefore it has control over the human body. As it also directly effects the life or death, Pericardium(心句) substitutes the xin and protects the external invasion. In Shi-er-won(十二原) and Bonsu(本輸), instead of the Xin Channel the Pericardium Channel was used in healing patients. The xin can be interpretable as the mind, because the xin includes spirit. The mind can be distinguished into 'desire' and 'state of profound reason'. In ${\ll}$Huangdineijing(黃帝內徑)${\gg}$, the disease of the xin caused by emotion was mentioned many times. This emotion is 'desire' which resorted to the sentiment. The reason one mind has both character is; man preserves given principle (reason) and emotion reveals via the reason exercised. The above is about the xin related with the broad sense of vitality. Concerning the narrow sense of vitality, one of the five vitalities is stored with the others away in the five solid organs. Then it takes part in the operation of five body constituents and it is linked with the personified description of five solid organs. The xin, spleen, stomach and kidney are 'the ground of life'. Spleen and stomach are the origin of making qi and blood, which 'means the ground after birth'. Kidney keeps the essence of life, and manages the growing and generative function of human body. The xin keeps 'Shin-myung(神明)', in other words, it has control over and supervise whole activity of body. Therefore xin's role is needed for the appropriate working of spleen, stomach and kidney. And 'Shin-myung' is its motive power. In ${\ll}$Huangdineijing(黃帝內經)${\gg}$, the reason why xin was assigned to September and October is that yang-qi of the human body goes to the inner part, with xin at the same time. This explains that yang-qi of the human body is adapted to change of season and goes into xin-fire(心火) in order to get away from the cold. In this case, heart means more inner part than liver, spleen and lung. Mengzi(孟子), philosopher of the China's turbulent ages emphasized the thinking function of xin. Sunzi(荀子) asserted that xin is 'heaven monarch(天君)' and the other organs are 'heaven rninisters(天官)'. This conception is similar to 'monarch of the organs' of ${\ll}$Huangdineijing(黃帝內經)${\gg}$. After the Ming Dynasty, commentators of Huangdineijing(黃帝內經) explained the heart, as 'monarch of the organs', or 'the master of body(一身之主)'. This was due to the influence of Sung Confucianism.

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