• Journal of Chest Surgery
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• 제13권1호
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• pp.60-65
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• 1980

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

• Journal of Chest Surgery
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• 제31권1호
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• pp.32-39
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• 1998

체외순환에 의한 개심술시 술후 출혈을 줄이고 아울러 혈액제재 투여를 감소하기 위하여 여러병원에서 최근 수년간 aprotinin을 Hammersmith 요법에 준하여 고용량으로 투여해 오면서 위 약제의 부작용이나 경제적 비용도 함께 고려되어 오고있다. 특히 aprotinin은 신장에서 대사되기 때문에 다른 부작용보다 aprotinin이 미치는 신기능장애에 대하여서도 논의되고 있다. aprotinin을 저용량으로 투여하였을 때 그 지혈효과와 아울러 신기능에 미치는 영향을 조사하기 위하여 체외순환을 시행한 33 명의 환자를 각각 무작위로 실험군(16명)과 대조군(17 명)으로 나누어 전향적 연구를 시행하였다. 출혈 감소의 정도를 파악하기 위하여 혈중 혈색소와 혈소판수치 및 수술후 출혈량을 수술전, 수술후에 측정하였고, 신기능 장애정도를 파악하기 위하여 혈중 BUN과 creatinine, 그리고 뇨 creatinine, 총단백질량, albumin, 및 alpha-1-microglobulin 수치를 수술전후로 측정하였다. 수술직후 6 시간동안 출혈량은 대조군보다 aprotinin군에서 상당히 감소되어(406$\pm$303 ml vs 243$\pm$123 ml ; P = 0.037) 통계적으로 유의한 차이를 보였을 뿐만아니라 수술후 24 시간 동안 출혈량도 통계적으로 의미있게 감소되었다( 869$\pm$570 ml vs 494$\pm$358 ml ; P = 0.045). 뇨중 alpha-1-microglobulin/creatinine 이나 microalbumin/creatinine는 대조군에 비하여 aprotinin군에서 수술후에 증가되었으나 통계적으로 유의한 차이는 없었다 (수술후 3 일째 alpha-1-microglobulin/creatinine; 24$\pm$10 vs 55$\pm$23, microalbumin/creatinine ; 38$\pm$25 vs 56$\pm$19 ). 일반적인 다른 신기능지표상에서도 두 군에서 유의한 차이는 없었다. 본연구에서 aprotinin을 저용량으로 투여함으로써 개심술시 체외순환후 발생하는 출혈량을 줄일 수 있을 뿐만 아니라 신기능에 영향이 없었다.

• 대한핵의학회지
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• 제28권1호
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• pp.22-30
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• 1994

Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

• 환경영향평가
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• 제6권1호
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• pp.5-31
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• 1997

Strategic Environmental Assessment (SEA) is an assessment process integrated with policy and planning processes considering environmental impacts, not at the level of individual project, but at higher level of policy and plan. Presently, two systems for the SEA are being implemented in Korea. One is "the consultation of environmental investigation into a change in national land utilization", which is to be pre-discussed with the head of the related central administrative organizations, based on the respective individual code. The other is "the consultation of environmental investigation into an administrative plan and project", which is to be pre-discussed with the minister of the environments for the administrative plan. However, these two systems are not integrated procedures with the planning process. In other words, there is a separate post-environmental assessment after planning. Also concrete proposal is not yet prepared for the method and procedure of environmental investigation about details of the planning. Therefore, they do not playa role in taking precautions for environmentally sustainable development. In this study, for the effective environmental investigation at the level of planning, environmental assessment model to be integrated with urban comprehensive plans was developed. The results of this study can be summarized as follows: First, based on the analysis of systematic problems in environmental investigation of this country, the study compared and analysed the SEA method of foreign countries. derived the potential limitations in its applications to this country. Also, the new method in this study, is integrated into planning process by improving the limitations. Thus, we developed the SEA model for this country, which consists of seven steps ; Phase 1; establishing a work program, Phase 2; defining the scop. of the SEA, Phase 3; analyzing an existing environmental situation, Phase 4; examining the consistency with environmental policy, Phase 5; appraising and synthesizing the plan content, Phase 6; proposing recommendations, Phase 7; monitoring and feedback. Second, the two types of application program of the developed assessment model were proposed. One is to integrate this model into planning process, and the other is for the institute and ministry of environments to implement SEA after planning. An aim of this study was developing an environmental assessment model at the planning level which was not yet established in this country and was to apply the model to urban comprehensive plan for inspection. This research will make the effective operation of environmental investigation system possible at the planning level in this country and contribute to the environmental protection at the global level.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.36-48
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• 2008

To repair bone defects in the oral and maxillofacial field, bone grafts including autografts, allografts, and artificial bone are used in clinical dentistry despite several disadvantages. The purpose of this study was to evaluate new bone formation and healing in rat calvarial bone defects using hydroxyapatite (HA, $Ca_{10}[PO_4]_6[OH]_2,\;Bongros^{(R)}$, Bio@ Co., KOREA) and tricalcium phosphate (${\beta}-TCP,\;Ca_3[PO_4]_2$, Sigma-Aldrich Co., USA) mixed at various ratios. Additionally, this study evaluated the effects of type I collagen (Rat tail, BD Biosciences Co., Sweden) as a basement membrane organic matrix. A total of twenty, 8-week-old, male Sprague-Dawley rats, weighing 250-300g, were divided equally into a control group (n=2) and nine experimental groups (n=2, each). Bilateral, standardized transosseous circular calvarial defects, 5.0 mm in diameter, were created. In each experimental group, the defect was filled with HA and TCP at a ratio of 100:0, 80:20, 70:30, 60:40, 50:50, 40:60, 30:70, 20:80, and 0:100 with or without type I collagen. Rats were sacrificed 4 and 8 weeks post-operation for radiographic (standardized plain film, Kodak Co., USA), histomorphologic (H&E [Hematoxylin and Eosin], MT [Masson Trichrome]), immunohistochemical staining (for BMP-2, -4, VEGF, and vWF), and elementary analysis (Atomic absorption spectrophotometer, Perkin Elmer AAnalyst $100^{(R)}$). As the HA proportion increased, denser radiopacity was seen in most groups at 4 and 8 weeks. In general radiopacity in type I collagen groups was greater than the non-collagen groups, especially in the 100% HA group at 8 weeks. No new bone formation was seen in calvarial defects in any group at 4 weeks. Bridging bone formation from the defect margin was marked at 8 weeks in most type I collagen groups. Although immunohistochemical findings with BMP-2, -4, and VEGF were not significantly different, marked vWF immunoreactivity was present. vWF staining was especially strong in endothelial cells in newly formed bone margins in the 100:0, 80:20, and 70:30 ratio type I collagen groups at 8 weeks. The calcium compositions from the elementary analysis were not statistically significant. Many types of artificial bone have been used as bone graft materials, but most of them can only be applied as an inorganic material. This study confirmed improved bony regeneration by adding organic type I collagen to inorganic HA and TCP mixtures. Therefore, these new artificial bone graft materials, which are under strict storage and distribution systems, will be suggested to be available to clinical dentistry demands.

• 한국식품과학회지
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• 제28권6호
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• pp.1001-1008
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• 1996

우리나라의 세균성 식중독의 주된 원인은 식중독성 황색포도상구균에 의한다. 따라서 식품공전에는 도시락, 빵, 떡으로부터는 이 미생물이 검출되지 않도록 규정되어있다. 현행의 황백포도상구균의 검사 방법은 적어도 5일 이상을 요하므로 이 식중독에 대한 대처가 미흡한 설정이다. 이 연구에서는 식중독성 황색포도상구균의 검출법을 중합효소 연쇄반응을 이용하여 개선하였다. 이 반응을 위해 황색포도상구균의 장도속도를 암호하는 유전자를 유형별로 증폭할 수 있는 시발물질들을 고안하였다. 한 황색포도상구균으로부터 중합효소 연쇄반응에 적합한 DNA를 신속하게 추출하는 방법을 개발하였다. 중합효소 반응조건은 다음과 같다. 반응액의 총부피, $(50\;{\mu}l)$; 표적 DNA, $2\;{\mu}l$ (약 20ng); 10배 진한 반응완충액, $5\;{\mu}l$; 시발물질, 100pmole; dNTP (10 mM), $4\;{\mu}l$; Taq DNA 중합효소, 205단위, 작동조건은 변성전, $94^{\circ}C$-5분; 변성, $94^{\circ}C$ 15초; 냉각, $50^{\circ}C$15초; 연장, $72^{\circ}C$ 20초; 연장후, $72^{\circ}C$-5분이었으며 변성-냉각-연장을 30회 되풀이하였다. dlj한 검출조건으로 황색포도상구균을 5시간 이내에 독소 유형별로 확인할 수 있었으며 이를 시판되는 떡과 빵에 적용하여 이 미생물의 존재를 확인하였다.

• 디지털융복합연구
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• 제18권8호
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• pp.55-67
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• 2020

본 연구는 CELL교육과정 참여가 대학생의 학습몰입, 학습동기, 학업적자기효능감, 자기주도학습능력에 미치는 효과를 알아보고자 하였다. 이를 위해 2020년 1학기에 K대학교 재학생 386명을 대상으로 사전·사후 설문조사를 실시하고 SPSS를 사용하여 분석하였다. 주요 연구결과는 다음과 같다. 첫째, CELL교육과정 참여가 대학생의 학습몰입, 학습 동기, 학업적자기효능감, 자기주도적학습능력에 통계적으로 유의한 향상을 보였다. 둘째, 성별에 따른 분석에서는 여학생의 경우에만 학습몰입, 학업적자기효능감, 자기주도학습능력에 유의한 향상을 보였다. 셋째, 학년별 분석에서는 2학년은 학습몰입과 자기주도학습능력에, 3학년은 모든 변인에, 4학년은 학업적자기효능감과 자기주도학습능력에 유의한 향상을 보였다. 넷째, 참여학생 인터뷰를 통해 참여소감과 개선점을 정리하였다. 본 연구는 CELL교육과정의 효과를 살펴보고 체계적인 운영과 지원을 위한 실천적인 방안을 제시하였다는 점에서 의의를 지닌다.

• 대한치과기공학회지
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• 제37권3호
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• pp.131-144
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• 2015

Purpose: This study set out to propose plans for more efficient and effective clinical practice by investigating the current state of clinical practice in the field of dental technology and thus provide basic data to develop pre- and post-education programs for clinical practice. Methods: The subjects include dental technicians at dental technical laboratories that were appointed as the place of clinical practice by the Department of Dental Technology of G University. The survey period spanned from December 22, 2014 to January 20, 2015. Total 250 questionnaires were distributed to them, and 190(76.0%) were returned. After excluding 23 whose answers were uncertain or seemed to lack reliability, total 167(66.8%) were used in final analysis. Results: 1. The most frequent practice the student did during clinical practice was articulator attachment, which was followed by pin operation or model making, one's own task and practice, sand and crow sculpturing, burying, casting, and grinding. 2. In case of going through the entire process, porcelain had the most students at 39(23.4%), being followed by crown & bridge at 28(16.8%), clinical model at 23(13.8%), full denture at 17(10.2%), and partial denture at 17(10.2%) in the order. 3. Of the students, 59.8%(30.5% for reinforced basic practice; 29.3% for intensive practice education) said that intensive practice education should be reinforced in school; and 22.3% said that intensive theory and practice education was needed, which indicates that 82.6% voiced their opinion of reinforcing education around practice. 4. The students felt that they lacked diligence, passion, and theoretical knowledge somewhat and were relatively good at clinical adaptation and operational skills. Conclusion: The findings show that the students felt an absolute lack of practice education as the school education was focused on theory and national exams in the field of dental technology, thus raising a need to reinforce practice education. Of all the respondents, 62.9% said there was a need to improve the current education with a focus on jobs. In future, education of dental technology should work to bring up able dental technicians that can perform in clinical dental technology right after graduation by reinforcing job-based practice education.

• Journal of Gastric Cancer
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• 제6권1호
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• pp.47-51
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• 2006

위에서 생기는 점막하 종양은 내시경적 조직검사로는 그 기원을 알기 어려운 경우가 많다. 이러한 점막하 종양 중, 슈반 세포(Schwann cell)로부터 분화하여 생기는 종양을 신경초종(Schwannoma)이라고 하며, 위에서 생기는 전체 종양의 0.2%를 차지한다고 알려져 있다. 이 증례는 2개월 전부터 시작된 다량의 흑색변과 빈혈을 주소로 내원한 57세 여자 환자에 대한 보고이다. 복부 컴퓨터 단층 촬영 및 상부 위장관 내시경에서 위 분문에서 3 cm정도 아래부터 위각 직상부까지 위체부 소만을 대부분 차지하는 약 8 cm 이상의 돌출된 종양이 관찰되었고, 수 차례에 걸친 내시경적 조직검사를 시행하였으나 괴사조직과 육아종성 조직, 만성 위염 소견만 반복해서 나왔다. 출혈을 동반한 진행성 위암, 림프종 등을 생각하여 정확한 진단 및 출혈에 대한 치료를 위해 수술을 시행하였다. 술 후 조직검사에서 전반적으로 소엽상 형태(lobulating pattern)로 주변에 림프구 침윤(lymphocyte cuffing)이 있었고 책상핵(palisading nuclei), 방추세포(spindle-cell) 등이 보였다. C-kit, CD34, SMA 모두 음성이었으며 S-100 양성으로 신경초종으로 진단되었다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2013년도 추계학술대회
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• pp.455-458
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• 2013

종래의 정보시스템 아키텍쳐 설계는 설계자 개인의 경험을 바탕으로 진행되어 정보시스템의 적절한 자원 배분 활용과 성능 향상에 한계로 작용되어 오고 있다. 개인 경험에 의존한 아키텍쳐 설계는 설계자 경험의 다양성, 관련 업무 및 환경에서의 지식수준, 개인의 성향에 따른 아키텍쳐 품질수준에 많은 차이가 발생한다. 이러한 문제점은 결국 고비용의 하드웨어 자원 낭비라는 결과를 초래한다. 업무 현장에서는 아키텍쳐의 성능 모니터링, 병목구간 발견 및 정보시스템 운영 프로세스 상의 문제점을 발견하고 대응할 목적으로 사후적 모니터링 Tool 들이 다양하게 개발되어 운영되고 있다. 그러나 아키텍쳐 설계 초기에 사전적으로 예측하여 대응하기 위한 시뮬레이션 툴이나 모델들은 거의 없으며, 있더라도 제한적인 모델에서만 적용 가능하다. 이러한 문제점들을 개선하고자 정보시스템 아키텍쳐 설계를 위한 시뮬레이션 모델을 우선 파이롯 형태로 개발, 실험을 통하여 타당성을 검증한다. 실험의 결과 오차율이 허용범위 이내에서 발생되면 시뮬레이션 모델이 현실 세계의 정보시스템 아키텍쳐 특성을 잘 반영하고 있다고 할 수 있다. 향후에 본 개발 모델이 다양하게 활용 가능한 수준으로 개발된다면 그동안 수식계산에 의존해 오던 방식을 벗어나 정확한 성능산정이 가능할 것이고 잘못된 아키텍쳐 설계로 인한 유휴자원의 발생 및 예산낭비를 예방할 수 있다.