• 제목/요약/키워드: thought of change

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<황제내경(黃帝內經)>에 유입(流入)된 오행학설(五行學說)에 관(關)한 연구(硏究) (A STUDY ON THE FIVE ELEMENT THEORY INTODUCED )

  • 김부환;박현국
    • 동국한의학연구소논문집
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    • 제1권
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    • pp.161-191
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    • 1992
  • The purpose of this study is how have the form and theory of the five element theory in the (黃帝內徑) by the investigation of the course of the course of the five element introduced the ancient oriental medicine from ancient oriental philosophy. The following results were obtained. 1. The five elements in (尙書) meaned the uses of water, fire, earth, wood, metal which were important in living. Because these had very important meaning in ancient political and economic society, emphasized to big law(洪範) 2. The five elements in (左傳) and (國語) mean the five uses too, and there are the phases of "five win metal"(火勝金) and "wather win fire"(水勝火), but these only meaned the physical interrelation. 3. In the five circulating factor theory made by Chu Yen(鄒衍) which have the attribute of the five elements, he more reasonably had argued human affairs like that a dynasty become different in step with the circulating five favors. There is the regular annual policy in the (呂氏春秋) which closely connected nature and human living, and attached the various colors, animals, visceras, flavors, sounds, the sexagenary cycle and so on to the five elements. 4. In the (春秋繁露) writed in fore-period of Han(漢) dynasty, the interactions of the five elements are concretely applicated to policy, Dong Jung Soe(童仲舒) had discrived the interactions of the five elements by Dong Lyu Sang Dong theory(同類相動說) and the misfortune theory(災異說), emphasized the sympathy of nature and human. Thought there is many content which are superstitious and contradictory, I concider which that affcted many effects in the formation of five element theory of oriental medicine. In the (淮南子) the order of matters were explained by the five element theory too, as the interrelations of the five elements were explained by the sexagenary ctcle, I assume that the bud of O-Un theory(五運理論). And there was not founded the fullscale intriduction of the five element theory in the Ma Wang Tye(馬王堆) excavated finds, the Mu Yyi medical writings formed the dynasty(武威漢代醫簡) and the documents about Pyun Jak(偏鵲) and Sun U Ie(淳于意). 5. The application of the five element theory in the (Whang Di Nei Qing) (黃帝內徑) is devided into the attachement to the five elements, the interelations of the five elments, and Un Gi theery(運氣論). In the attachment to the five elemeant theory, it made the attachment of the five viseras of (今文尙書) party a standard and attached the sections of a human body, the whole internal organs of sense, the five colors, the five flavors and the five sounds and so on to the five elements. It put to use by means of the apllivation of the interrelation of the five elements in the transferations of the diseases and the relative severeness of a disease in step with change of time and season. Un Gi theory(運氣論) which synthesized by the attachment to the five elements, the inter-relations of the five elements and the climate which observerd from ancient times systematically argued the effects of weather to human. 6. The application of the five elements theory in (黃帝內徑) have the significant what had get rid of irrational factors like that the emotion and action of human could to influense the weather, what had been formes more rational thingking by the obesrvation of human and nature. It is required more reserches about the possibility of the formation of the doctrinal faction bt the geographical effect of the Yon, Je(燕,薺) region, the application of the five element theory in other ancient medical books and the relationship of the five element theory and Yin Yang(陰陽)

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한국인(韓國人) 남자(男子) 30-40대(代)와 50-60대(代)의 사상체질별(四象體質別) 안면형태(顔面形態)에 관(關)한 비교(比較) 연구(硏究) (The Comparison Research of the Head and Face on the 30's, 40's, and the 50's, 60's in Korean Men according to Sasang Constitution)

  • 임규성;김상복;이준희;박계수;이수경;이의주;고병희;송일병;윤종현
    • 사상체질의학회지
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    • 제12권2호
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    • pp.143-152
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    • 2000
  • 1. Background and Purpose The faces of human being change as they grow older. We could know the characters of the each ages, through the facial comparison between the 30's, 40's and the 50's, 60's. As a conclusion, I carried out this Study because I thought that the errors of diagnosis would be reduced a lot through the standardization researches about the morphology of faces. 2. Objectives The object of this study is selected from the patients who were already diagnosed Sasang Constitutions at the department of Sasang Constitutional Medicine in Kyunghee Oriental Medical Center. The number of the patients were 69 men in 30's and 40's, and 74 men in 50's and 60's. 3. Method I took the photographs of front view and lateral view of the objectives by digital camera and obtained the 200 measure through the facial measurement program. I compared the measure of 50's and 60's with 30's and 40's by independant t-test. 4. Results 28 measures are different 30's and 40's with 50's and 60's in Soyangin, 31 measures in Soeumin, 40 measures in Taeumin. 5. Conclusion (1) Soyangin showed wider interpupillary distance in 30's and 40's than 50's and 60's. They also showed the large brow and cheek and their lips were thick and prominent and their ophyrion were prominent and their noses were wide and large and they showed wide bigonial breadth in 30's and 40's than 50's and 60's. (2) Soeumin showed the position of ears were higher and the brows were longer and larger in 30's and 40's than 50's and 60's. The width of both eyebrow were wider in 50's and 60's than 30's and 40's. The lower 2/3 portion of the face was longer and the shape of head was longer in vertical in 50's and 60's than 30's and 40's. (3) Taeumin showed the wider brow in 30's and 40's than 50's and 60's. The width of each eyes was wider and the width of cheek and face was larger, too. The ophyrion was prominent and the mouth was bigger and the face showed longer in 50's and 60's than 30's and 40's. (4) The upper 1/3 portion of the face was large in 30's and 40's and the lower 2/3 portion of the face showed large and long in 50's and 60's regardless Constitution.

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How effective has the Wairau River erodible embankment been in removing sediment from the Lower Wairau River?

  • Kyle, Christensen
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2015년도 학술발표회
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    • pp.237-237
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    • 2015
  • The district of Marlborough has had more than its share of river management projects over the past 150 years, each one uniquely affecting the geomorphology and flood hazard of the Wairau Plains. A major early project was to block the Opawa distributary channel at Conders Bend. The Opawa distributary channel took a third and more of Wairau River floodwaters and was a major increasing threat to Blenheim. The blocking of the Opawa required the Wairau and Lower Wairau rivers to carry greater flood flows more often. Consequently the Lower Wairau River was breaking out of its stopbanks approximately every seven years. The idea of diverting flood waters at Tuamarina by providing a direct diversion to the sea through the beach ridges was conceptualised back around the 1920s however, limits on resources and machinery meant the mission of excavating this diversion didn't become feasible until the 1960s. In 1964 a 10 m wide pilot channel was cut from the sea to Tuamarina with an initial capacity of $700m^3/s$. It was expected that floods would eventually scour this 'Wairau Diversion' to its design channel width of 150 m. This did take many more years than initially thought but after approximately 50 years with a little mechanical assistance the Wairau Diversion reached an adequate capacity. Using the power of the river to erode the channel out to its design width and depth was a brilliant idea that saved many thousands of dollars in construction costs and it is somewhat ironic that it is that very same concept that is now being used to deal with the aggradation problem that the Wairau Diversion has caused. The introduction of the Wairau Diversion did provide some flood relief to the lower reaches of the river but unfortunately as the Diversion channel was eroding and enlarging the Lower Wairau River was aggrading and reducing in capacity due to its inability to pass its sediment load with reduced flood flows. It is estimated that approximately $2,000,000m^3$ of sediment was deposited on the bed of the Lower Wairau River in the time between the Diversion's introduction in 1964 and 2010, raising the Lower Wairau's bed upwards of 1.5m in some locations. A numerical morphological model (MIKE-11 ST) was used to assess a number of options which led to the decision and resource consent to construct an erodible (fuse plug) bank at the head of the Wairau Diversion to divert more frequent scouring-flows ($+400m^3/s$)down the Lower Wairau River. Full control gates were ruled out on the grounds of expense. The initial construction of the erodible bank followed in late 2009 with the bank's level at the fuse location set to overtop and begin washing out at a combined Wairau flow of $1,400m^3/s$ which avoids berm flooding in the Lower Wairau. In the three years since the erodible bank was first constructed the Wairau River has sustained 14 events with recorded flows at Tuamarina above $1,000m^3/s$ and three of events in excess of $2,500m^3/s$. These freshes and floods have resulted in washout and rebuild of the erodible bank eight times with a combined rebuild expenditure of $80,000. Marlborough District Council's Rivers & Drainage Department maintains a regular monitoring program for the bed of the Lower Wairau River, which consists of recurrently surveying a series of standard cross sections and estimating the mean bed level (MBL) at each section as well as an overall MBL change over time. A survey was carried out just prior to the installation of the erodible bank and another survey was carried out earlier this year. The results from this latest survey show for the first time since construction of the Wairau Diversion the Lower Wairau River is enlarging. It is estimated that the entire bed of the Lower Wairau has eroded down by an overall average of 60 mm since the introduction of the erodible bank which equates to a total volume of $260,000m^3$. At a cost of $$0.30/m^3$ this represents excellent value compared to mechanical dredging which would likely be in excess of $$10/m^3$. This confirms that the idea of using the river to enlarge the channel is again working for the Wairau River system and that in time nature's "excavator" will provide a channel capacity that will continue to meet design requirements.

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Apolipoprotein A1 Inhibits TGF-β1-Induced Epithelial-to-Mesenchymal Transition of Alveolar Epithelial Cells

  • Baek, Ae Rin;Lee, Ji Min;Seo, Hyun Jung;Park, Jong Sook;Lee, June Hyuk;Park, Sung Woo;Jang, An Soo;Kim, Do Jin;Koh, Eun Suk;Uh, Soo Taek;Kim, Yong Hoon;Park, Choon Sik
    • Tuberculosis and Respiratory Diseases
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    • 제79권3호
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    • pp.143-152
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    • 2016
  • Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal lung disease characterized by the accumulation of excessive fibroblasts and myofibroblasts in the extracellular matrix. The transforming growth factor ${\beta}1$ (TGF-${\beta}1$)-induced epithelial-to-mesenchymal transition (EMT) is thought to be a possible source of fibroblasts/myofibroblasts in IPF lungs. We have previously reported that apolipoprotein A1 (ApoA1) has anti-fibrotic activity in experimental lung fibrosis. In this study, we determine whether ApoA1 modulates TGF-${\beta}1$-induced EMT in experimental lung fibrosis and clarify its mechanism of action. Methods: The A549 alveolar epithelial cell line was treated with TGF-${\beta}1$ with or without ApoA1. Morphological changes and expression of EMT-related markers, including E-cadherin, N-cadherin, and ${\alpha}$-smooth muscle actin were evaluated. Expressions of Smad and non-Smad mediators and TGF-${\beta}1$ receptor type 1 ($T{\beta}RI$) and type 2 ($T{\beta}RII$) were measured. The silica-induced lung fibrosis model was established using ApoA1 overexpressing transgenic mice. Results: TGF-${\beta}1$-treated A549 cells were changed to the mesenchymal morphology with less E-cadherin and more N-cadherin expression. The addition of ApoA1 inhibited the TGF-${\beta}1$-induced change of the EMT phenotype. ApoA1 inhibited the TGF-${\beta}1$-induced increase in the phosphorylation of Smad2 and 3 as well as that of ERK and p38 mitogen-activated protein kinase mediators. In addition, ApoA1 reduced the TGF-${\beta}1$-induced increase in $T{\beta}RI$ and $T{\beta}RII$ expression. In a mouse model of silica-induced lung fibrosis, ApoA1 overexpression reduced the silica-mediated effects, which were increased N-cadherin and decreased E-cadherin expression in the alveolar epithelium. Conclusion: Our data demonstrate that ApoA1 inhibits TGF-${\beta}1$-induced EMT in experimental lung fibrosis.

푸른곰팡이 대치배양에 의한 꽃송이버섯 균사 생장 특성 및 계통간 교잡균주의 rDNA 분석 (Characteristic of mycelial growth of cauliflower mushroom (Sparassis latifolia) using replacement culture with Trichoderma and rDNA analysis in genealogy of crossbreeding strain)

  • 오득실;김현석;김영;위안진;윤병선;박화식;박형호;왕승진
    • 한국버섯학회지
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    • 제12권1호
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    • pp.41-51
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    • 2014
  • ${\beta}$-glucan 함량이 높다고 알려진 꽃송이버섯의 농가재배 활성화를 위하여 푸른곰팡이 내성균주를 선발하고자 푸른곰팡이 대치배양에 의한 꽃송이버섯 균사생장 특성을 확인하였으며, 또한 생장이 우수한 신품종을 개발하고자 교잡육종 균주에 대한 유전 다양성을 분석하였다. 먼저 푸른곰팡이 대치배양에 의한 꽃송이버섯 균사의 생장 특성을 확인한 결과, 6951 (T. viride) 균주에서는 대치선을 형성한 후 별다른 변화를 보이지 않았고, 6952 (T. spp.) 균주에서는 대치선을 형성한 다음 보다 많은 포자를 형성하는 것이 관찰되었다. 그러나 6426 (T. harzianum) 균주에서는 꽃송이버섯 균사가 생장하고 있던 부분까지 모두 덮어버리는 것이 확인되었다. 그 중 특이하게도 구례에서 채집선발한 균주인 JF02-06 균주에서는 다른 균주에 비해 푸른곰팡이 포자가 형성되지 않는 것을 확인되어 다소 푸른곰팡이에 대한 저항성을 갖는 것으로 사료되었다. 전남 산림자원연구소에서 보유 중인 균주 중 생장 및 자실체 발생이 우수한 모균주를 선발하여 교잡을 실시하여 생장특성을 조사한 결과, 미송톱밥배지에서 JF02-47, 49, 50 균주의 균사생장량이 우수한 것으로 확인되었다. 이러한 교잡육종 균주의 유전 다양성을 분석하기 위하여 ITS1, 5.8S와 ITS4 영역에 대한 염기서열을 분석한 결과 Genebank에 등록된 다른 꽃송이버섯 균주와 높은 유의성을 갖는 것으로 확인되었다. 이러한 꽃송이버섯의 포자 및 균사를 현미경으로 관찰하여 생장 특성을 확인한 결과, 포자의 크기는 장경 $6{\mu}m$, 단경 $5{\mu}m$의 물방울 모양으로 확인되었고, 균사에서 3가지 형태의 꺽쇠가 관찰되었다. 균사의 폭은 $3{\mu}m$이며 꽃송이버섯 균사의 특징으로는 약 50% 정도 꺽쇠에서 균사가 뻗어나가는 특성을 갖고 있음이 확인되었다. 균사의 생장 속도는 $0.507{\mu}m/min$이며, 2차 균사는 $0.082{\mu}m/min$의 속도로 생장하다가 모균사와 평행을 이루는 시점에서는 모균사의 생장속도와 유사한 속도로 생장하였다. 꺽쇠발생은 약 5시간 동안 균사 내부 전해질의 이동이 관찰된 후 작은 꺽쇠를 형성하였다. 약 3시간 후 격막이 형성되기 시작하였으며, 그로부터 2시간 후 최종적으로 완성되었다. 이러한 특성을 갖는 꽃송이버섯의 푸른곰팡이 저항성을 확인하고, 교잡균주의 유전 다양성 및 균사의 생장 특성을 확인하여 꽃송이버섯에 대한 기초적인 이해를 높이고, 더 나아가 버섯산업 발전에 이바지하고자 한다.

밀폐된 챔버의 QRD 마이크로파 조사용량과 위치에 따른 분산효과 (Dispersion Effect Based on Irradiation Dose and Position of QRD Microwave in Sealed Chamber)

  • 김진현;한충수;이근우;임경호;이재현;김경민;하유신
    • 생물환경조절학회지
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    • 제23권1호
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    • pp.1-10
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    • 2014
  • 본 연구에서는 파장의 위상차를 변화시켜 균일한 살균을 유도할 수 있고 저전력으로 효과를 높일 수 있는 QRD(quadratic residue diffusor) 마이크로파를 이용하여 챔버 내부의 위치에 따른 온도변화를 측정하여 효율성과 균등성을 분석한 결과는 다음과 같다. 챔버 내부의 수직 35cm, 중앙 위치에서는 7kW 조사시 가장 효율이 높게 나타났고, 좌우측 위치에서는 5kW에서 효율성이 높았다. 그리고 마그네트론 No. 1, 2, 3에서 3kW로 하였을 때, Bar의 위치에 따른 온도 균등성은 1Bar와 2Bar의 위치에서는 거의 비슷하게 나타났다. 마그네트론 No. 3, 4, 5의 3kW로 하였을 경우에는 3Bar에서 온도가 약 10~20% 정도 높게 나타났고 마그네트론 용량을 5, 7, 9kW로 하였을 때, 조사 시간에 대한 평균 온도는 Bar의 위치에 무관하게 거의 유사한 형태로 증가하였다. 반면에 챔버의 적정 내용적에 대한 효율성은 조사용량에 반드시 비례하지는 않았다. 마그네트론 3kW를 60, 120, 180초 동안 조사하였을 경우 마그네트론 조사 위치에 따라 구석 부분에서 약 $5{\sim}10^{\circ}C$ 더 높게 상승하였고 수평면의 위치별 온도 분포는 비교적 균일하였으며 부분적으로 구석부분에서 약간 더 온도가 상승하는 경향이 있었다. 마그네트론 5, 7, 9kW 조사에서는 Bar의 위치와 상관없이 전반적으로 온도가 비교적 균일하게 상승하고 있었다.

다산역의 관점에서 본 경방의 효변설 (Jingfang's yaobian theory seen from Dasan Jeong Yagyong's view on the Book of Change.)

  • 방인
    • 철학연구
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    • 제131권
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    • pp.199-222
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    • 2014
  • 서한(西漢) 시대의 역학자 경방(京房)은 다양한 해석방법을 개발함으로써 상수역의 이론적 발전과정에 심대한 영향을 미친 인물이다. 다산역의 해석방법론은 상수역에 연원을 두고 있기 때문에 그 역학사적 기원을 밝히기 위해서는 경방역과의 관계가 명확히 해명될 필요가 있다. 필자는 다산역과 경방역의 관계를 해명하기 위하여 정약용이 효변설과 관련하여 경방에 대해 어떠한 평가를 내렸는지의 문제를 고찰하였다. 효변설이란 효의 변화에 의하여 변괘(變卦, 즉 지괘(之卦))가 형성된다는 이론이다. 정약용은 "주역사전"에서 경방이 역사(易詞)를 풀이함에 있어 효변설을 적용하였다는 추정을 내리고, 그것을 뒷받침하는 근거를 건초구(乾初九), 관상구(觀上九), 박상구(剝上九) 등의 역주(易注)에서 찾았다. 정약용이 제시한 증거를 통해서 본다면, 건초구(乾初九)와 박상구(剝上九)는 효변을 취한 명백한 증거로 보이는 반면에 관상구(觀上九)는 증거로 채택하기에 의심스러운 점이 있다. 그러나 설령 두 곳에서 경방이 효변을 적용한 것이 명백하다고 하더라도 정약용의 효변설과 경방의 효변설이 같은 것이라고 볼 근거는 없다. 오히려 양자의 효변설을 면밀히 검토해 보면, 서로 계통을 달리하는 이론이라는 것이 드러난다. 그 다음으로, 정약용은 건초구(乾初九)의 역주(易注)에서 경방과 더불어 효변을 이해하고 있는 인물로 경방보다 대략 백여년 이전(以前)에 활동했던 가의(賈誼)를 언급하였다. 필자는 가의가 세상을 떠난 기원전 168년은 마왕퇴 3호 한묘(漢墓)의 묘주(墓主)의 묘장(墓葬) 연대와 같다는 점에 주목하였다. 효변설의 근거로 제시되어 온 "춘추좌씨전"의 '모괘지모괘(某卦之某卦)'의 형식은 마왕퇴(馬王堆) 백서본 "주역"에서도 나타난다. 따라서 기원전 168년 이전(以前)에 "모괘지모괘(某卦之某卦)"의 형식이 널리 유행하고 있었음이 확실해진다. 만약 가의가 마왕퇴 백서본 "주역"에 나타난 효변설에 대한 이해를 공유하고 있었고, 경방도 역시 효변설을 이해하고 있었다면, 효변설은 역학사적으로 가의 이후로 경방에 이르기까지 백여년 동안 전승되었을 것이라는 추론이 가능해진다. 이러한 추론에 대해 설득력있는 증거를 제시할 수 있다면, 이것은 역학사적으로 중요한 발견이 될 뿐 아니라, 다산역의 이론을 확증해주는 증거로도 활용될 수 있을 것이다.

토마토 폐배지를 딸기 수경재배 배지로 재이용 가능성 연구 (A Study on the Possibility of Recycling Coir Organic Substrates for using Strawberry Hydroponics Media)

  • 이규빈;박영훈;최영환;손병구;김준엽;강남준;강점순
    • 한국폐기물자원순환학회지
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    • 제34권2호
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    • pp.205-213
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    • 2017
  • The current study was performed to investigate the effect of recycling coir substrates on the growth, fruit yield, and quality of strawberry plants. Analysis of physical properties revealed that the pH of a fresh coir substrate was 5.04 while those of substrates reused for one and two years were 5.20 and 5.33, respectively. The electrical conductivity (EC) of a new substrate was as high as $4.58dS{\cdot}m^{-1}$. This can cause salt stress after transplanting. The EC tended to decrease as the substrate was recycled, and the EC of a two-year recycled substrate was $1.48dS{\cdot}m^{-1}$. The fresh substrate had lower nitrogen and calcium concentrations, but higher phosphate, potassium, and sodium concentrations than the recycled coir substrate. The coir substrates recycled for one or two years maintained better chemical properties for plant growth than the fresh substrate. Strawberry growth varied depending on the number of years that the coir substrate was recycled. In general, strawberries grown in substrates that had been reused for two years did better than those grown in substrates that had been reused once or were fresh. Ninety days after transplanting, a plant grown in a substrate that had been reused for two years contained 25 leaves, which was 3.6 more than with a fresh substrate. In addition, the plants grown in a substrate that had been reused for two years exhibited larger leaf areas than those grown in other substrates. Coir substrates that had been reused for one year increased the number and area of leaves, but not as much as the substrate that had been reused for two years. One- and two-year reused coir substrates increased the weight of strawberries produced relative to the unused substrate, but the difference was not statistically significant. The plants grown in two-year reused substrates were longer and wider, as well. Also, the number of fruits per plant was higher when substrates were reused. Specifically, the number of fruits per plant was 28.7 with a two-year reused substrate, but only 22.2 with a fresh substrate. The fruit color indices (as represented by their Hunter L, a, b values) were not considerably affected by recycling of the coir substrate. The Hunter L value, which indicates the brightness of the fruit, did not change significantly when the substrate was recycled. Neither Hunter a (red) nor b (yellow) values were changed by recycling. In addition, there were no significant changes in the hardnesses, acidities, or soluble solid-acid ratios of fruits grown in recycled substrates. Thus, it is thought that recycling the coir substrate does not affect measures of fruit quality such as color, hardness, and sugar content. Overall, reuse of coir substrates from hydroponic culture as high-bed strawberry growth substrates would solve the problems of new substrate costs and the disposal of substrates that had been used once.

동적 세기조절방사선 치료 시 선량률 변화에 따른 선량학적엽간격 변화 분석 (Analysis of dosimetric leaf gap variation on dose rate variation for dynamic IMRT)

  • 양명식;박주경;이승훈;김양수;이선영;차석용
    • 대한방사선치료학회지
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    • 제28권1호
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    • pp.47-55
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    • 2016
  • 동적 세기조절방사선치료 시 선량률 변화에 따른 다엽콜리메이터의 엽의 위치를 반영하는 선량학적엽간격과 다엽콜리메이터 투과계수 변화를 분석하여 다엽콜리메이터의 정확성을 평가하고자 하였다. Millennium 120 MLC 시스템이 장착된 선형가속기의 6 MV와 10 MV X선으로 물 팬텀의 깊이 10 cm에서 CC13과 FC-65G 전리함을 이용하여 선량률을 200, 300, 400, 500, 600 MU/min으로 변화시켜 선량학적엽간격과 다엽콜리메이터 투과계수를 측정하였다. 400 MU/min의 선량률 기준으로 200, 300, 400, 500, 600 MU/min으로 선량률을 변경하여 선량학적엽간격 값을 측정한 결과, 6 MV의 경우 각각 -2.59, -1.89, 0.00, -0.58, -2.89%의 차이가 나타났고, 10 MV에서는 각각 ?2.52, -1.69, 0.00, +1.28, -1.98%의 차이가 나타났다. 다엽콜리메이터 투과계수는 두 종류의 에너지와 모든 선량률에서 약 ${\pm}1%$ 이내의 범위로 측정되었다. 본 연구는 동적 세기조절방사선치료 시 선량률 변화에 대하여 다엽콜리메이터의 선량학적엽간격과 투과계수 변화를 평가하였다. 선량률 변화에 따라서 다엽콜리메이터의 투과계수의 차이는 미미했지만, 선량학적엽간격의 차이는 큰 것으로 확인하였다. 따라서 동적 세기조절방사선치료 시 임의로 선량률을 변경하면 종양에 전달되는 선량에 많은 영향을 미치므로 치료 중에 선량률을 변화시키지 않는 것이 더욱 정확한 방사선치료 방법이라 사료된다.

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소아의 외측 원판형 반월상 연골의 슬관절경 치료: 유형에 따른 임상증상 및 치료 결과 (Arthroscopic Treatment for Lateral Discoid Meniscus in Children: Clinical Symptoms & Treatment Results According to Meniscus Type)

  • 신성일;현윤석;강정우;오범석
    • 대한관절경학회지
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    • 제15권1호
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    • pp.7-12
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    • 2011
  • 목적: 소아에서 외측 원판형 연골판의 관절경 치료 후 임상 결과를 평가 하였다. 대상 및 방법: 1999년 1월 1일부터 2007년 12월 30일까지 외측 원판형 반월상 연골 때문에 슬관절의 비정상적인 소견을 보인 7 내지 12세의 소아에서 관절경 치료를 시행한 21예에 대하여 후향적 평가를 하였다. 평균 추시 기간은 38.4개월(14~60개월)이었으며, 평균 나이는 9.5세(7~12세)이었다. 슬관절의 주 임상 소견은 신전 제한이 11예로 가장 많았으며, 그밖에 슬관절통 8, 탄발음 6, 보행 이상 10례를 보였다. 외측 원판형 반월상 연골의 형태는 완전형이 14예, 불완전형이 5예, 그밖에 Wrisberg형이 2예이었다. 수술은 모든 환자에서 슬관절경적 반월상연골 부분 절제술을 시행하였다. 임상 결과는 Ikeuchi grading system을 이용하여 평가 하였으며, 정기적인 방사선 촬영으로 슬관절의 변화를 관찰하였다. 결과: 외측 원판형 반월상 연골의 주변부 과유동성은 7예에서 보였다. 주변부 파열은 4예에서 발견되었으며 치료 7예는 모두 반월상 연골의 부분 절제술과 함께 봉합술을 동시에 시행하였다. 최종 임상결과는 매우좋음 5예, 좋음 12예, 보통 4예를 보였다. 방사선학적으로 슬관절의 외측 관절부위에서 경도의 협소와 subchondral sclerosis를 보인 경우가 5예이 었고, 1예에서는 대퇴골 외과의 관절면에서 골연골염이 발생하였다. 반면에 임상증상의 IKDC score를 볼 때 주관적으로 정상이거나 또는 거의 정상인 경우가 20예 였고 1예가 비정상군에 속하였다. 결론: 소아의 외측 원판형 연골판의 치료로 슬관절경적 부분 절제술이 유용하며, 주변부 파열이 함께 있는 경우 봉합술이 필요할 것으로 생각한다.

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