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만성폐쇄성폐질환 환자에서 열량섭취와 폐기능지표와의 상관관계 (Correlation between Caloric Intake and Lung Function Parameters in Patients with Chronic Obstructive Pulmonary Disease)

  • 윤호일;박영미;조여원;강영애;권성연;이재호;이춘택
    • Tuberculosis and Respiratory Diseases
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    • 제65권5호
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    • pp.385-389
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    • 2008
  • 연구배경: 이전의 연구에서 섭취의 제한은 폐기종과 유사한 변화를 유발할 수 있음이 알려져 왔다. 그러나 이러한 현상이 만성폐쇄성폐질환 환자에서 갖는 의미는 밝혀진 적이 없다. 저자들은 만성폐쇄성폐질환 환자에서 영양섭취량과 폐기능지표와의 상관관계를 알아보고자 본 연구를 수행하였다. 방 법: 분당서울대학교병원에서 2006년 3월부터 1년동안 진료받은 만성폐쇄성폐질환 환자들을 대상으로 하였으며 폐활량검사, 확산능검사, 폐용적검사와 함께 영양섭취상태평가를 시행한 후 분석하였다. 결 과: 총섭취열량과 1초간노력호기량이나 최대노력호기량(%예측치)과는 아무런 상관관계를 찾을 수 없었다. 반면 폐확산능의 지표인 DLCO (%예측치), DLCO/VA (%예측치)와는 양의 상관관계를, 총폐용량(%예측치)과는 음의 상관관계를 보임을 관찰할 수 있었다. 섭취한 열량 중 단백질섭취열량과 폐확산능 DLCO (%예측치), DLCO/VA (%예측치)은 통계적으로 의미 있는 상관관계를 보였다. 그러나 탄수화물 및 지방섭취에 의한 열량과 폐기능지표는 의미 있는 상관관계를 보이지 않았다. 결 론: 만성폐쇄성폐질환 환자의 하루 섭취 열량은 그 환자의 폐확산능과는 양의 상관관계, 총폐용량과는 음의상관관계에 있어 섭취열량과 폐기종의 관련성에 대한 추가 연구가 필요하다.

시설 거주 지적장애인들의 재활체육 프로그램 참여에 따른 여가시간 사용과 여가활동 수행에 미치는 영향 (Effects of Leisure Time-Use and Occupational Performance according to the Participation of a Rehabilitation Sports Program for Intellectual Disabilities Residing in a Residential Care Facility)

  • 손성민;이경락;전병진
    • 대한지역사회작업치료학회지
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    • 제6권2호
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    • pp.51-59
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    • 2016
  • 목적 : 본 연구에서는 규칙적인 재활체육 프로그램 참여에 따른 시설 거주 지적장애인들의 여가시간 사용과 여가활동 수행에 미치는 영향을 규명하여 시설 거주 지적장애인들의 여가시간 사용과 여가활동 수행에 대한 기초자료를 제공하는 데 그 목적이 있다. 연구방법 : 연구대상은 경기도 용인시 지적장애인 거주시설에서 거주하는 지적장애인 8명을 대상으로 하였으며, 2015년 09월 01일부터 11월 30일 까지 총 12주간 재활체육 프로그램을 실시하였다. 재활체육 프로그램으로 짐볼과 탄성밴드를 활용한 근력운동을 적용하였으며, 프로그램 참여에 따른 여가시간 사용의 변화를 조사하기 위해 매월 시간 조사표 기록에 따른 총시간, 운동 빈도를 조사하였고, 여가활동 수행에 미치는 영향을 분석하기 위해 프로그램 전, 후 캐나다작업수행측정(COPM)을 활용하여 동적 여가활동에서의 수행도와 만족도를 분석하였다. 수집된 자료는 SPSS ver.18.0으로 기술통계, 프리드만 검정(Friedman), 윌콕슨 부호순위 검정(Wilcoxon's Signed-Ranks Test)을 실시하였다. 결과 : 여가시간 사용의 분석 결과 총시간, 운동 빈도에서 프로그램 참여 후 통계적으로 유의미하게 지속적으로 증가하였으며, 여가활동 수행의 분석 결과 동적 여가활동에서의 수행도, 만족도에서 프로그램 참여 후 통계적으로 유의미하게 증가하였다. 결론 : 재활체육 프로그램의 참여가 대상자들의 여가시간 사용을 효과적으로 변화시킬 수 있는 긍정적인 요인으로 작용할 수 있어 시설에 거주하고 있는 지적장애인들에게 재활체육 프로그램의 참여는 필수적이다. 또한, 이러한 프로그램을 지속적으로 제공하고, 체계적으로 발전시키고 관리하여, 지적장애인들의 여가생활의 질을 높이고 시설 내 생활과 하루일과의 만족도를 높이는 데 기여할 수 있을 것이다.

과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증 (Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis)

  • 정재경;김의중
    • 수면정신생리
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    • 제18권1호
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    • pp.40-44
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    • 2011
  • 기면병은 과도한 주간 졸림, 탈력발작, 수면 분절화, 입면환각의 특징을 가진 수면 질환이다. 기면병의 증상은 내과적, 신경과적 질환으로부터 생길 수도 있다. 17세의 고등학생 남자 환자가 3개월 전부터 발생한 참을 수 없는 과도한 주간 졸림으로 본원 수면클리닉을 통해 입원하였다. 내원 이후 측정된 체질량지수는 30.4 kg/$m^2$였고 맥박은 분당 70~90회, 혈압은 150/100~120/70 mmHg로 관찰되었다. 갑상선기능 검사에서 T3 391.2 ng/dL(60~181), free T4 4.38 ng/dL(0.89~1.76), TSH(thyroid stimulating hormone) <0.01 ${\mu}IU$/mL(0.35~5.5)로 갑상선 중독증이 시사되었다. 수면다원검사가 실시되었고, 수면 자세의 변환은 시간당 81 회로 매우 많은 편이었다. 입면 잠복기는 33.5분, 수면 효율은 47.9%, 입면에서 렘수면 입면시간은 153.6분으로 지연되었고 렘수면은 27.1%로 증가하였다. 주기성 사지 운동지수는 13.4/h로 나타났다. 수면잠복기반복검사에서 평균 입면잠복시간은 24초, SOREMP(sleep onset REM period)은 3회에서 관찰되었다. actogram상 수면-각성의 경계가 불분명하였고, HLA typing에서 DQB1 $^*0602$는 음성이었다. 환자의 갑상선중독증은 대해 3개월간 methimazole 30 mg, propranolol 40 mg이 투약되며 갑상선 기능이 호전되었다. 탈력발작은 venlafaxine 75 mg으로 조절되었고, 야간 수면 유지와 주기적 사지운동증을 치료 하기 위해 clonaze-pam 0.5 mg이 사용되었고 주관적인 야간 수면의 질은 향상되었다. 과도한 주간 졸림에 대해서는 3개월간 modafinil 200~400 mg이 투여되었고 부분적이긴 하지만 다소의 호전을 보이고 있다. 본 증례는 기면병으로 최종 진단된 환자에 있어 병력과 검사상 발견된 갑상선 중독증, 그리고 수면 효율 감소 등이 과도한 주간 졸림을 평가하는데 혼란 변수로 작용한 경우라 하겠다. 다만, 주간 과다 졸림이 modafinil에 부분적인 효과를 보이는 것, HLA DQB1 $^*0602$ 음성의 결과를 보인 환자에게 나타났던 탈력발작에 대해서도 더 설명이 필요할 것으로 보인다. 향후 CSF hypocretin level을 추가로 측정하고 수면 문제의 추이를 관찰하면서 추가적인 PSG와 MSLT가 필요할 것으로 사료된다.

서울시 간호사회 가정간호시범사업 서비스 내용 및 만족도 분석 (The Contents and Satisfation of Home Care Progral Delivered by Seoul Nurses Association)

  • 임난영;김금순;김영임;김귀분;김시현;박호란
    • 대한간호
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    • 제36권1호
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    • pp.59-76
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    • 1997
  • The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

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Serum Carbohydrate Antigen 19-9 as an Indicator of Liver Metastasis in Colorectal Carcinoma Cases

  • Dong, Hang;Tang, Jie;Li, Long-Hao;Ge, Jun;Chen, Xin;Ding, Jing;Men, Hai-Tao;Luo, Wu-Xia;Du, Yang;Li, Cong;Zhao, Feng;Chen, Ye;Cheng, Ke;Liu, Ji-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.909-913
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    • 2013
  • Purpose: The liver is the organ to which colorectal carcinomas (CRCs) most commonly metastasize, and surgical resection has been established as the most effective and potentially curative treatment for CRC with liver metastasis (LM). Therefore, surveillance of LM is vital for improvement of prognosis of CRC patients. In this study, we aimed to explore the potential value of carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and marker enzymes in indicating LM with CRC. Methods: Three groups of eligible patients with metastatic cancers were retrospectively included: CRC patients with LM (CRC-LM) or without LM (CRC-NLM), and non-CRC patients with LM (NCRC-LM). All metastatic lesions were identified by CT or MRI. Data on characteristics of the patients, the primary site, the locations of metastasis, CA 19-9, CEA, and biochemical parameters were collected for analysis. Results: A total of 493 patients were retrospectively included. More alcohol consumption was found in CRC-LM than CRC-NLM. Some biochemical enzymes were found to be significantly higher in groups with LM than without (CRC-LM or NCRC-LM v.s CRC-NLM). Both CEA and CA 19-9 were much higher in CRC-LM than CRC-NLM or NCRC-LM. For CRC patients, CA 19-9, ${\gamma}$-glutamyl transpeptidase, CEA and alcohol consumption were identified as independent factors associated with LM. Conclusion: Our analysis suggested the CA 19-9 might be a potential valuable indicator for LM of CRC in the clinic.

입원환자의 투약체계와 방법의 개선을 위한 현장연구 (Field Study For The Improvement of Medication System and Method for Inpatients at General Hospital)

  • 유형숙;권영미;송미숙;김형애;박경숙
    • 간호행정학회지
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    • 제1권1호
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    • pp.147-211
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    • 1995
  • Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

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노인의 건강증진을 위한 율동적 운동프로그램의 적용효과 (An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly)

  • 이숙자
    • 대한간호학회지
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    • 제30권3호
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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Carboxymethylcellulose(CMC) 용액과 인공 타액의 점도와 습윤성 (Viscosity and Wettability of Carboxymethylcellulose(CMC) solutions and Artificial Saliva)

  • 박문수;김영준
    • Journal of Oral Medicine and Pain
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    • 제32권4호
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    • pp.365-373
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    • 2007
  • 구강건조증 환자에서 자주 발생하는 구강 연조직과 경조직의 손상은 구강건조증 환자의 삶의 질에 심각한 문제를 일으킨다. 타액선의 기능을 완전히 상실한 구강건조증 환자의 경우 인공타액은 유일한 처치법임에도 불구하고, 현재 통용되고 있는 인공타액은 환자들의 기대치에 비해 많이 부족한 실정이다. 본 연구는 CMC 용액과 인공타액의 점도와 습윤성을 비교함으로써 향후 이상적인 인공타액의 개발에 필요한 정보를 얻고자 시행되었다. CMC를 타액모방완충용액(simulated salivary buffer, SSB)과 증류수에 용해시켜 동물 mucin 용액을 완성한 후, 이를 인체 전타액, 인체 개별 타액선 타액, 그리고 CMC를 주성분으로 하는 인공타액인 Salivart 및 Moi-Stir와 비교 분석하였다. 점도는 cone-and-plate digital viscometer로 검체 당 6개의 전단율에서 측정하였고, 습윤성은 아크릴릭 레진과 Co-Cr alloy 표면 위에서의 접촉각 측정을 통해 평가하여 다음과 같은 결론을 얻었다. 1. CMC 용액의 점도는 CMC 농도에 비례하여 증가하였으며, 0.5% CMC 용액의 점도는 비자극성 전타액의 점도와 유사하였다. 반면에 CMC 용액의 접촉각은 점도와는 반대로 CMC 농도를 증가시킴에 따라 감소하였다. 2. 인체 타액의 점도는 전단율 증가에 따라 감소하는 non-Newtonian fluid의 특성을 나타내었다. 다양한 전단율에서의 평균 점도는 자극성 이하선 타액, 자극성 전타액, 비자극성 전타액, 자극성 악하선-설하선 타액의 순으로 증가하였다. 3. 인체 타액의 접촉각은 점도와는 반대로 자극성 이하선 타액, 자극성 전타액, 비자극성 전타액, 자극성 악하선-설하선 타액의 순으로 감소하였다. 4. 타액모방완충용액에 용해시킨 CMC를 가열하여 변성시킨 경우 점도가 감소하였다 (P < 0.01, 전단율 $90s^{-1}$). 5. 인체 타액의 아크릴릭 레진 표면에서의 접촉각은 인체 타액의 Co-Cr alloy 표면에서의 접촉각보다 유의하게 작은 것으로 나타났다 (P < 0.01). 6. 인체 타액의 아크릴릭 레진 표면에서의 접촉각은 CMC 용액의 아크릴릭 레진 표면에서의 접촉각보다 유의하게 작은 것으로 나타났다 (P < 0.01). 이번 연구에서 CMC 용액의 유동학적 성질을 객관적으로 확인할 수 있었으며, 이상의 결과를 종합하여 보면 CMC는 향후 효과적인 인공타액의 개발에 있어서도 중요한 역할을 수행 할 것으로 기대된다.

기공학(氣功學) 발달(發達)에 관한 문헌적(文獻的) 연구(硏究) (A Documentational Study on the Development of Chi-Kung-Hak)

  • 김우호;홍원식
    • 대한한의학원전학회지
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    • 제4권
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    • pp.19-73
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    • 1990
  • Today, many people are more interested in preventing the disease than curing it. Chi-Kung (氣功) is the way of Life-Cultivation (養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions ; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae (三皇五帝 )period to cure the abnormal circulation of the vital force and blood caused by damp (濕). 2. As the principle and the method of the Life-Cultivation of the Chun-chu-Jeon-Kook (春秋戰國) periods were recorded in Huang-Jae-Nai-Gyung (黃帝內徑) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin (導引), Haeng-Chi (行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta (華陀) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical gymnastics what is called O-Keum-Hi (五禽戱). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja' (莊子) or 'Hoy-Nam-Ja' (淮南子). 4. In Wui-Jin-Nambook Jo (魏晋南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism (佛敎) and Taoism (道敎). Galhong (葛洪), the author of 'Po-Bak-Ja' (抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung (陶宏景), the author of 'Yang-Seong-Yeun-Myung-Rok' (養性延命錄) recorded the 'Yook-Ja-Geul' (六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae (隋唐五代) pefiods, especially So-Won-Bang (巢元方), the author of 'Jey-Byung-Won-Hwu-Ron' (諸病源候論) collected aimost all of the Chi-Kung method, for curing the disease formed before soo (隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob' (小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist (道敎內丹學派) in Song-Keum-Won (宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum' (八段錦) was appeared and assignment of six-Chi (六氣) for bowel and viscera in the 'Yook-Ja-Geul' (六字訣) was decided firmly, that is to say Lung-Si (肺-呬), Heart-Kha (心-呵), Spleen-Hoa (脾-呼), Liver-Hoe (肝-噓), Kidneychui (賢-吹), Three-Burner-shi (三焦-嘻). 7. In Myung-Cheong (明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi' (辨證論治) to the Chi-Kung field, and after Myeong dynasty the style of doing 'Yook-Ja-Gyel' (六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak (氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom (氣功學教室) and Medical Chi-Kung Center (氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician (氣功師) is also needed.

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우리나라 연안화물선의 적정선복량 추정에 관한 연구 (A Study on Estimating Optimal Tonnage of Coastal Cargo Vessels in Korea)

  • 이청환;이철영
    • 한국항해학회지
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    • 제13권1호
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    • pp.21-53
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    • 1989
  • In the past twenty years, there has been a rapid increase in the volume of traffic in Korea due to the Korean great growth of the Korean economy. Since transformation provides an infrastructure vital to economic growth, it becomes more and more an integral part of the Korea economy. The importance of coastal shipping stands out in particular, not only because of the expansion limit on the road network, but also because of saturation in the capacity of rail transportation. In spite of this increase and its importance, coastal shipping is falling behind partly because it is givenless emphasis than ocean-going shipping and other inland transportation systems and partly because of overcompetition due to excessive ship tonnage. Therefore, estimating and planning optimum ship tonnage is the first take to develop Korean coastal shipping. This paper aims to estimate the optimum coastal ship tonnage by computer simulation and finally to draw up plans for the ship tonnage balance according to supply and demand. The estimation of the optimum ship tonnage is peformed by the method of Origin -Destimation and time series analysis. The result are as follows : (1) The optimum ship tonnage in 1987 was 358, 680 DWT, which is 54% of the current ship tonnage (481 ships, 662, 664DWT) that is equal to the optimum ship tonnage in 1998. this overcapacity result is in excessive competition and financial difficulties in Korea coastal shipping. (2) The excessive ship tonnage can be broken down into ship types as follows : oil carrier 250, 926 DWT(350%), cement carrier 9, 977 DWT(119%), iron material/machinery carrier 25, 665 DWT(117%), general cargo carrier 17, 416DWT(112%). (3) the current total ship crew of 5, 079 is more than the verified optimally efficient figure of 3, 808 by 1271. (4) From the viewpoint of management strategy, it is necessary that excessive ship tonnage be reduced and uneconomic outdated vessels be broken up. And its found that the diversion into economically efficient fleets is urgently required in order to meet increasing annual rate in the amounts of cargo(23, 877DWT). (5) The plans for the ship tonnage balance according to supply and demand are as follows 1) The establishment of a legislative system for the arrangement of ship tonnage. This would involve; (a) The announcement of an optimum tonnage which guides the licensing of cargo vessels and ship tonnage supply. (b) The establishment of an organization that substantially arrangement tonnage in Korea coastal shipping. 2) The announcement of an optimum ship tonnage both per year and short-term that guides current tonnage supply plans. 3) The settlement of elastic tariffs resulting in the protect6ion of coastal shipping's share from other tonnage supply plans. 4) The settlement of elastic tariffs resulting in the protection of coastal shipping's share from other transportation systems. 4) Restriction of ocean-going vessels from participating in coastal shipping routes. 5) Business rationalization of coastal shipping company which reduces uneconomic outdated vessels and boosts the national economy. If we are to achieve these ends, the followings are prerequisites; I) Because many non-licensed vessels are actually operating and threatening the safe voyage of the others in Korea coastal routes, it is necessary that those ind of vessels be controlled and punished by the authorities. II) The supply of ship tonnage in Korean coastal routes should be predently monitored because most of the coastal vessels are to small to be diverted into ocean-going routes in case of excessive supply. III) Every ship type which is engaged in coastal shipping should be specialized according to the characteristics of its routes as soon possible.

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