분만손상

김태승,황건성,김주학 대한골절학회 2003 대한골절학회지 Vol.16 No.2

서론 : 분만손상이란 진통이나 분만기간 중에 발생될 수 있는 태아에게 해로운 모든 조건을 말한다. 이러한 손상에는 저 산소증으로 인한 뇌손상과, 기계적인 요소에 의한 골절, 신경마비, 두개내 혈종 및 복부손상 등을 포함하고 있다. 분만손상을 야기시킬 수 있는 위험 요인으로는 둔위분만, 감자분만, 아두골반 불균형, 난산, 과체중 등이 있으나 최근에는 산전관리 및 분만방법의 개선, 그리고 제왕절개술의 증가추세로 분만손상율은 감소를 보이고 있다. 정형외과 영역에서의 분만손상은 쇄골 골절, 상완골 골절, 상완 신경총손상, 대퇴골 골절 등이 있으며, 이에 본 병원에서는 최근 11년간 경험한 분만손상에 대해 연구 분석하였다. 대상 및 방법 : 1991년1월부터 2001년 12월까지 한양대의료원 서울병원에서 경험한 분만손상중 두개 내외의 혈종과 뇌신경손상 복부손상을 제외한 사지에 발생된 골절, 신경손상 환자 17명(남자 9명, 여자 8명), 20례를 대상으로 하였다. 두개 내외의 혈종과 뇌신경손상, 복부손상은 제외하였으며, 지료기록지를 조사하여 분만손상에 대한 자료를 얻었다. 결과 : 본 병원에서 경험한 분만손상 중 사지에 발생한 골절, 신경손상은 쇄골 골절 9례, 대퇴골 골절 3례, 상완골 골절 1례, 상완 신경총손상 6례, 원위대퇴골 골단분리증 1례이었다. 쇄골 골절 환아는 재태기간 40-42주사이에 분만되었으며, 신생아의 평균 체중은 4.25 ㎏으로 신생아체중 표준치에 비해 높았으며, 상완 신경총손상 환아 역시 재태기간 40-42주에 분만되었고, 평균 체중 4.42 ㎏으로 높았다. 대퇴골 골절 3례는 모두 둔위로 인한 제왕절개술 분만시에 발생하였고, 이들 중 1례는 좌골부결합체 (ischiopagus)로 태어났다. 원위대퇴골단 분리증 분리손상은 초기에는 간과되었으나, 시간이 경과하면서 현저한 골막반응을 나타내어 통해 분만손상으로 진단되었다. 결론 : 쇄골 골절과 상완 신경총손상은 과체중과 매우 관련이 있다고 할 수 있겠으며, 대퇴골골절은 둔위와 관련하여 제왕절개술시의 분만술기와 관계있다고 할 수 있겠다. 또, 마비증상은 상완 신경총 손상이나 골절로 인한 가성마비로서 나타날 수 있기 때문에 이에 대해 주의깊게 관찰해야 되겠다.무엇보다도 분만손상은 과체중과 관련된 경우가 많으므로, 초음파 검사 또는 산전 진단 방법을 통해 과체중으로 분만되는 것을 지양하여 분만손상을 줄이는 것이 필요하다 하겠다. Purpose : Birth injury is any condition that affects the adversely during the labor of delivery. These traumatic injuries are subdivided further into those from hypoxia and mechanical factors. Risk factor of birth injuries have been reported to breech presentation, forcep delivery, cephalopelvic desproportion dystocia, and high birth weight. But, because of preterm care and development of delivery method and Cesarian section, recently the rate of birth injury was decreasing and the articles about birth injuries in orthopaedic fields have not been much. We analyzed the data about birth injuries occurred during recent 11 years. Materials and Methods : We reviewed the charts and patients the 17 patients (20 cases) of birth injuries including fracture, nerve injury during the delivery at Hanyang University hospital from Jan. 1991 to Dec. 2001. But, we excluded birth injury of head and abdomen. Results : The number of fractures and nerve injuries on extrimities in our hospital were clavicle fracture 9 cases, brachial plexus injury 6 cases, femur fracture 3 cases, separation of distal remoral epiphysis I case, humerus fracture I case. Patients of clavicle fracture were born at mean intrauterine period 41.5 weeks and mean birth weight of the patients was 4.25 ㎏. Patients of brachial plexus injury were born at mean intrauterine period 39.5 weeks and mean birth weight of the patients was 4.42㎏. Three cases of femoral fracture were all due to breech position while cesarean operartion and one of these cases were born were as ishiophagus. We found the distal femoral epiphyseal separation injury missed initially and diagnosed a kind of birth injuries through remarkable periosteal reaction. Conclusion : The birth injuries including clavicle fracture and brachial plexus injury are highly related to high birth weight at birth and the femur fractures are related to delivery maneuver in C-section and breech delivery. Strict observation and monitoring are required because occasionally the paralysis might be the sign of brachial plexus injury or pseudoparalysis due to fracture. By the adequate preterm care or preterm ultrasound check up, high weight delivery could be avoided and then the birth injury must be reduced.

고추 근권에서 분리한 Bacillus subtilis J-24의 검은 곰팡이병원균 Alternaria alternata에 대한 길항력 및 고추의 초기 생육에 미치는 영향

주길재,김학윤,허상선,우철주,이인구 경북대학교 농업과학기술연구소 1999 慶北大農學誌 Vol.17 No.-

Thirty bacteria were isolated from the red pepper rhizosphere. The isolates were screened for antagonism to Alternaria alteranta causing red pepper black rot. Antagonistic bacterium No. J-24 was selected among the isolated bacteria and was identified as Bacillus subtilis based on morphological and physiological characterisitics and MIDI system. B. subtilis J-24 showed antifungal activities against A.alternata(inhibition percentage, 99%), Botrytis cinerea, Phytophthora capsici, Pythium ultimum, Colletotrichum gloeosporioides, Stemphylium botrysum. The growth of red pepper seedling was promoted as compared to control when the microbial inoculants was mixed in bed soil. In the mixed microbial inoculants bed soil, the leaf area of red pepper was increased of 15 percent, the hypocotyl weight 12 percent, the root length 12 percent, total dry weight 13 percent as compared to those grown in the genenal bed soil.

심동적 영역의 평가에서 문항반응이론의 활용

김종택,고병구,김주학 師範大學 體育硏究所 1998 서울大學校 體育硏究所論集 Vol.19 No.2

The purpose of this study was to introduce item response theory(IRT) and to explore the possible applications to the measurement of psychomotor behavior. The primary assumption of IRT is an individual will respond to an item on a test can be described in terms of a probabilistic function that describes the probability of an examinee responding correctly to an item. By contrast with the classical test theory, the advantage of IRT is to be able to estimate examinee's true ability and the estimate does not depend on the other examinees or on the particular test administered. When the item response of an examinee is dichotomous, if the probability of an examinee responding correctly to an item would be dependent of the ability of the examinee and the difficulty of the item, Rasch Model or 1-parameter IRT model could be used for estimating the item parameters. But if the discriminant or guess factor would be considered, then 2-parameter of 3-parameter model could be used. However, when the item response is polytomous, polytomous response model such as Partial Credit Model, Rating Scale Model, Nominal Response Model can be used. Especially, Binomial Trial Model, Poisson Counts Model, and Inverse Binomial Model can be used for analyzing multiple-attempt, single-item skill tests of psychomotor domain. Through reviewing the literatures of IRT, item bank, computer adaptive testing, mastery test measurement of change, repeating skill test, and sequential test has been proposed as the possible applications for psychomotor domain. In conclusion, for more valid and reliable assessment in the pychomotor domain, IRT and the possible applications of IRT should be seriously considered in measurement research in physical education.

체육측정에서 신뢰 계수 추정모형에 관한 고찰

김주학 명지대학교 예체능연구소 2001 藝體能論集 Vol.12 No.-

The purpose of this study is to review structural equation model for estimating reliability in internal-consistency and test-retest methods. Models for estimating reliability in internal-consistency were explored models of Raycov(1997) and Miller(1995) . And models for estimating reliability in test-retest method were explored perfect simplex models, quasi-simplex models, multiple indicators simplex models, multiple indicators general models. Consequently, structural equation model for estimating reliability can be used to examine assumptions for estimating reliability within the content of classical test theory and to assess accurately the estimate of reliability.

남자 중ㆍ고등학생의 체력 발달에 관한 경향분석

김주학 서울대학교 체육연구소 2000 서울大學校 體育硏究所論集 Vol.21 No.2

The purpose of this study was to analyze the trend of physical fitness development of male students from the first grade of the middle school through the 3rd grade of the high school. The subjects of the study were 166,525 male students who were served as the subjects for the research, the Development the Norm of Korean Youth Physical Fitness Test conducted by the Ministry of Education in 1999. 50m dash, sit-ups, standing long jump, sit-and-reach, distance run, and push-ups were tested as physical fitness factors. The data were analyzed by using POLYNOMINAL which are the subprograms of SPSS/PC+. The results of the study were as the following; 1) Linear, quadratic and quartic trend were statistically significant in 50m dash. 2) Linear, quadratic cubic quartic and quintic trend were statistically significant in push-ups. 3) Linear, quadratic quartic and quintic trend were statistically significant in sit-ups. 4) Linear, quadratic quartic and quintic trend were statistically significant in standing long jump. 5) Linear, quadratic cubic quartic and quintic trend were statistically significant in sit-and-reach. 6) Linear, quadratic and trend were statistically significant in distance run.

구조방정식모형의 이해와 활용

김주학 師範大學 體育硏究所 1999 서울大學校 體育硏究所論集 Vol.20 No.1

Recently, methods of structural equation modeling are issued in physical education research. These methods merge the logic of confirmatory factor analysis, multiple regression and path analysis within a single data analytic framework. Structural equation modeling can be used to test whether a hypothesized causal structure is consistent or inconsistent with the data. Applications of structural equation modeling are still rare, but are rapidly increasing use in physical education. The purpose os this study was to provide guidance for substantive researchers on the use of structural equation modeling in practice for theory testing and development. Especially, this study show how the SAS system's PROC CALIS can be used the test causal models and follow a two-step approach recommended by Anderson and Gerbing(1998). With this approach, the first step involves using confirmatory factor analysis to develop an acceptable measurement model. Then the second step simultaneously estimate the measurement and structural submodels. Two-step modeling approach provides a basis for making meaning for inferences about theoretical constructs and their interrelations, as well as avoiding some specious inferences.

미국 연방관재관 제도의 도입논의에 대한 실무적 검토

김주학 법무부 2010 선진상사법률연구 Vol.- No.50

The most criticized feature of the US Bankruptcy Act of 1898 was the dual responsibilities of the bankruptcy judge, and the judicial judgment was inconsistent with the administrative supervision. Administrative functions usually involved contact with trustees, which was unavoidable by the administrative duties imposed upon the bankruptcy judge. Even if no impropriety existed, the administrative duties performed by the bankruptcy judge created the appearance of a bias in favor of the estate because private trustees had frequent contact with the judge. Besides, some kind of supervision over trustees in the private trustee system was felt to be needed. The United States Trustee Pilot Program began on October 1, 1979. Currently, the Program operates in 21 regions. The duties of the US Trustee include the establishment, maintenance, and supervision of a panel of private trustees to serve in Chapter 7 cases. The US Trustee monitors applications for compensation and reimbursement and files comments to the court regarding these applications. Plans filed in Chapters 11,12 and 13 cases are monitored as are disclosure statements in Chapter 11 cases. Creditors' committees in Chapter 11 cases are appointed and supervised by the US Trutee. The US Trustee prevents undesired delays in bankruptcy cases by monitoring the progress of cases and taking action whenever necessary. The US Trustee can also object to the confirmation of a plan in Chapter 11 cases. Korean Bankruptcy Law has begun to be affected by US law since 1998. DIP system in Chapter 11 was imported in 2005. Now the import of the US Trustee Program is under discussion. Its main function is to separate the administrative supervision from the judicial judgment in bankruptcy cases, and to give the administrative duties to the US Trustee. But there are alternative methods to solve the problem, which includes separating the genuine judicial judgment from the semi- judicial one and to forward it to a civil court. If the rule of business judgment is accepted, DIP will not undergo big hardships in managing bankrupt business even though the bankruptcy judge performs the administrative supervision. In addition, Korea does not have a large stock of bankruptcy professionals to administer a National Bankruptcy Trustee Program. Currently, Korea does not have the capacity of undertaking a National Trustee similar to the US. 미국에서는 도산절차에 관여하는 공권력을 사법과 행정으로 구분하여 사법적 역할은 법원에, 행정적 역할은 법무부장관이 임명하는 연방관재관(the US Trustee)에 나누어 맡긴다. 그 취지는 법관을 사법적 역할에 전념시켜 업무 부담을 덜어 주고, 법관이 사법적·행정적 역할을 동시에 담당함으로 말미암은 이해관계의 대립을 없애려는 데 있다. 최근 연방관재관 제도를 우리나라에 도입하자는 주장이 제기되고 있는데 이 제도를 도입할 필요가 있는지는 다음의 세 가지 측면에서 살펴볼 필요가 있다. 첫째, 헌법상 권력분립 원칙과의 관계이다. 이는 도산법원이 사법적․행정적 역할을 동시에 담당하면 이해관계의 대립을 가져오므로 행정적 역할은 독립한 행정조직에 맡겨야 한다는 논의이다. 우리 도산법 체계하에서도 사법적 판단과 행정적 감독이 충돌하는 면이 있는 것은 사실이다. 그러나 실체적 법률문제에 관한 분쟁은 일반법원에 그 판단을 맡기면 도산법원의 이중적 지위로 말미암은 문제점을 해결할 수 있으므로, 권력분립 원칙 때문에 굳이 연방관재관 제도를 도입할 필요는 없을 것이다. 둘째, 법원은 재판을 담당하는 기관이라는 점이다. 다시 말하면 도산절차는 거래실정에 맞게 역동적으로 진행하여야 하는데 법원이 행정적 감독을 맡으면 업무처리에 지장을 가져온다는 측면이다. 그렇지만, 절차가 원활하게 진행되느냐는 회생채무자(또는 관재인)가 도산기업을 경영하는 과정에서 내리는 경영판단(business judgment)이 존중되느냐에 달렸지 절차감독자가 누구이냐(법원이냐 연방관재관이냐)에 달린 문제는 아니다. 셋째, 연방관재관 제도를 운용할 전문인력의 부족이다. 미국에는 도산과 관련된 전문인력이 약 4만 명에 이르고, 일본도 사법시험 시절부터 도산법이 선택과목으로 채택되어 법조인력 가운데 도산법 이론과 실무에 정통한 인력이 적지 않다. 그러나 우리나라에는 도산법이나 도산실무를 전공한 인력이 매우 드물어 관재관 제도를 창설할 경우, 현실적으로 이 직책을 담당할 마땅한 인력을 구하기 어려울 것이다. 미국식 연방관재관 제도가 이론적으로 또 제도적으로 더욱 잘 정비된 제도임은 틀림없으나, 우리나라 실정에 그 도입은 시기상조인 면이 있다.

3on3 길거리 농구대회에 나타난 기업의 스폰서십 효과 연구

김주학,정연성 명지대학교 예체능연구소 2003 藝體能論集 Vol.14 No.-

According to the result of the sponsorship measurement, men show more fnendly feeling than women. This is because men are more Interested in sports than women. Therefore, the enterprise planning sports sponsorship participation will get greater effects in the male-aimed market. Lastly, through this study, the sports sponsorship is the means of advertisements and public relations, improves the enterprise image, and promotes the recognition of products. Considering the preceding research is deficient at present, the study on the sports sponsorship effects is necessary.

제 2형 당뇨병 환자에서 혈중 Metalliproteinase-9의 농도

김상용,김희중,주유철,최동현,배학연 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Purpose : Diabetic nephropathy is a serious complication of diabetes and accounts for much of its morbidity and mortality. It is well known that the overt clinical phase of diabetic nephropathy is preceded for many years by the presence of microalbuminuria. Microalbuminuria is thought to be a marker of widespread vascular damage and may underlie the propensity toward severe extrarenal vascular disease in microalbuminuric patients. Metalloproteinase-9 has a broad substrate specificity for native collagens as well as proteoglycan and elastin. One study reported that an increased plasma metalloproteinase-9 concentration precedes the development of microalbuminuria in type 2 diabetic patients. Another study reported that a high glucose concentration cause a abnormality on the activity of metalloproteinase by the mesangeal cell. The purpose of the present study was to examine whether palsma metalloproteinase-9 concentrations are altered at various complications in type 2 diabetic patients. Methods : Sixty patients with type 2 diabetes and thirty healthy control were recruited for the present study. No patient had any malignancy or history of heart disease, liver disease, collagen disease. We recorded age, duration of diabetes, and blood pressure. After an overnight fast, blood was drawn from an antecubita1 vein of measurement of glucose, metalloproteinase-9, HbA1C, and serum creatinine. To measure plasma concentration of metalloproteinase-9, a one step sandwich enzyme immunoassay using two monoclonal antibodies was used. Patients were divided into two group according to the presence or abscence of microalbuminuria. The groups were then compared with regard to clinical and laboratory characteristics and serum concentration of metalloproteinase-9. Results : The mean serum levels of metalloproteinase-9 in diabetic patients (62.32±25.83ng/㎖) were significantly higher than in healthy controls(12.92±4.97ng/㎖) (p<01). The mean serum levels of metalloproteinase-9 in diabetic patients with microalbuminuria(81.16±41.43ng/㎖) were significantly higher than in those with normoalbuminuria(31.48±7.34ng/㎖) (p<01) and much more than in healthy control(12.92±4.97ng/㎖) (p<05). Furthermore, the severity of nephropathy were closely associated with the serum metalloproteinase-9 level and the serum metalloproteinase-9 level was significantly correlated with microalbuminuria. The mean serum level of metalloproteinase-9 in diabetic patients with retinopathy(61.74±39.07ng/㎖) was significantly higher than in those with no retinopathy(34.98±9.02ng/㎖) (p<05). But, in diabetic patients with normoalbuminuria, there is no difference between the groups with retinopathy versus no retinopathy. Conclusion : In summary, a sustained increase in serum metalloproteinase-9 in patients with type 2 diabetes is associated with a high risk for the development of microalbuminuria. The results of this study suggest that the serum rnetalloproteinase-9 was a useful and noninvasive marker for the development of diabetic nephropathy. It could be also used to predict the development of diabetic complications and to assess therapeutics or the prognosis of diabetes. The usefulness of this model will be clarified by a larger scale and serial study.

住民의 價値觀과 政策受容度에 關한 硏究

金秉燦,金學守,李相魯,鄭正佶,金元主 경북대학교 교육대학원 1973 논문집 Vol.4 No.-

1. Introduction Governmental policies should receive strong support from the general public to be effectively implemented. Therefore to find some clue as to how public policies might receive nation-wide support is very important. As the research objective was to find some factors which effect degree of policy acceptability, we interviewed 1,179 persons(633 citizens of Tae-gu city and 546 persons from rural communities in Kyung-puk Province) from July 10 to August 20, 1973, by stratified sampling. Stratifying criteria were sex, age, financial assets and educational background. X^2 was used as a tool to test the hypotheses that there may be differences in values and degree of policy acceptance among persons of different strata and that there may be differences in degree of policy acceptance among persons who have different values. 2. General Tendency Forty percent of those interviewed choose the item "None" among the choices to the following question; Question; Which one do you choose, if you can choose only one of three? Answer; 1) Money or wealth 2) Power 3) Honour 4) None Let us call the persons who choose 1) "Money-oriented" and so "Power-oriented", "Honour-oriented". More persons interviewed preferred a self-restraining life to a hedonistic life, and egoistic, to altruistic. Egoists here means the persons who choose item 1, 2, 3, and altruists, 4 and 5 in the following question; Question; For whom do you think you live? Answer; 1) My-self 2) Children 3) Ancestor 4) Community 5) Nation or country More persons believed that the moral order of a society is more important than economic affluence. Almost seventy percent of the interviewed preferred that public policies be formulated for a better future life for the people than for immediate present well-being. Economic policies including those for increasing national income and increasing export were believed to be goood and effective in their implementation. However, taxes were regarded as too heavy. This shows that people rely much on the government for economic development on the one hand, but do not recognize their responsibilities to support those governmental efforts through taxes on the other. The Sae-Ma-Ul movement received as strong support as the economic policies and city development policies received sufficient support. But educational policies such as school expenses and ethics and moral education were denounced, as were the public health policies. 3. Differences among Strata ⑴ Region: people of rural communities regarded power and honour with more value than their urban counterparts, while urban people were more money-oriented. Rural people accepted tax policies more readily than did urban people, but they denounced the public health policies and educational policies mentioned above more severely than urban people. ⑵ Sex: men were more power and honour-oriented than women. Men preferred the moral order of scociety more than women, while women preferred economic affluence more than men. Export increasing policies, public health policies and school expense policies were accepted more readily by women. However, city development policies were accepted more readily by men. ⑶ Education: the more educated persons were more honour-oriented, emphasized the moral order of society and the better future life of the people more strongly than less educated persons. All these reflect the effects of moral education. However, from non-educated persons to high school graduates, the more educated the more money and power-oriented they were, while college graduates were far less money and power-oriented than middle or high school graduates. This points out the good effects of college education and some problems of middle and high school moral and ethics education. The more educated regarded the present compulsory educational system as more effective and school expences less expensive than the less educated. However, college graduate gave less support to the new school entrance system, while they gave the highest support to the Sae-Ma-Ul movement. ⑷ Age: the older persons emphasized the moral order of society more frequently and showed more political apathy than younger persons. They also accepted the public health policies more readily than the younger people. ⑸ Assets: the richer persons were more honour-oriented and regarded school expenses as less expensive than the poor persons. 4. Correlation between Values and Policy Acceptance ⑴ Money-oriented persons(who choose Money among given items of Money, Power, Honour and None) were much more egoistic (mentioned above in General Tendency) than the honour-oriented persons. ⑵ Honour-oriented persons accepted more readily than the money-oriented persons policies for increasing national income, reestablishing law, moral order and a better atmosphere of a society and the Sae-Ma-Ul movement (three of five policies analized in detail to test our hyphotheses about correlation between people's values and the degree of policy acceptance). Altruists supported policies for increasing national income and city development policies more strongly than the egoists. Therefore we assume that honour-oriented persons or altruists accept the public policies more readily than money-oriented persons or egoists.