두피에 발생한 혈관 육종 증례 보고 2례

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: Angiosarcoma of the scalp is rare vascular tumor originating from endothelial cell. The prognosis is very poor with high propensity of local recurrence and distant metastasis. The author reports experiences with the latissimus dorsi free flap in the reconstruction of soft tissue defect of scalp caused by excision of angiosarcoma. Methods: Two patients visited the hospital with 9x10cm, 8x11cm sized lesion on scalp. Distinguishing features were frequent occurrence of a peripheral erythematous ring, satellite nodules, intratumoral hemorrhage, and the tendency to bleed spontaneously. Both lesions in each patient had developed and increased in size for 5 months and for 3 months, respectively. Results: Two patients were diagnosed as an angiosarcoma. Prior to the operations, the patients had evaluations preoperatively including brain CT, brain MRI and whole-body PET-CT. There were no evidence of metastasis. We performed wide excision and reconstruction by latissimus dorsi musculocutaneous free flap with split thickness skin graft on both cases. In case 2, radiation therapy was done within 1 month of tumor excision. Multiple distant metastasis occurred in case 1. Conclusion: Angiosarcoma is a highly malignant tumor with poor prognosis. Treatment and reconstruction method was not yet established. Reconstruction methods include free flap, split thickness skin graft, local flap. We performed latissimus dorsi musculocutaneous free flap as reconstruction method. This method has advantages that have sufficient blood supply and bulk that offer durability to radiation therapy. However, it has a disadvantage in detection of local recurrences. And it has high potency than other reconstruction method for distant metastasis due to sufficient blood supply. Further discussion between doctor and patient is needed for the best possible selection of treatment.

액취증에서 투메슨트와 최소절개를 통한 피하조직 절제술의 치료 효과

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Purpose: Axillary osmidrosis is a condition of abnormal unpleasant body odor caused mostly by apocrine gland secretion. Surgical excision of the subcutaneous tissue has been the treatment of choice for several decade. However, there are risks for complications including wound necrosis, hematoma, seroma, obvious scars following surgical treatment. We report our method of treatment of subdermal excision with small skin incision under local anesthesia with tumescent infiltration. Methods: From December 2008 to August 2010, 33 consecutive patients underwent subdermal excision with small transverse incision under tumescent anesthesia for axillary osmidrosis. The average age of the patients was 22 years (range, 13 to 62 years) and the average follow-up period was 7.6 months (range, 3 to 22 months). Result: Through a questionnaire that was answered by 33 patients, 97% reported satisfactory reduction of malodor. Complication included small hematoma (1.5%) and superficial epidermal necrosis (1.5%) which healed spontaneously. According to the postoperative histologic examination, only a few remnant of apocrine and eccrine glands were found. Conclusion: The subdermal excision with small incision using tumescent anesthesia for axillary osmidrosis decreases the bleeding during procedure and enables removal of sweat glands easily under direct vision. Therefore this operation has the advantages such as a high success rate, rapid recovery and a low complication and recurrence rate.

위볼기 동맥 천공지 프로팰러 피판을 이용한 천골부 욕창의 재건

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Purpose : Superior gluteal artery perforator(SGAP) flaps are surgical options in pressure sore reconstruction. There are several advantages in reliability, preservation of muscle, versatility in flap design, and low donor site morbidity. An anatomical study was carried out to improve the flap's effective value. SGAP propeller flap can be successfully used in sacral pressure sore reconstruction. so we report this clinical experiences with review of the literatures Methods : 5 cadaver were dissected to investigate localization, distribution of the perforators and to measure thickness of subcutaneous tissue on gluteal region. and SGAP propeller flaps were performed in 3 patients with sacral pressure sore. The fasciocutaneous flap based on the SGAP was designed in elliptical shaped pattern from sacral region toward the inferolateral aspect of buttock and was elevated from adjacent tissue. The flaps rotated 120~180 degree to cover sacral defect. Donor defect was repaired primarily. Results : Several perforators were found under the SGAP propeller flap area. Its mean number was 3. The thickness of elevated flap were 2.02cm in medial side and 4.49cm in lateral side. The patients' mean age was 52.3 and the average follow up period was 9 months. No serious complications such as flap necrosis or infection occurred except 1 hematoma in postoperative day 3. No functional disturbances in walking were observed. The long term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusion : The anatomical study suggests that the SGAP flap as propeller type is possible in its enough volume and perforators' location. The SGAP propeller flap may be a reliable method in sacral sore reconstruction especially in patients who expected ability in walking after rehabilitation

비골골절 정복술 후 복합 환기실리콘부목과 바세린 거즈를 이용한 비강충전

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: The majority of nasal bone fractures have been managed by closed reduction and intranasal packing. Various packing methods have been used for maintaining stability of nasal bone and reducing patient's discomfort. In this study we compare previous procedure with only vaseline gauze and nasal packing with airway silicone splint and vaseline gauze after closed reduction of nasal bone fracture. Methods: We performed a prospective study with 60 patient treated nasal bone fracture from Dec. 2009 to Oct. 2010. Sixty patients were divided into vaseline gauze packing group and airway silicone splint and vaseline gauze packing group. Airway silicone splint (Doley Combo Splint®) consists of silicone sheet, hemicircular airway tube and Rhinocell®. We evaluated the patients' discomfort such as nasal obstruction through questioning survey and recorded packing periods and accidental packing material removal. Results: Nasal obstruction, dry mouth, swallowing difficulty and headache associated with intranasal packing were significantly improved among the patients who underwent packing with airway silicone splint and vaseline gauze. And packing period of airway silicone splint packing group was longer than other group Conclusion: Intranasal packing with airway silicone splint and vaseline gauze can be a useful method for reducing patients' discomfort associated with nasal obstruction. And this method can be used in the others surgery such as septoplasty and corrective rhinoplasty

朝鮮時代 地方都市의 空間構造에 關한 硏究 : 尙州, 慶州, 大邱를 中心으로

예명해,足立裕司,신상화 대구대학교 과학기술연구소 1998 科學技術硏究 Vol.5 No.3

The objective of this research is to clarify the regional structure of the cities of the Chosun Dynasty and the principles of their formation. A comparative study of three cities, namely Sangju. Kyoungju and Taegu has been carried out. The results of the investigation are as follows. 1) Although the formation of the cities of Sangju, Kyoungju and Taegu took place before the occurance of Feng-shui, it is clear that the adoption of Feng-shui and techniques complimentary to the natural topography were highly regarded in the Chosun Dynasty. 2) The political ideas at the time, based on the strict principles and ranking-order of Confucianism also influenced the process of formation; seen particularly well in the structure of the GAMYOUNG. In addition, sacrificial facilities, being an expression of confucianism, were newly established outside these castle cities.

흙의 다짐에 있어서 最大乾燥密度와 最適含水比의 推定에 對하여

姜乂默,趙成燮,金在英 충남대학교 농업과학연구소 1976 農業技術硏究報告 Vol.3 No.2

In order to obtain the prediction of the maximum dry density and the optimum moisture content of soil without soil moisture test, compaction test results from 157 different places either under construction or already completed were analyzed. The analyzed results were as follow The relationship between the maximum dry density and the optimum moisture content of the soil showing a correlation coefficient of 0.96 indicated that there was a high correlation between them. From the above relationship we obtained the equation. ◁그림 삽입▷ (원문을 참조하세요) Equation between the optimum moisture content and the maximum wet density of the soil was ◁그림 삽입▷(원문을 참조하세요), and the values of the optimum moisture content being predicted with the maximum wet density of the soil showed a little difference between those and tested values. The values of the maximum dry density being predicted with the moisture content estimated by the maximum wet density of the soil were within the range of ±5% of its tested values. The relationship between the dry density and the void ratio showed a high correlation between them (γ=0.9706). From the above relationship, we obtained the equation, ◁그림 삽입▷(원문을 참조하세요)

지나이다 기피우수의 페테르부르그 일기에서 본 작가의 형상

한예경 대구대학교 인문과학 예술문화연구소 2000 人文科學硏究 Vol.21 No.-

Петербургские Дневники-это в лервуЮ очередь документ эпохи, соде ржаЮщий собЫтийно-Фактический материал. Анализ дневникого текста Зинаиды「иппиус услоЖнеется недосткоам контеста. Далеко не всё, создан ное поэттессов издано в России. Отсутствует собраниие соуиниениий з. Г., не собраны вместе многоуислнные отзывы о ней её современников. Так Же односторонне оценивались и идеологические взгляды поэтессы, ук ладываюшиеся в простую Формулу, звучащую прблизительно так: "Мадонна серебряного века" очернила Россию и русскую кул4ьтуру." Её образ пред ствлялся двойственным: с одной строны, "изысканная эстетка", с друго й-" злобная пасквилянтка." Нтак, даЖе беглый экскурс в область худо Жественного творчества 「иппиус позволяет внести определённые коррек тивы в слоЖившийся в сознании читателя чсойчивнй образ. Обращение кЖанру дневника не было случайиым в творчестве 「иппиус. На протяЖении своего долгого творчекого лути поэтесса неоднократно обращалась кмемуарным Жанрам. То Же чувство ответственности перед потомками, стр емление довести до них правду в"страшные годы России"(А. Блок) и по будило З. 「. запечтлеть "эти годы" в форме литературного дневника. Следуег заметить, что в характернстнке Петербургских дневников. В записах большое место занимает фиксация общественно-политических со бытий. В Петербургских дневниках представлены записи, которые вела З. 「. в период с 1914 по 1919 годы. Петербргские дневники предста вят собой ценный исторко-литературиый документ эпохи. Характерной че ртой образа автора в дневниках является стремление к обьективности изложения. Одной из оснобеных личностных характеристнк З. 「. считал ась субективность. Однако , несмотря на повышенную эмоциональнось ха рактера, З. 「. постоянно стремится сдерживать себя, пытаясь обуздать свой субьективизм. В то же время именно интеллектуальность З 「.яв ляется тем сдерживающим фактором, который вводит в рамки корректности её сильные эмоции. З. 「. сознвала уникальнть историческго момен та и хотела докумнтально сохранить кусок уходящей россии. ЧУВСТВУеТ СВОЮ ответственностЬ художника перед эпохой. Образ автора в Петербур гских дневниках далёк от образа "декадентской мадонны." Перед читаел ям предстает совсем другое лицо - лицо умного, и серЬёзного мыслител я, сильной личности, нашедщей в себе мужество статъ летописецем траг ической зпохи и честно рассказать в времени и о себе. И З. Г. всегда была верна зтому завету. Она могла упрекнуть себя во многом, но в од ном никогда! Она всегда оставалась честной перед собой и своим врем енем. Зто совсем немало для летописеца, роль которого взяла на себя " декадентская мадонна."

지방자치단체 공무원 교육훈련 전이에 영향을 미치는 요인에 관한 실증적 조사

강여진,최호진 서울대학교 행정대학원 2003 行政論叢 Vol.41 No.2

본 연구에서는 교육훈련 전이에 영향을 미치는 제 요인들을 국내·외 선행연구의 문헌검토를 통해 도출하여 지방자치단체의 공무원들을 대상으로 실증적으로 규명하였다. 선행연구 검토 결과 본 연구에서는 교육훈련 전이에 영향을 미치는 제 요인들로 크게 두 가지 요인, 즉 교육훈련 프로그램의 설계요인으로서 강사의 자질, 교육내용, 피훈련자의 개인적 특성(학습동기, 성취욕구, 자기유능감)과 조직적 환경요인으로 상사 및 동료의 지원, 지속적 학습문화로 설정한 뒤, 설문조사를 실시하였고 조사결과를 요인분석과 회귀분석을 통해 분석하였다. 분석결과, 교육훈련 프로그램의 설계요인과 조직적 환경요인이 공무원 교육훈련 전이에 대해 통계적으로 유의미한 긍정적인 영향을 미친다는 결론을 얻었다. The purpose of this study were to find the relationship between training components and training transfer, and to analyze the effects of the training program components and the organizational support on the training transfer. First, training program components made trainer’s teaching ability, training contents, and trainee’s personal characteristics(motivation to learn, need for achievement, and self-efficacy) that were supposed to affect the training transfer were chosen by the literature review. Second, organizational support made superior’s support, peer’s support, and continuous learning culture. Also, this study examines the four hypotheses based on the literature reviews by way of conducting questionnaire surveys to the sample of about 702 local government’s civil servants. The result from empirical tests showed that training components were correlated to the training transfer positively. Specially, the higher superior’s support, peer’s support, training contents, trainee’s motivation to learn, and continuous learning culture were related. Trainer’s teaching ability, trainee’s self-efficacy, and trainee’s need for achievement were accepted partially.

製造物 責任 訴訟과 立證責任

金麗會 대구효성가톨릭대학교 1997 연구논문집 Vol.54 No.1

In recent years, as the production, sale and consumption of the goods becomes large quantity, the products liability come to serious day by day. The products liability pay for damage that some goods with a defect come to a consumer or a third in a production and flowing. A principle of law on the products liability come into being in the Anglo-American law, is discussed actively in Germany, Japan and France, tend to legislation in these days. If we compose legaly the liability of the producers who produce goods with a defect, we clear up that is the contact liability or that is the tort liability? We have difficult as interpretation of the contemporary civi law, i-e, the contact liability and the tort one. It is reality that we are returned to products liability as a amendment of the proof law. It is right that we will make a peculiar law to solve difficult of a principle of law on the products liability.

채종박에 대한 extrusion처리 및 formaldehyde처리가 젖소의 반추위내 in situ 분해율에 미치는 영향

문여황 진주산업대학교 농업기술연구소 1998 農業技術硏究所報 Vol.11 No.-

채종박에 대한 extrusion처리의 적정온도를 규명하기 위하여 반추위 누관이 장착된 Holstein젖소 4두를 이용하여 in situ시험을 수행하였다. 시험구는 무처리, 110, 135 및 150℃ extrusioncc처리구, 그리고 0.3% formaldehyde처리구로서 총 5처리를 두어 반추위내에서 0, 3, 6, 9, 12 및 24시간동안 발효시켰다. 공시동물은 NRC(1988)요구량의 110%수준에서 농후사료와 조사료를 각가 50%씩 급여하였고, 물과 린칼블록은 자유섭취토록하였다. 시험사료 중 조단백질의 반추위내 분해특성에 대한 비선형회귀방정식과 유효분해도(ED)의 결과는 다음과 같이 유도되었다. 무처리구 : P = 61.63 + 34.01(1-e^-0.075) ED(k=0.05) = 82.04% 110℃ extrusion : P = 34.56 + 54.81(1-e^-0.049t) ; ED(k=0.05) = 61.69% 135℃ extrusion : P = 35.23 + 41.19(1-e^-0.076t) ; ED(k=0.05) = 60.07% 150℃ extrusion : P = 29.53 + 60.67(1-e^-0.034t) ; ED(k=0.05) = 54.09% 0.3% HCHO : P = 15.17 + 67.27(1-e^0.046t) : ED(k=0.05) = 52.94% 단, P = 반추위내 발효시간(t)동안 소실율, k = 사료의 통과속도(%/시간/100). 건물, 조단백질, 유기물 및 에너지의 반추위내 분해율은 처리에 의해 유의적으로 감소되었으며, formaldehyde처리구에서 가장 낮았고, extrusion 처리온도에 따라서는 온도가 증가함에 따라 각 영양소의 분해율은 감소되었다. 조단백질의 경우, 150℃에서 extrusion처리시 반추위내 분해율과 서서히 분해되는 부분(b)이 formaldehyde처리구와 비슷한 수준이었으며, 시간당 분해상수(c)는 처리구중 가장 낮았다. Four ruminally cannulated Holstein cows were employed to verify the effect of temperature in extrusion processing on ruminal degradation characteristics of rapeseed meal. Treatments were composed of rapeseed meals untreated(Control), extruded at 110, 135 and 150℃, and treated with 0.3% formaldehyde(HCHO). In situ trials were scheduled to 0, 3, 6, 9, 12 and 24 hours of suspension time in the rumen. Animals fed the diet of 50 : 50 in concentrated and roughage(orchard grass hay) at 110% of NRC(1988) requirement, and were ad libitum access to water and mineral block. Non-linear regression equations for degradation characteristics and effective degradability(ED) of crude protein in the rumen were obtained as follows. Control P = 61.63+34.01(1-e^-0.075t) ; ED(k=0.05) = 82.04% 110℃ extrusion P = 34.56 + 54.81(1-e^-0.049t) ; ED(k=0.05) = 61.69% 135℃ extrusion P = 35.23 + 41.19(1-e^-0.076t) ; ED(k=0.05) = 60.07% 150℃ extrusion P = 29.53 + 60.67(1-e^-0.034t) ; ED(k=0.05) = 54.09% 0.3% HCHO P = 15.17 + 67.27(1-e^0.046t) : ED(k=0.05) = 52.94% where, P = Degradability during the time(t) suspended in the rumen, k = Passage rate(%/hr/100). Ruminal degradabilities of dry matter, crude protein, organic matter and energy significantly decreased by extrusion or HCHO treatments, and were lowest for the HCHO treatment. Increasing the temperature of extrusion processing resulted a decrease in the ruminal degradabilities of nutrients. The rapeseed meal extruded at 135℃ was similar to the 0.3% HCHO treatment in degradation characteristic of crude protein, and was slowest in degradation rate per hour of nutrient in the rumen.