SMAS 거상술 및 Malar Fat Pad의 수지박리를 이용한 안면거상술

강연웅,유원민,김지명,박병윤 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.5

정신장애인의 재활의 위한 사회기술훈련의 효과성에 관한 연구

황태연,손덕순,백형의,박종원,김지현,이경화 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.2

우리나라 4년제 대학졸업자의 직업교육훈련 성과분석 : 교육투자수익률 추정을 중심으로 With The Estimation for The Rate of Return to investment in Education

장창원,이지연 한국직업능력개발원 1999 직업능력개발연구 Vol.2 No.1

ABSTRACTThe purpose of this study was to provide the practical policy suggestions for the re-vitalization of vocational education and training at the higher level of education. For the purpose, data from ^P Earning Structure Basic Statistics Survey Reportj was re-analyzed with such variables as educational level, gender, individual who have or not a qualification, and the kinds of qualification. Jacob Mincer earnings function was used to explain and predict the differences between groups on the suggested variables by estimating the rate of return to investment in education.The empirical estimation of the rate of return to investment in education was concluded that adults with higher levels of education (Bachelor's degree : 15.8%) were more likely to have a high wages in the labor market than those with less education (High school graduate : 8.6%, Associate degree:11.7%). For the rate of return to investment by education level for those who have a qualification, 13.8 percent was shown to adults with a bachelor's degree, compared with 10.3 percent of persons with associate degree, and 7.4 percent of persons with high school graduate. In contrast, for those who have a non-qualification, 14.9 percent was shown to adults with a bachelor's degree compared with 10.7 percent of persons with associate degree, and 7.4 percent of persons with high school graduate.The rate of return to investment in education for adults who have a non-qualification with bachelor's degrees were 1.1 percent higher than the persons who have a qualification with similar levels of education. This results show the evidence that persons with lower levels of educational attainment were more likely to have a lower wages in the labor market than those who had a higher levels of educational attainment. Futhermore, persons who have a non-qualification with higher levels of educational attainment were more likely to have a higher wages in the labor market compared with persons who have a qualification with higher levels of educational attainment. This result revealed that acquirement of qualification is not important issue to judge the performance of the vocational education and training nor standard for employability for entering labor market. Statistics on educational attainment of the entire population show that graduation from university is not simply an academic honour. Educational attainment reflects admission to a particular position in society and influences even job opportunities. His or her own employability by acquirement of qualification does not value in our society. Most business and industry differentiate between those jobs which require a university degree, regardless of qualifications or skills, and those that do not. Regardless of his or her ability, social status as determined by university graduation, has become more important than employability.For making a change from the degree-oriented toward person's ability-oriented valued society, vocational education and training at the higher level of education must emphasis in a new direction. Followings are the summary policy suggestions for the re-vitalizing vocational education and training at the university, where is the place for development of workforce and for preparing world of work.1) Most Korean youth want to go to four-year university after high school. The percentage of high school graduates who indicated plans to enter a four-year university increased to "get a better job" and "make more money". However, a large percentage of graduates from four year universities have a significant problem finding employment. Higher level of education must play a important role to make students as a employable person during their 4 year of campus life. Thus, vocational education and training must emphasis at the university level with changing curriculum structure.2) Curriculum at the higher level of education of the 21century may focus more on helping students transferable workplace competencies and advanced work-related technology in a variety method rather than a simple theoritical knowledge delivery in one way communication teaching structure.3) Changes in qualification system may emphasis more on workplace readiness and assessment process with collaborative partnership with business/industry and university.4) Much attention must directed to the role and responsibility of 4-year university in creating and disseminating the practical and advanced knowledge and technology for those who can meaningful transfer university to work beyond Bachelor's degree only.

자살 시도에 영향을 미치는 정신사회적 요인

허지원,최광연,이분희,심세훈,양종철,김용구 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objectives : A lots of studies have investigated the psychosocial characteristics of suicidal attempters in order to find eff-cient coping strategy and treatment intervention. The purpose of this study was to examine the psychosocial factors affecting the suicide attempt in psychiatric patients. Methods : Two hundred eighty patients who attempted suicide and admitted in the emergency room in 3 university hospitals from December 2003 to May 2006 were recruited in this study. The patients were interviewed using Structured Clinical Inter-view for DSM-IV Axis I disorder (SCID-RV), Lethality of Suicide Attempt Ratings Scale (LSARS) and Risk-Rescue Rating system (RRR). Results : The suicide attempters have psychosocial characteristics of female preponderance, age 20-39, high school in educational level, married in marriage condition, inoccupation, house makers in occupation. Most of attempters used the non-severe methods such as drug ingestion or wrist cutting, and selected home as the place of attempt. The delay until discovery was less than 4 hours for most suicide attempters, and the rate of asking for help directly or dropping clues were high. Major depressive disorder was the most common psychiatric illness among attempters. Conclusions : The present study would be the early stage to explore the risk factor and protect factor of suicidal attempt. This study suggests that the closed observation to potential-suicidal attempter in daily life is critical to protect against the fatal results due to suicidal attempts.

다중주파수·다중성분 고막운동도에 관한 연구

소원섭,이지연,강희라,손원진,허승덕 대구대학교 특수교육재활과학연구소 2012 再活科學硏究 Vol.30 No.1

이 연구는 이학적·청각학적 정상 소견을 가진 성인들의 다중주파수 고막운동도(multi-frequency tympanogram, MFT)와 다중성분 고막운동도(multi-component tympanogram, MCT)의 특성을 알아보고자 하였다. 연구 참여자는 D대학교 재학 중인 19명(M:F=9:10, 만 19∼23세)으로 하였다. MCT는 각 성분(admittance; Y, susceptance; B, conductance; G)별 정점의 수를 확인하였고, MFT는 200 ㎐부터 2 ㎑ 순음에 대한 고막 긴장 및 이완상태에서 전도율을 통해 공명주파수와 ΔB, Δ∅를 각각 구하였다. MCT는 668 ㎐ 자극에 대해 47.4 %가 1Y1B1G를, 52.6 %가1Y3B1G를 보였고, MFT의 공명주파수는 829~1,213(1,021±192) ㎐, ΔB와 Δ∅의 평균은 각각 –0.18, -19.3으로 관 찰되었다. This study will be to confirm the characteristic of Multi-component tympanogram(MCT) and Multi-frequency tympanogram(MFT) of adults who have physical and audiological normal findings. Participants were 19 students(M:F = 9:10) who are attending D-university. MCT checked the number of peaks per each component(admittance; Y, susceptance; B, conductance; G) and MFT got the resonance frequency through the conductivity rate of tympanic membrane's tense and relaxation state, and ΔB, Δ∅ respectively. 47.4% of MCT showed 1Y1B1G about 668 ㎐ stimulus and 52.6% of that showed 1Y3B1G. Resonance frequency of MFT was 829~1,213(1,021±192) ㎐, and the average of ΔB and Δ∅ was observed -0.18, -19.3 respectively.

신체화장애 환자의 스트레스 대처방식 및 심리적 특성

이주연,이무석,윤진상,양종철,문지웅,정해원,은성종 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : The purpose of this study was to investigate the stress coping strategies and psychological charactehstics, such as combined psychopathology and tendency of symptom interpretation, in patients with somatization disorder. Methods : Thirty patients meeting the criteria of DSM-IV somatization disorder were compared with thirty controls. We evaluated the subjects using Symptom Checklist-90-Revised (SCL-90-R), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and The Ways of Stress Coping Questionnaire (SCQ). Independent t-test and Pearson correlation analysis were used. Results : From the results of SCL-90-R subscales, the scores of somatization, obsession-compulsion, depression, anxiety, and psychoticism were significantly higher in patients with somatization disorder than nonnal controls. Somatization disorder patients had greater amplification of physical sensation in SSAS and significantly higher score in physical interpretation of SIQ compared with psychological or environmental interpretation, In the SCQ of somatization disorder patients, we observed generallylower levels of total coping scores than the control group and significant positive correlation between passive coping style of SCQ and psychological interpretation of SIQ. Conclusion : These results show that patients with somatization disorder have various psychopathology, greater amplification of physical sensation, physical interpretation tendency of symptoms, and insufficient copying strategy.

신경회로망을 이용한 이면비드 폭 예측에 관한 연구

정재원,김일수,박창언,김학형,서주환,김인주,심지연 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

The development of robotic welding process is a very complex assignment because the system is affected by a number of process parameters which are very difficult to determine or predict in practice. The full automation welding has not yet been achieved partly because the mathematical model for the process parameters of a given welding task is not fully understood and quantified. Several mathematical models to control welding quality, Productivity, micro structure and weld properties in arc welding processed have been studied. However, it is not an easy task to apply them to the various practical situations because the relationship between the process parameters and the bead geometry is non-linear and also they are usually dependent on specific experimental result. Practically, it is difficult, but important to know how to establish a mathematical model that can predict the result of the actual welding process and how to select the optimum welding condition under a certain constraint. In this paper, an attempt has been made to develop an neural network model to predict the back-bead width as a function of key process parameters in the GMA (Gas Metal Arc) welding and to compare the developed models with the experimental results

연속회분식 반응기를 이용한 축산 폐수의 생물학적 고도 처리 운전 인자 도출에 관한 연구

김창원,최명원,이해군,이해일,하지연 부산대학교 환경문제연구소 1998 環境硏究報 Vol.16 No.-

축산폐수는 고농도의 유기탄소 뿐만아니라 영양염류를 포함하는 대표적인 고농도 폐수이며 적절히 처리되어지지 못할 경우 심각한 담수의 부영양화와 연안의 적조를 야기할 수 있다. 이러한 축산폐수를 보다 경제적이며 기술적으로 처리하기 위해 본 연구에서는 연속회분식반응기(SBR)을 이용한 축산폐수의 고도처리에 적용할 수 있는 운전인자와 운전기법을 연구하였다. 초기 암모니아와 유기탄소부하를 달리하며 정해진 주기로 운전하는 네 가지 전형적인 회분식 실험과 원수를 연속으로 주입하면서 간헐 폭기로 운전하는 세 가지의 변형회분식 반응 실험을 통하여 전형적인 SBR에서 비 질산화 속도에 가장 많은 영향을 미치는 인자가 초기 pH 와 유리 암모니움 농도이며 최적 초기 암포니아성 비 질소 부하율은 0.1 ~ 0.15 kg NH_4^+-N /kg VSS 근처이며 이때 비 질산화율은 0.06 kgNH_4-N/ kg MLVSS·day로 관찰되었으며, 변형 SBR로 운전하는 경우 최소 35%에서 최대 65% 까지 탈질용 외부기질 주입량을 절감할 수 있었다. Piggery wastewater is a representative of high strength wastewater which contents not only high concentration organic carbon but also nutrients. From this reason piggery wastewater could be cause a serious eutrophication of fresh water and red tide in coastal areas if not properly treated. In this study to treat these piggery wastewater technically and more economically, the operation parameters and methods for advanced treatment using Sequencing Batch Reactor (SBR) were investigated. Four sets of experiments were conducted on laboratory scale typical SBR (Fill in a time) with fixed cycle and different till ratio to evaluate most proper initial loading of organic carbon and nitrogen and three sets of experiments on laboratory scale inodified SBR (Fill continuously) with intermittent aeration. As results the nitrification rate was most sensitively affected by intial pH and free ammonia concentration and in typical SBR operation most profit initial specific nitrogen loading were investigate around 0.1~0.15kg NH_4^+-N /kg VSS and in this range the average specific nitrification rate was 0.06 kg NH_4-N/ kg MLVSS·day. And in modified SBR operation with most profit specific nitrogen loading rate the cost of external denitrification cost were saved minimum 35% to maximum 65% each experimental sets.

항결핵 6개월 단기요법의 성과 고찰

서지원,정연채,김남재,홍석철,김주옥,김선영,노흥규 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

To evaluate the effect of 6-month short term antituberculosis chemotherapy with INH, Rifampin, Ethambutol, and Pyrazinamide(2HREZ/4HRE) in the patients with pulmonary and/or extrapulmonary tuberculosis, the authors prescribed 2HREZ/4HRE regimen in 79 tuberculosis patients for 6 months with measuring the sputum staining for AFB, chest X-ray findings, recurrence rates and possible side reactions of the treatment. The result were as follow; 1. Pulmonary Tuberculosis 1) Among the 56 pulmonary tuberculosis patients who had taken 2HREZ/4HRE regimen. 32 patients showed initial positivity in sputum AFB smear stain(57.2%). Negative conversion occurred usually within 2 months after initiation of chemotherapy and the mean period of negative conversion was 1.4 months. 2) Among the 56 pulmonary tuberculosis patients, chest X-ray finding changed in 41 patients (37.21%). From these 41 patients 39 patients showed continuous improvements in chest X-ray finding, though 3 patients showed initial aggravation in spite of continuous medication. The remainder 2 cases aggravated due to the failure of treatment. 3) Treatment failure occurred in 2 patients (3.57%) during the chemotherapy among 56 patients of pulmonary tuberculosis and they were infected with secondary drug-resistant strains of M. tuberculosis. 2. Extrapulmonary tuberculosis. Among 8 patients with tuberculous pleurisy and 15 patients with superficial tuberculous lymphadenitis, there were no evidence of treatment failure after completion of antituberculosis chemotherapy for 6 months with 2HREZ/4HRE regimen. 3. Follow-up study was performed from 6 months to 50 months after completion of antituberculosis chemotherapy and the relapse was not noted in both pulmonary and extrapulmonary tuberculosis patients group during this period. 4. Serum AST/ALT elevated in 9 patients(11.4%) during the treatment and this occurred usually within 3 months after the initiation of antituberculosis chemotherapy. However treatment interruption occurred in 2 patients (2.5%) due to the development of hepatitisone due to drug-induced hapatitis and the other due to type B viral hepatitis. In conclusion, we could find this 2HREZ/4HRE 6-months short-term antituberculosis regimen is effective and could be recommanded as a promising regimen for the treatment of tuberculosis.

전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향

김지윤,이동원,서일숙,김세연 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

복와위는 신체 후부 노출이 필요한 척추 수술을 위해 주로 사용되고 있으며 수술부위로의 접근이 용이하고 수술 도중에 척추를 안정적으로 유지해주는 장점이 있다. 하지만 전신마취하에 있는 환자를 양와위에서 복와위로의 전환은 여러 가지 부작용을 동반하며 특히 순환기계의 변화를 초래할 수 있다. 이를 줄이기 위해 다양한 복와위 전용 수술대들이 연구 개발되어 임상에 사용되고 있다. 이에 저자들은 양와위에서 복와위로의 체위 변환 시에 Jackson spinal surgery table의 이용이 체위에 의한 압박 때문에 생기는 환자의 순환기계 변화를 얼마나 효과적으로 줄여줄 수 있는지 알아보고자 하였다. 본 연구는 추간판탈출증, 퇴행성척추전방전위증, 척추협착증의 진단 하에 본원 정형외과와 신경외과에서 수술을 받기로 예정된 환자 중 미국 마취과학회 신체등급 분류 1급 또는 2급에 해당하는 성인 환자 30명을 대상으로 하였다. 연구 대상 환자의 성별은 남자가 15명, 여자가 15명이었고, 심혈관계나 호흡기계 질환이 있는 환자는 연구 대상에서 제외되었다. 모든 환자는 마취전투약으로 수술 시작 1시간 전에 glycopyrrolate 0.2 mg, fentanyl 1 μg/kg을 근주하였으며 수술실에 도착한 후 비침습적 자동 혈압 측정기, 심전도 및 맥박산소 계측기를 거치하였다. Thiopental sodium과 vecuronium으로 마취를 유도하였으며 환자의 의식소실과 충분한 근이완을 확인한 후 기관내 삽관을 시행하였다. Enflurane 1.5-2.0 vol%와 O₂N₂O 각각 2 L/min을 사용하여 마취유지를 하였으며 급격한 활력 징후의 변동으로 마취유지가 용의치 않은 경우는 연구 대상에서 제외시켰다. 환자의 활력 징후 안정 후 요골 동맥에 카테터를 거치하여 지속적으로 동맥압을 측정하였고, 우측 쇄골하 정맥에 중심정맥 카테터를 거치하여 중심정맥압을 측정하였다. 부분 재호흡 심박출량 감시기 (NICO^(ⓡ), Novametrix Medical Systems INC., USA)를 통해 비침습적으로 환자의 심박출량을 측정하였다. 양와위에서 복와위로 체위변경 직전에 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 양와위의 값으로 삼았으며, 척추 수술 전용 수술대인 Jackson spinal surgery table을 사용하여 복와위를 취하였다. 복와위로 체위 변경 뒤 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 복와위의 값으로 기록하였다. 본 연구 결과 양와위와 복와위의 혈역학적 지수의 비교시 심박수와 평균동맥압은 별다른 차이가 없었다. 중심정맥압은 유의한 정도는 아니지만 감소 소견을 보여 수술시 출혈의 위험성을 감소시킬 것으로 생각된다. 심박출량과 심박출 계수도 유의한 감소 소견을 보였으나 convex saddle table을 이용한 경우와 knee-chest position을 취한 경우보다 적은 변화를 보여 Jackson spinal surgery table의 사용은 유용할 것으로 사료된다. 그러나 Jackson spinal surgery table을 사용하여 복부와 흉부에 과도한 압력이 가해지지 않더라도 유의한 심박출량 감소가 있을 수 있음을 유념해야 할 것이다. 특히 심폐여력이 부족한 환자들에 있어서는 심박출량의 감소는 위험한 결과를 초래할 수 있으므로 복와위에 의한 생리적 변화에 관한 충분한 이해와 함께 마취 시 보다 적극적인 감시와 관리가 요구된다고 여겨진다. Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by NICO^(ⓡ). We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.