대장직장종양에 있어서 Hand-Assisted Laparoscopic Surgery (HALS)의 초기 경험

조호영,최선근,구지회,허윤석,이건영,김세중,조영업,안승익,홍기천,신석환,김경래,우제홍 대한내시경복강경외과학회 2003 대한내시경복강경외과학회지 Vol.6 No.-

자발성 심막기종 1례

안지영,이상래,안성훈,류석용,김홍용 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Pneumopericardium, as a form of barotrauma, refers to the presence of air within the pericardial sac. The causes of pneumopericardium are various, Clinically, pneumopericardium is typically present with dyspnea and precordial chest pain. On physical examination, heart sounds are usually distant, and precordial tympany may be elicited. The diagnosis can be made by clinical and radiographic findings. Management of pneumopericardium depends on many factors, such as the age of the patient, the suspected causes, and the extent of clinically observed respiratory compromise. The case shown here, a patient who developed pneumopericardium, involved an associated underlying pulmonary parenchymal process as the cause of pneumopericardium.

朱子ㆍ陽明ㆍ象山의 格物致知說

안영석 새한철학회 2000 哲學論叢 Vol.21 No.-

『대학』의 格物致知에 대해 주자가 '格物補傳'을 써서 그의 견해를 피력한 이후, 유학계 에서는 이와 관련하여 다양한 견해와 의문들이 제기되었다. 특히 양명은 주자의「大學章句』의 타당성을 부정하고 이와 성격을 전혀 달리하는 그의 격물치지설을 제출하였다. 또한 그는 南宋心學의 대표자인 상산의 격물설에 대해서도 비판하며 그 한계를 지적하였다. 본 논문은 상산의 격물설이 같은 심학계통인 양명에게 왜 수용될 수 없었는지 그리고 상산의 격물설의 특징과 한계가 무엇인지를 해명하기 위해, 주자·양명·상산의 격물설의 내용과 특징을 해명하고 비교하는 방법을 취하였다. 먼저 주자의 격물설은 첫째로 心 밖의 物의 理를 궁구하는 향외궁리적 이론이며, 둘째로 認識心의 식별지가 주가 되는 주지주의적 이론이며, 셋째로 주체와 대상의 대립구도에 기초한 주객대립의 이론이다. 이에 반해 상산의 격물설은 本心을 밝힘으로써 理를 자각하는 向內明理의 이론이며, 둘째로 心의 본래성의 회복으로 理를 체득하는 '전인격적 체득의 이론'이며, 셋째로 '내 마음이 곧 우주'인 본심을 회복하는 主客合一의 이론이다. 이 양자는 격물설을 인식이론으로 해석하였지만, 향외와 향내, 주지적 방법과 체득적 방법, 주객분립과 주객합일의 내용적 차이를 지닌 상반된 이론이다. 그런데 이러한 상산의 격물설이 왜 양명에게 수용되지 않고 비판되었는가는 다음과 같이 말할 수 있다. 양명의 격물설은 본래부터 내게 갖추어진 良知의 깨달음과 실현을 통해 사물을 완성하려는 주체 중심의 도덕이론이며, 양지라는 道德心의 자발적인 知와 行의 발현으로 도덕행위를 이루려는 知行合一의 실천적 이론이며, 物과 대립하지 않는 良知의 실현으로 주객분리를 지양하려는 主客合一의 이론이다. 이상을 볼 때 상산과 양명의 격물설은 주체 중심의 향내적 이론성격, 주객합일을 담지한 주체의 존재성격, 心의 변화를 통한 전인격적 체득방식이라는 점에서 그 맥을 같이 한다. 그러나 상산은 주자처럼 격물을 인식론적 과정으로 설명하고 知先行後說을 주장하여 격물치지를 도덕실천적으로 해석하지 않았다. 이러한 사정으로 인해 격물설 속에 유학의 도덕실천성을 명시적으로 확보하려던 양명에게는 상산의 격물설은 거칠고 종래의 설을 답습한 이론으로 이해되어 비판될 수밖에 없었다고 하겠다. This is a study to disclose the characteristic and limitation of Xiang-shan's theory of the investigation of things. In order to prove my claim above, I shall compare Xiang-shan's theory of the investigation of things with Zhu-xi's and Yang-ming's. Zhu-xi's theory of the investigation of things is characterized by the following features. First feature is a recognition of the principle through studying his outer things. Second feature is an intellectualism which attachs great importance to discriminating Mind. Third feature is a separation of the subject and the object in his theory of knowledge. On the contrary, Xiang-shan's theory of the investigation of things is characterized by the following features. First feature is a recognition of the principle through enlightening of his own mind. Second feature is the moral culture which is accompanied by transformation of his own mind. Third feature is a coincidence between the subject and the object in his theory of knowledge. And Yang-ming's theory of the investigation of things is characterized by the following features. First feature is a subjective moral philosophy which intends to accomplish his affairs through realization of his innate good intellect. Second feature is the moral culture which ensures to coincidence between knowledge and deed through innate good intellect. Third feature is a coincidence between the subject and the object by realizing innate good intellect which is not confronted with things. Judging from the above facts, Xiang-shan's and Yang-ming's theory of the investigation of things are very much alike in the nature of their study. But Xiang-shan didn't explain the investigation of things as a moral act, rather, he explained it as a process of knowledge as Zhu-xi did. On account of this point Xiang-shan's theory of the investigation of things was criticized and rejected by Yang-ming who asserted the coincidence between knowledge and deed.

외상성 횡격막 손상

안성국,이상목,이기형,고석환,김용호,박호철,고영관,조규석 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Fifty two cases of traumatic diaphragmatic injuries that we have experienced from Jan. 1973 to Oct. 1994 were evaluated. The following results were obtained. The age of the patient was ranged from 1 to 74 years. Male was 38 and female was 14 in number with a ratio of 2.7 : 1. The traumatic diaphragmatic injuries were due to blunt trauma in 35 cases(motor vehicle accident 25, fall down 8, press 1, kick by fight 1) and penetrating trauma in 17 cases(stab wound 15, shot wound 1, explosion 1). In the blunt trauma, the preoperative diagnosis of the diaphragmatic injury was possible in 25 out of 35 cases(71%) and in the penetrating trauma, 15 out of 17 cases(88%). In the blunt trauma, the repture site was located in the left in 22 cases(63%) and in the right in 13 cases(31%). In the penetrating trauma, the rupture site was located in the left in 9 cases(53%) and in the right in 8 cases(47%). In the blunt trauma, 20 cases(63%) were treated within 24 hours and in the penetrating, 15 cases(88%) within 24 hours. In the blunt trauma, the herniated organs into the thorax were stomach(7), omentum(6), spleen(6), liver(5), colon(4), small bowel(2) and in the penetrating, stomach(7), colon(6), omentum(3), liver(2), and spleen(1) were herniated. Injury severity score(ISS) of 35-blunt trauma ranged from 11 to 66 with mean value of 30.6. Mean ISS of survivors and nonsurvivors was 27.6 and 52.7 respectively. The diaphragmatic repair of 49 cases was performed with thoracic approach in 23 cases, thoracoabdominal approach in 7 cases and abdominal approach in 19 cases, and 3 cases were not operated. The postoperative complication and mortality were developed in 16 out of 49 cases(33%) and in 5 cases(9.6%) respectively, and the causes of death were hypovolemic shock(1), combined head injury(2), asphyxia(1), and pulomnary edema and renal failure(1). In conclusion, the injuries of the diaphragm should be suspected in all patients with severe blunt trauma or penetrating injuries at thorax and upper abdominal area near the diaphragm. All of the cases had associated injury and most of deaths were related to the severity of associated injuries.

배관결함 검출을 위한 자왜형 초음파 센서의 특성

안봉영,김영주,김영길,이승석 한국비파괴검사학회 2000 한국비파괴검사학회지 Vol.20 No.1

석유화학 설비 등과 같은 노출 배관의 결함을 검출하는데 효율적으로 이용될 수 있는 자왜형 초음파 센서를 제작하였다. 최대의 초음파 발생 효율을 얻기 위한 최적 조건을 설정하였으며, 실험에 사용된 배관의 경우 250~350Oe의 정자기장이 최적이었으며, 180kHz의 주파수를 갖는 초음파를 발생시키기 위해서는 15mm 폭의 코일을 사용하는 것이 가장 좋았다. 최적의 조건에서 발생된 초음파는 50m 이상을 충분히 진행할 수 있으며, 결함의 단면적이 증가함에 따라 수신된 결함 신호는 직선적으로 증가함을 확인하였다. Magnetostrictive sensors which can be used effectively to detect flaws in pipe were fabricated. The optimal conditions to obtain the maximum generation efficiency of the ultrasonic wave were established. In case of the used steel pipe the optimal magnetic field was 250~350Oe and the coil width of 15mm showed the best efficiency for generating a wave with the frequency of 180 kHz. In the best condition, the wave can propagate further than 50m without serious attenuation. The amplitude of the ultrasonic wave reflected from artificial flaw had a good linear relationship to the cross-sectional area of the flaw.

儒家心學의 도덕적 인식과 실천 : 家心學의 도덕실천 陸象山의 心學思想을 중심으로

안영석 새한철학회 1999 哲學論叢 Vol.17 No.-

만성 B형 간염에서 라미부딘 치료중 발생한 Viral Breakthrough 예의 임상 결과

안수현,장윤정,오성남,최도원,백수정,정원석,최창원,김경오,임형준,조남영,박종재,김재선,박영태,이명석,연종은,변관수,이창홍 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

목적: 만성 B형 간염의 치료 중 발생하는 약제 내성 변이종은 임상적으로는 치료 중 음전되었던 혈청 HBV DNA가 다시 양전되는 viral breakthrough 로 진단할 수 있다. 현재 약제 내성 변이종이 발생했을 경우라도 라미부딘 치료를 계속 유지하는 것을 권장하고 있으나, viral breakthrough 발생 예들의 장기적 임상경과가 아직도 불명확하여 이것을 일반화하기는 어려운 상황이다. 이에 라미부딘 사용 중 viral breakthrough 가 발생한 예들을 대상으로 그 임상경과를 알아보고자 하였다. 대상과 방법: 9개월 이상 라미부딘을 투약한 만성 B형 간염 환자로 viral breakthrough가 발생한 74명을 대상으로 하였다(남/여 54/20, 평균연령 42세). Viral breakthrough 후 혈청 ALT치, 총 빌리루빈치, HBV DNA 역가, HBeAg, anti-HBe를 정기적으로 검사하면서 임상경과를 관찰하였다. Viral breakthrough 후 라미부딘의 투약기간은 평균 13개 월(1-41개월)이었다. 결과: Viral breakthrough 발생후 혈청 ALT치가 정상으로 유지되었던 환자는 8예(11%)에 불과했고 나머지 66예(89%)에서는 ALT치가 증가하였으며, 이중 30예(41%)에서 급성 악화(ALT 정상 상한치의 5배 이상 상승)를 보였다. 급성악화는 viral breakthrough 후 3개월 내에 19예 (63%)에서 발생하여 3개월 내에 발생한 예가 많았으나 12개월 이상 지나서 나타나는 예도 약 20%에서 있었다. 비대상성 악화는 6예에서 관찰되었다. Viral breakthrough 후 급성악화가 일어난 예와 없었던 예의 비교에서 급성악화를 예측할 수 있는 인자는 발견할 수 없었다. Viral breakthrough 후 발견할 수 없었다. Viral breakthrough 후 HBeAg이 음전된 예는 8예(11%)였으나 그 임상경과는 양호하지 않았다. 결론: 만성 B형 간염 환자 에서 라미부딘 투여 중 발생한 viral breakthrough 예 중 상당수에서 급성악화가 발생하였으며, HBeAg 이 소실되더라도 그 임상경과는 양호하지만은 않았다. Viral breakthrough 발생 후 주의 깊은 임상경과 의 관찰이 요구되며, 앞으로 viral breakthrough 후 급성악화 예에 대한 대규모 연구와 적절한 치료방향의 제시가 이루어져야 할 것으로 생각된다. Background/Aims: Long-term lamivudine therapy can induce the emergence of lamivudine resistant hepatitis B virus (HBV) mutants. Clinically emergence of the mutant is expressed by the reappearance of disappeared HBV DNA in serum. Continued lamivudine treatment has been usually recommended in cases of viral breakthrough. However, the clinical outcome in patients with viral breakthrough is not clear. The aim of this study was to investigate the clinical course of chronic hepatitis B patients after viral breakthrough during lamivudine therapy. Methods: A total of 74 patients with chronic hepatitis B who showed viral breakthrough after at least 6 months of lamivudine treatment were included in this study. They had positive HBeAg and HBV DNA before treatment. The median follow-up duration after breakthrough was 13 months. Results: After viral breakthrough, only 8 patients (11%) maintained normal ALT levels and 66 patients (89%) showed elevation of ALT. 30 patients (41%) showed acute exacerbation of hepatitis (ALT increase over five-times upper normal limit). These acute exacerbations occurred within three months after breakthrough in 19 patients (63%). In the cases of acute exacerbation, 6 patients showed decompensated progression such as elevation of serum total bilirubin. One of them died of hepatic failure. A predictive factor for acute exacerbation was not found. HBeAg seroconversion occurred in 8 patients after viral breakthrough but their clinical course was highly variable. Conclusions: Chronic hepatitis B patients who had viral breakthrough during lamivudine therapy should be followed carefully and regularly in mind of potential clinical deterioration. New strategies are needed to manage the cases of acute exacerbation after viral breakthrough.(Korean J Hepatol 2002;8:389-396)

초고층 건축물의 경제성 증진을 위한 사례 연구

김영학,한범석,안종문,신성우 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

An economic analysis is one of the most important factor to determine the project feasibility. In some mega projects, however, it is not unique factor to make a Go or No-Go decision because of overriding an economic aspect by some project indirect factors such as political, social, environmental, and technical factors, etc. The purpose of this study is to investigate the economical effects of supertall buildings through application of optimum structural system and materials. Analytical results shows that economical effects of RC structures used high strength concrete in supertall buildings can be achieved.

영양상태가 다른 두 호수에서 섬유소 기질에 부착한 세균 군집의 천이

이영옥,홍선희,안태석 江原大學校 附設 環境硏究所 1998 環境硏究 Vol.15 No.-

To scrutinize the bacterial succession on detritus in aquatic ecosystem, morphology, numbers, and phylogenetic group of the bacterica were studied by Scanning Electron Microscopy, epiflourescence microscopy, and in situ hybridization respectively. Cellulose films as substrate were exposed to epiliminon of Lake Soyang and Moonchon from May, 1996 and collected weekly for analysis . In Lake Soyang, mesotrophic reservoir, the lesions as result of degradation apperaed after 5 week. while in Lake Moonchon , eutrophic reservoir, those appeared only after 1week. In Lake Soyang, the proportions of proteobacteria increased with the increase of exposing period. The proportions of proteobacteria were 48% after 4 weeks, 81% after 6 weeks and 100% after 8 weeks. In Moonchon Lake, Those were 57% after 2 weells, 100% after 6 weeks, and dracticallt dropped to 11% after 8 weeks. Among the phylogenetic group, α-group become dominant in both lakes.

LQ서보제어기를 이용한 천정크레인 시스템의 위치 제어

조영호,이한석,신승권,안두수 成均館大學校 科學技術硏究所 1998 論文集 Vol.49 No.1

An overhead crane is commonly used in factories and dockyards. An overhead crane operation is manually accomplished by skilled operators. Usually, the skill of the operators is relied on to bring the load to its destination exactly and have it stationary at the end of the journey. Recently, the concept of automation is widely introduced in shipping and unloading operation using the overhead crane for the enhanced producity. In this paper, we reduced overhead cranes scale and objection for experimental purpose in lab. The controller for an overhead crane was designed using LQ-servo technicques and simulated by MATLAB. The performance of the controller was verified through the experiment results and the simulation walls by MATLAB.