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다한증 환자에서 클립을 이용한 교감신경 교통가지 차단술 사체 연구 및 임상적용
이성호,조성준,정재승,김태식,손호성,선경,김광택,김형묵 대한흉부외과학회 2003 Journal of Chest Surgery Vol.36 No.8
배경: 다한증 환자의 가장 효과적인 치료방법은 흉강경 최소절개를 이용한 교감신경 차단술로 알려져 있다. 하지만 수술 후 발생하는 보상성 다한증과 무한증이 수술의 만족도를 감소시키는 중요한 요인이므로 환자에게 적극적인 수술 적응을 하기가 어렵다. 합병증을 줄이기 위한 방법으로 교감신경의 선택적인 교통가지 차단술을 시행하였으나 시술의 어려움과 혈관 손상으로 인한 출혈의 위험성으로 보편화되지 못하였다. 본원에서는 사체를 이용하여 새로운 수술기법을 연구하고 이를 임상에 적용하여 좋은 결과를 얻었기에 보고한다. 대상 및 방법: 포르말린 처리를 하기 전 사체 3구를 대상으로 실험하였다. 앙와위에서 전흉부를 모두 절제한 후 양측 흉부 교감신경을 노출시켰다. 교감신경의 분지와 교통가지의 위치를 확인하였고 2번째와 3번째 교통가지에 클립을 이용한 차단술을 시행하였다. 교통가지 차단술 후 교감신경절을 포함한 교감신경을 절제하여 교통가지의 차단 정도를 관찰하였다. 임상적용은 25명의 환자에서 시행하였으며 평균 연령은 21세였다. 수술은 전신마취와 양측 폐 환기를 하고 반 좌위 자세에서 시행하였다. 4번째 늑간에 2 mm 흉강경을 삽입하였고 겨드랑이에 5 mm 트로카를 삽입하고 내시경용 클립을 이용하여 2번째와 3번째 교감신경절 교통가지를 차단하였다. 수술 후 전화 설문 조사를 통하여 합병증의 유무, 만족도, 보상성 다한증의 발생 정도를 관찰하였다. 결과: 사체 3구에서 모두 교감신경 교통가지의 차단을 완벽하게 시행할 수 있었다. 임상환자에서 모두 수술로 증세의 호전이 있었으며 기존의 교통가지 절제술에 비하여 수술 시간을 단축할 수 있었고 수술로 인한 합병증은 발생하지 않았다. 수술 후 수부 다한증은 모든 환자에서 호전되었으나 4명의 환자는 수술의 만족도가 감소하였다. 보상성 다한증은 15명의 환자(60%)에서 중증 이상으로 발생하였고 6명의 환자는 없거나 잘 느끼지 못하는 정도로 발생하였다. 미각다한증은 2명의 환자에서 발생하였으나 정도는 심하지 않았다. 결론: 본 연구의 수술방법은 2개의 피부 절개와 하모닉 스칼펠, 클립을 사용하여 쉽게 교감신경의 교통가지를 차단할 수 있었고 교통가지 절제술에 비하여 수술시간 및 출혈의 위험성을 감소시킬 수 있었다. 또한 교감신경 절제술에 비하여 비슷한 정도의 수술 성공률을 보이면서 보상성 다한증의 정도나 발생 빈도를 줄일 수 있어 우수한 수술 방법이라 생각한다.
李星鎬 연세대학교 교육대학원 1985 연세교육과학 Vol.27 No.-
In Korea, the two-year college came into existence in 1948. Since the legal foundation for its establishment was rearranged in 1978, the two-year trace & technical college began to increase tremendously. The goal of the two-year trade & technical college is to offer courses in knowledge and theory of trade and technical fields at the paraprofessional level and conduct related researches, with the goal of training for middle-level professionals, to meet the anticipated need for skilled manpower. However, those institutions have gained little popularity among high school graduates desirous of having a college education and among their own community citizens as well as industry. They have often been perceived as an institution peripheral or tangential to the mainstream of higher education system. The reasons for such winding-down and being·neglected are complex and interwoven. However, to name one of the very reasons, it is because of the conflict in expectations of the functions of those institutions. There is a wide range of discrepancy among the expectations by faculty members, students and industry or society as a whole of the functions that the two·year trade & technical college should perform. The present research is primarily concerned with the curricular practice of cooperative education between industry and two-year trade & technical college under the assumption that it is one of the best-fit strategies to soave the problem of functional conflict and obsolescence faced by those institutions of higher education. More specifically, the purposes of this study were: 1) to examine the historical development of cooperative education, its value and patterns being currently prevailed in such developed countries as the U.S.A., England, and Canada; 2) to develop a reform proposal for the curricular practice in cooperative education; 3) to conduct a needs assessment based on the developed reform proposal; and finally 4) to explore a course of development toward which our current cooperative educational program should be changed. A needs assessment was conducted concerning the following four areas : 1) How can the cooperative vocational education program be established independent of the current regular curriculum? ; 2) What are the procedures for the development of the cooperative vocational education program? ; 3) How can the cooperative vocational education program attract the able students and help them develop their potentiality? ; and 4) In what manner should the cooperative relationship between industry and two-year trade & technical colleges be established? The subjects (N=406) were composed of 111 faculty members and 187 students randomly sampled from 5 two-year trade & technical colleges and 108 employees from 15 industrial companies. The instruments for a needs assessment, developed by the researcher, included 20 statements. Each respondent was asked to identify on a Likers-typed 5-point scale in what extent he or she agrees with the statement. After obtaining such basic statistical values as mean, percentage and standard deviation, the obtained differences were analyzed using t-test and analysis of variance. The level of significance was set at the .05(5%) and .01(1%) levels. In their analysis and interpretation of the obtained data, only 16 statements were included, which more than 60% of the entire respondents agreed with. Replies from the 406 respondents revealed their agreement with the following reform proposals in general. First, the cooperative vocational education program should be selectively established in the two-year trade & technical colleges and an accreditation council should come into existence to perfrom the quality control function for the program. Second, the academic calendar for the cooperative vocational education program should be arranged as two-and-a-half or three year programs, permitting the students with at least six months of work experiences (15 to 30 credit hours). Third, the cooperative vocational education program must be selective as well as optional in that those must rank in the certain standards scholastically. Every and each successful graduates from the program should be provided with a guarantee for their employment and a certificate of the "second-class engineer", without any official written examination. Fourth, the reciprocal relationship between industry and the two-year trade & technical colleges should include the exchange of personnel and physical resources for teaching, research and guidance for the students' work experiences. Concerning the extent of agreement, it was found that the three gropes of faculty members, students and industry personnel were significantly different one another (p<. 01 or p<. 05). However, the demographic variables of each group made no significant difference statistically in their exetnt of agreement with the reform statement. The findings of analysis of literature and a needs assessment provided basis for the conclusions as follows : 1. The cooperative vocational education program is one of the best-fit strategies to improve the functional identity of two-year trade & technical colleges. 2. There is a wide and strong advocacy for qualitative innovation and improvement of cooperative vocational education among all the faculty members, students and industry personnel. 3. The cooperative vocational education program must be established as an independent, selective and optional course for a limited number of able students. 4. The cooperative vocational education program should be evaluated and certified by a voluntary, nongovernmental and nonofficial agency of accreditation, so that only some selected colleges can open such cooperative vocational education program. 5. For an effective cooperative vocational education program, a truly reciprocal relationship should be developed between industry and two-year trade & technical colleges, maximizing the exchange of personnel and physical resources. Throughout conducting this study, the researcher recognized some limitations and areas of further research. For an instance, more concrete alternatives for effective curriculum development of cooperative vocational education should be designed in depth. In particular, the exemplar cases of cooperative education should be analyzed. In addition, the more detailed due procedures for accreditation of cooperative vocational education program must be described and an in-depth survey could be made, using such a method as Delphi-technique. Finally, the subjects used in this study might not adequately represent the entire group collectively. The needs assessment should be replicated in extended circle of colleges and industry including the gaduates of the two-year colleges.
이성호,이동녕 대한금속재료학회(대한금속학회) 1988 대한금속·재료학회지 Vol.26 No.3
A two dimensional finite difference model has been developed to calculate the temperature distribution and the solidification profile of the continuously cast beam blank. The effect of the Pouring temperature, the casting speed, and the cooling condition has been examined. It has been shown by the calculation that the surface temperature and the solid shell thickness of the cast do not significantly vary with the pouring temperature or the casting speed, and that the effect of the cooling condition, particularly in the mold is critical. Non-uniform cooling resulting from the air gap formation develops the thermal stress in the solid shell and this is the main cause of the surface defects. Consequently, rather soft cooling should be applied to decrease the possibility of the crack formation.
이성호 尙志大學校 生産技術硏究所 1999 生産技術論叢 Vol.7 No.-
Environmental problems arise from the rapidly developing personal computers and are gradually becoming a significant part of problems. Computer industry are usually viewed as relatively clean. However, discarded personal computer and related equipment which are piling up at warehouse, or going to landfills has on the negative effects of hazardous substance on health and the ecosystem are growing problems which did not trouble society a few years age. This paper will estimate the quantity of the obsolete personal computer in the end of 1999.
李星鎬 서울産業大學校 1995 논문집 Vol.42 No.1
Frequency tuning range of a laser diode with optical feedback is calculated. The optical frequency deviation increases with external reflectivity, and decreases with external cavity length. This is due to the condition of stable single frequency solution. The result is important to determination of parameters in fabrication of tunable laser diodes.