• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.28-28
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• 1991

후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.21-26
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• 2009

Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.

• Annual Conference on Human and Language Technology
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• 1996.10a
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• pp.68-72
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• 1996

본 논문에서는 고유 명사 출현 패턴 정보와 부가 정보를 이용한 미등록 고유 명사의 색인 방법을 제안한다. 정보 검색 시스템에서 고유 명사의 처리는 정확하고 의미 있는 색인을 위해 매우 중요하다. 본 논문은 형태소 분석 결과에 고유 명사 출현 패턴과 패턴 부가 정보를 사용하여 인명, 기관명, 회사명 등의 고유 명사 추출의 정확도를 높이는 방법을 제시한다. 총 827개의 인명과 기관 및 회사명을 포함하고 있는 조선일보 경제면 기사 100개 7416 어절에 대하여 본 시스템으로 실험한 결과, 인명의 경우 89%의 정확률을 보였다. 본 논문에서 제시한 출현 패턴과 고유 명사의 부가 정보를 적용했을 때 단순한 형태소 분석 결과에 비하여 고유 명사 추출 오류가 크게 개선되었다.

• Proceedings of the Korea Contents Association Conference
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• 2017.05a
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• pp.361-362
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• 2017

본 연구는 사회복지실천 현장의 주요 공급자인 사회복지 기관종사자와 자원봉사자의 복지와 자원봉사활동에 대한 인식을 조사 분석함으로써 양자 간 상호 인식의 유사점과 차이점을 알아보는 것이 목적이다. 설문조사 기간은 2016년 5월 24일부터 5월 30일까지이며, 사회복지 기관종사자 179명, 자원봉사자 186명 등 365명을 조사한 설문지를 최종분석에 활용하였다. 연구결과, 첫째, 양자 간 복지인식과 자원봉사인식에 있어서 일치하는 부분도 일부 있지만, 대부분 상당한 인식 격차가 존재하였다. 둘째, 양자는 서로 협력하고 연대해야 한다는 인식에 대한 양자 간의 높은 일치성은 서로 간에 더 활발한 교류와 합의의 가능성을 열어 놓고 있었다. 셋째, 양자 간의 복지인식과 자원봉사인식은 사회복지서비스를 제공할 때에 어떤 유형으로든 영향을 미칠 수 있는 중요한 매개변수 역할을 할 것으로 나타났다. 넷째, 양자 간의 인식이 어떠한지에 따라 양자는 서로 영향을 받을 것으로 예측되었다. 다섯째, 양자 간 인식 결과들은 서로 존재하면서, 서로에 대한 관심이 미약했다고 할 수 있다.

• Journal of Nutrition and Health
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• v.51 no.3
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• pp.254-263
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• 2018

Purpose: This study examined whether there was a difference in the nutrients and food intake of young children depending on their lunch places. Methods: The dietary survey data of the fifth Korea National Health and Nutrition Examination Survey (2010 ~ 2012) were used. The children were grouped into either a child care center lunch group (n = 728) or home lunch group (n = 592) and their nutrients and food intakes were compared. Results: No differences in the 24-hr energy intake and energy intakes from lunch and dinner according to the lunch places were observed. The percentage of breakfast energy was lower in the child care center lunch group, whereas the percentage of snack energy was higher. In children aged 3 ~ 5 years, the sodium, potassium, and vitamin C intakes were high in the child care center lunch group. The 1 ~ 2 years and 3 ~ 5 year old children's vegetable intake from lunch was significantly higher in the child care center lunch group than in the home lunch group. Children aged 3 ~ 5 years in the child care center lunch group consumed more beans and fish at lunch. The adequacy of nutrients and food diversity of child care center lunch appear better than home lunch. Conclusion: Parents and care providers need to make efforts to use diverse foods, such as vegetables and fish, in children's meals to provide balanced diets and promote healthy eating behaviors to their children.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1237-1241
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• 1997

Tracheal stenosis is a difficult disease entity to manage. Laser ablation is one effective treatment for treacheal stenosis and can be utilized if tracheal reconstructive surgery is impossible. Potassium titanyl phosphate laser, transmitted via flexible quartz fiber, can be precisely manipulated through flexible bronchoscope under local anesthesia. We treated 7 patients with trach al and broncheal lesion under local anesthesia with KTP laser from January 1995 to July 1996. The patients included three males and four females. The age of patients ranged from 22 to 66 years with a mean of 43.7 years The etiology of tracheal stenosis in patients was stenosis after tracheostomy(3 cases), prolong inturbation in cases of sepsis(1 cases), and the recurrence of lung cancer within endobronchial lesion(2 cases). In the cases of tracheal stenosis treated with laser ablation, there were 2 cases of recurrence of stenosis at the anastomosis site after the operation, 3 cases of stenosis at tracheostomy site, and 2 cases of local recurrence of lung cancer. The site of the tracheal stenosis was the balloon site of the tracheostomy tube(3-4cm inferior to the tracheostomy site, 2-3cm superior to the carina) and the anastomosis site that were narrowed to less than 5mm(4 cases). For the stenosis lesion in the endobronchial area, there were 2 patients with a lesion at the anterior wa l, 1 patient with a lesion at the posterior wall, 2 patients with circumferential stenosis. Laser ablation time was 25.4 $\pm$5.9min and used energy was 1768 $\pm$365J. We have used KTP laser via (lexible bronchoscope without major complications. Adjuvant radiation therapy may prevent fibroblast proliferation which leads to restenosis. In three patients of restenosis after laser ablation, adjuvant irradiation started within 4 hours after laser ablation, and the radiation doses were 1500cGy given in five fraction. In patients with adjuvant radiation therapy, stenosis has not recurred

• Radiation Oncology Journal
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• v.14 no.4
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• pp.299-306
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• 1996

Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

• Communications for Statistical Applications and Methods
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• v.17 no.3
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• pp.423-440
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• 2010

The purpose of this paper is to prepare the department creation and the staff increase of education institution by forecasting the demand of health and welfare workers according to execution of the elderly's long-terms treatment insurance system in July, 2008. We estimated confirmors of the elderly's long-terms treatment and the demand of professional workers of health and welfare field due to the increase of care insurance users in facilities treatment organization, care at home service facilities, and family allowance facilities for 2010-2030. The numbers of social welfare professional worker are estimated as 16,624 workers in 2020 and 24,688 workers in 2030. The numbers of nurses are forecasted as 11.287 in 2020 and 16,624 in 2030, we expect that the increase of the demand be accelerated. The demand of necessary care probation worker is 44,824 in 2009, but we already trained over around 500,000 workers in 1,078 education institutions through one year in Aug. 31, 2009, which excesses over the numbers of workers demanded as much as 10 times.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.67-72
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• 1996

Bronchoesophageal fistula is a rare clinical entity whether congenital or acquired in adult. We experinced 8 cases of bronchoesophageal fistula and performed surgical correction from 1991 to 1994. Of the 8 patients, 5 patients were male and three were female aging from 21 to 61 years(mean 44.12$\pm$14.62 years). Seven of 8 patients had congenital bronchesophageal fistula and the other one had acquired bronchoesophageal fistula. According to the classification of Braimbridge and Keith, 4 cases were belonged to type I and 3 cases were type II . The diagnosis was confirmed by esophagogram in six patients, by bronchoscopy and bronchogram in two patients, and in one patient, the fistula was discovered i cidentally during operation. All patients received astulectomy and concomitant procedures were applied as follows ; 4 diverticulectomy, 4 right lower lobectomy, 1 bilobectomy, 1 left lower lobectomy and 1 wedge resection of left lower lobe. All but one patient were discharged without any complication and have been in good condition.

• Journal of the Korean Applied Science and Technology
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• v.37 no.5
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• pp.1409-1417
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• 2020

The purpose is to increase the likelihood of physical education students for employment in public institutions by examining the priority for hiring sports-related public institutions. The subject of the study was purposeful sampling of a total of 11 persons including 4 sports professors, 3 NCS experts in sports field, 2 judges from public sports institutions, and 2 personnel in charge of hiring public institutions. Through this process, from January 3 to March 12, 2020, the importance of priority was analyzed using hierarchical structure analysis using the main factors of NCS vocational basic competency. All data are coded so that statistical processing can be performed. Using SPSS/PC (ver. 21.0) for Windows, the hierarchical structure analysis was used for frequency analysis and priority determination. First, communication skills (.231), organizational comprehension skills (.177), resource management skills (.128), interpersonal skills (.110), vocational ethics (.082), problems in the major areas of recruitment of sports-related public institutions Solving ability (.061), information ability (.056), mathematical ability (.054), self-development ability (.052), and description ability (.049) were analyzed in order. Second, in terms of evaluation items, communication is communication skills (.442), mathematical skills are basic computation skills (.512), problem solving skills are thinking skills (.722), self-development skills are self-management skills (.587), Resource management ability was analyzed in order of time management ability (.531), interpersonal relationship ability as teamwork ability (.382), information ability in computer use ability (.677), technical ability in technology understanding ability (.599).