• Title/Summary/Keyword: 이학적 검사

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A Study on Analysis Method to Evaluate Influence of Damage on Composite Layer in Type3 Composite Cylinder (Type3 복합재료 압력용기의 복합재층 손상에 따른 영향성 평가를 위한 해석기법에 관한 연구)

  • Lee, Kyo-Min;Park, Ji-Sang;Lee, Hak-Gu;Kim, Yeong-Seop
    • Composites Research
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    • v.23 no.6
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    • pp.7-13
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    • 2010
  • Type3 cylinder is a composite pressure vessel fully over-wrapped with carbon/epoxy composite layers over an aluminum liner, which is the most ideal and safe high pressure gas container for CNG vehicles due to the lightweight and the leakage-before-burst characteristics. During service in CNG vehicle, if a fiber cut damage occurs in outer composite layers, it can degrade structural performance, reducing cycling life from the original design life. In this study, finite element modeling and analysis technique for the composite cylinder with fiber-cut crack damage is presented. Because FE analysis of type3 cylinder is path dependant due to plastic deformation of aluminum liner in autofrettage process, method to introduce a crack into FE model affect analysis result. A crack should be introduced after autofrettage in analysis step considering real circumstances where crack occurs during usage in service. For realistic simulation of this situation, FE modeling and analysis technique introducing a crack in the middle of analysis step is presented and the results are compared with usual FE analysis which has initial crack in the model from the beginning of analysis. Proposed analysis technique can be used effectively in the evaluation of influence of damage on composite layers of type3 cylinder and establish inspection criteria of composite cylinder in service.

Chronic Injuries and Types of Injuries Related to Adolescent Taekwondo Athletes (성장기 태권도 선수의 만성 통증과 손상 유형)

  • Kim, Ha-Kyung;Kim, Chang-Yoon;Shim, Hee-Jong;Park, Sung-Min;Bae, Byung-Jo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.46-50
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    • 2009
  • Purpose: This study was designed to analyze? the chronic pain of adolescent Taekwondo athletes, to research the understanding about chronic pain of coaches and athletes, to? reduce the development of chronic pain. Materials and Methods: From March. 2006 to June 2007, 210 athletics and 12 coaches of elementary, middle and high school in Kwang-ju city were surveyed. They was evaluated by physical examination, simple radiographs and MRI. Results: In 210 athletics, 162(77.1%) athletes had chronic pain. 19(11.7%) athletes had over three regions of pain, 74(45.7%) athletes had two regions of pain, 69(42.6%) athletes had one region of pain. In 274 cases of 164 athletes, the most common region was foot and ankle(145 cases, 52.9%), followed by hand(47 cases, 17.2%) and knee(38 cases,13.9%), hip(25 cases, 9.1%), and lumbar area(19 cases, 6.9%) The chronic pain was classified by injury type. Contusion of foot was 103 cases(most common), sprain of ankles was 40cases, Contusion of hands and wrists was 28 cases, and so on. The etiologies of injury that causes the chronic pain were match injury in training that is most common, intensive exercise and match injury in competition. Conclusion: The chronic pain was common in adolescent Taekwondo athletes. The ankle and foot were the most common region of chronic pain and the match injury was the most common injury, caused the chronic pain. Although athletes had considerable mental stress about chronic pain, the treatment of chronic pain and rest were insufficient. Therefore the variable effort to prevent injury and to treatment injury must be considered importantly.

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Correlation of the Body Mass Index with the Rates of Postoperative Wound Complications in Gastric Cancer Patients (위암 환자에 있어서 신체질량지수(BMI)값과 수술 후 창상 합병증과의 관계)

  • Shin, Bum-Sik;Kim, Dae-Yeon;Nam, So-Hyun;Yook, Jeong-Hwan;Oh, Sung-Tae;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.242-247
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    • 2007
  • Purpose: We assumed that an obese patient has a high rate of postoperative wounds, but there is no objective data showing the relationship between the body mass index (BMI) and the rate of postoperative wounds in Korea. We describe the relationship of BMI and rates of postoperative wound complications. Materials and Methods: From September 2005 to February 2006, 772 patients undergoing elective gastrectomy surgery due to gastric cancer were enrolled in a retrospective study to measure postoperative wound complications. A preoperative history, physical examination and daily progress notes were reviewed retrospectively from the medical records. Postoperative wound complications were detected from the elective medical record and from a doctor in charge statement. Results: The total number of patients was 772, the mean age of the patients was $57{\pm}11.2$ years and the sex ratio (male/female) was 1.82:1. Postoperative wound complication rates were different among the BMI groups (BMI < $20\;kg/m^2$ vs $20{\leq}BMI{\leq}25\;kg/m^2$ vs >$25\;kg/m^2$), and patients with a BMI>$25\;kg/m^2$ that underwent gastrectomy had a significantly higher wound complication rate (4.6%) than underweight and normal weight patients (0.9% and 1.6%, respectively) (P=0.038). Conclusion: Overall, there was a statistical correlation between BMI and the postoperative wound complication rate. Overweight (BMI>$25\;kg/m^2$) patients that underwent gastrectomy had a higher wound complication rate than normal body weight ($BMI{\leq}25\;kg/m^2$) patients. Further studies will be required with a larger population and prospectively designed study considering other factors that affect the wound complication rate.

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A Follow-Up Study after Discontinuation of Antiepileptic Drug Therapy in Children with Well-Controlled Epilepsy : The Factors that Influence Recurrence (항전간제로 조절된 간질 환아에서 약물 중지 후 추적 관찰 - 재발위험인자)

  • Chung, Sa Jun;Chung, Hye Jeon;Choi, Young Mi;Cho, Eu Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1559-1570
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    • 2002
  • Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.

Clinical Features and Treatment Response in 18 Cases with Idiopathic Nonspecific Interstitial Pneumonia (특발성 비특이성 간질성 폐렴 18례의 임상상 및 치료반응)

  • Kang, Eun-Hae;Chung, Man-Pyo;Kang, Soo-Jung;An, Chang-Hyeok;Ahn, Jong-Woon;Han, Joung-Ho;Lee, Kyung-Soo;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.530-542
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    • 2000
  • Background : Nonspecific interstitial pneumonia (NSIP) has been reported recently to have shown much better response to medical treatment and better prognosis compared with idiopathic UIP. However, clinical characteristics of idiopathic NSIP discriminating it from UIP have not been clearly defined. Method : Among 120 patients with biopsy-proven diffuse interstitial lung diseases admitted to the Samsung Medical Center between July 1996 and March 2000, 18 patients with idiopathic NSIP were included in this study. Retrospective chart review and radiographic analysis were performed. Results : 1) At diagnosis, 17 patients were female and the average age was $55.2{\pm}8.4$ years (44~73 years). The average duration from development of respiratory symptom to surgical lung biopsy was $9.9{\pm}17.1$ months. Increase in bronchoalveolar lavage fluid lymphocytes ($23.0{\pm}13.1%$) was noted. On HRCT, ground glass and irregular linear opacity were observed, but honeycombing was absent in all patients. 2) Corticosteroids were initially given to 13 patients, but the medication was stopped in 3 patients due to severe side effects. Further medical therapy was not possible in 1 patient who experienced streroid-induced psychosis. Herpes zoster (n=3), tuberculosis (n=1), avascular necrosis of the hip (n=1), cataract (n=2) and diabetes mellitus (n=1) developed during prolonged corticosteroid administration. Of the 7 patients receiving oral cyclophosphamide therapy, hemorrhagic cystitis hindered one patient from continuing with the medication. 3) After medical treatment, 14 of 17 patients improved, and 3 patients remained stable (mean follow-up ; $24.1{\pm}11.2$ months). FVC increased by $20.2{\pm}11.2%$ of predicted value and the extent of ground glass opacity on HRCT decreased significantly ($15.7{\pm}14.7%$). 4) Of the 14 patients who had stopped medication, 5 showed recurrence of NSIP and 2 became aggravated during steroid tapering. All patients with recurrence showed deterioration within one year after completion of initial treatment. Conclusion : Since idiopathic NSIP has unique clinical profiles and shows good prognosis, diagnosis different from UIP, and aggressive medical treatment are needed.

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Diagnostic Value of Cyfra 21-1 in Differential Diagnosis of Pleural Effusion (흉수의 감별 전단으로 Cyfra 21-1의 진단적 가치)

  • Lee, Hak-Jun;Lee, Kwan-Ho;Shin, Kyeong-Cheol;Shin, Chang-Jin;Park, Hye-Jung;Mun, Yeung-Chul;Lee, Kyung-Hee;Chung, Jin-Hong;Hyun, Myung-Soo;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.50-56
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    • 1999
  • Background : Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. Methods: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. Results: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper comer and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. Conclusions: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.

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Results of Open Versus Arthroscopic Method in Recurrent Anterior Shoulder Instability (관혈적 방법과 관절경적 방법을 이용한 재발성 견관절 전방 불안정의 치료 결과)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Oh Se-Jin;Lee Chul-Ho;Ha Kwon-Ick
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.154-158
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    • 2002
  • Purpose: To compare the results of open and arthroscopic method in recurrent anterior should erinstability. Materials and Methods: The 68 patients who have been taken the open or arthroscopic Bankartrepair for the period of Jan. 1995 to April. 2000. One group (23 patients) had elected an arthroscopic Bankart repair, the other group (45 patients) had chosen open stabilization. Patients were followed up12 to 63 months (ave. 34 months) after surgery. Results: We found 2 cases of subluxation out of open repair group, and then treated by conservative method. There were another 2 cases of dislocation and 2 cases of subluxation out of arthroscopicrepair group, and we have taken out 1 case of reoperation by open method. Using the functional scales by Rowe, the patients who have taken the open method posted at the average point of 87, while the arthroscopic method posted 85 points. Patients satisfaction points were 84.6 and 72.5 respectively. There were no criteria of statistically significant except stability and motion score. Conclusion: Open Bankart repair would be better in stability, and arthroscopic method in ROM gain. Proper patient selection based on physical examination and arthroscopic inspection to optimize the indications contributed to successful treatment.

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Trends in the Use of Assessment Tools by Korean Occupational Therapists: Focus on Adult and Older Adult Populations (한국 작업치료사의 평가도구 사용 동향: 성인 및 노인 분야를 중심으로)

  • Ha, Yae-Na;Jeong, Ji-In;Kang, Byoung-Ho;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.13 no.3
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    • pp.51-67
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    • 2024
  • Objective : This study investigated trends in the use of assessment tools by occupational therapists working with adults and older adults. Methods : Occupational therapists were surveyed to gather data on general characteristics, assessment tool usage, assessment time and frequency, usage trends by area, and education. The tools were categorized by the Occupational Therapy Practice Framework (OTPF) into Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and play and leisure for occupations, and cognitive functions, motor functions, and psychosocial aspects for client factors. Data from 98 respondents were analyzed using frequency analysis and one-way ANOVA with SAS. Results : Most surveyed occupational therapists worked in university or general hospitals (40.82%). The assessment time per patient was under 30 min (62.25%), and re-assessment frequency was one~three months (68.38%). The most frequently used assessment tools by the OTPF were as follows: ADL: Modified Barthel Index (94.90%), IADL: Canadian Occupational Performance Measure (31.63%), cognitive functions: Mini-Mental Status Examination (89.80%), visual perception: Motor-free Visual Perception Test (56.12%), dementia: Global Deterioration Scale (63.27%), motor functions: Jamar Dynamometer & Pinch Gauge (59.18%), dysphagia: Video Fluoroscopic Swallowing Study (28.57%), physical examination: Range of Motion (59.18%), and psychosocial: Geriatric Depression Scale (33.67%). Conclusion : This study identified the use and rationale of assessment tools for occupational therapy in adults and older adults. These findings aim to enhance the curriculum and continuing education of occupational therapists.

Process Risk Assessment for a Batch Condensation Reaction of Polyester Resin using K-PSR Technique (K-PSR 기법을 활용한 회분식 폴리에스터 축합반응에서의 공정 위험성 평가 연구)

  • Park, Kyung-Min;Lee, Dong-Kyu;Lee, Haakil;Lee, Joon-Man;Ahn, Won-Sool
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.35-42
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    • 2019
  • Risk assessment and analysis for a medium-to-small sized chemical plant that manufactures a polyester resin by the process of batch-type condensation reaction was conducted using K-PSR technique which is one of the risk assessment methods used to implement the Process Safety Management System (PSM). K-PSR is a risk assessment technique developed by KOSHA to compensate for difficulties caused by the lack of infrastructure of medium-to-small sized chemical plants in the re-evaluation. To apply the K-PSR technique, the entire process of a selected chemical palnt was classified in two review sections, i.e., the condensation reaction process and the dilution/filtration process, and the potential risks of the process about these review sections were identified and classified based on the four guide-words (release, fire.explosion, process trouble, and injury). As the results of the research, refer to recommend of risk rating has been confirmed that non-destructive testing of old facilities and the preparation of LOTO procedures for the electrical equipments are necessary as specific measures to prevent the risk of release and fire.explosion. It was also shown that pressure gauges and thermometers should be installed on the hot-oil supply piping to minimize the process trouble, and exhausting hood should be installed to prevent potential injury.

Clinical Manifestations of the Lung Involvement in Behçet's Syndrome (Behçet 증후군에서 폐침범의 임상양상에 관한 고찰)

  • Park, Kwang Joo;Park, Seung Ho;Kim, Sang Jin;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.763-773
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    • 1996
  • Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

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