• Archives of Plastic Surgery
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• 제36권5호
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• pp.605-610
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• 2009

Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.

• Journal of Chest Surgery
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• 제31권5호
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• pp.509-512
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• 1998

후측개흉술은 흉근을 절단하는 단점은 있으나 훌륭한 수술시야를 제공하므로 표준개흉술로 이용되고 있다. 이에 반하여 근육보존수직개흉술은 흉근이 보존되며 팔을 내리면 액와부 수술 상흔이 감추어지는 미용상의 장점이 있다. 그러나 수직개흉술은 흉부의 정측면에 절개선이 이루어지므로 측와위에서 수직으로 수술시야를 내려다보게 되어 흉강내의 구조물, 특히 폐문부나 첨부 및 하부의 길이가 멀어져 수술조작이 불편하다. 본 인하대병원 흉부외과에서는 수술조작에 관련된 차이를 알아보고자 후측개흉술(15례)과 수직개흉술(14례)을 이용해 폐쐐기절제술 이상의 수술을 실시한 29례에서 수술과 관련된 임상지표들을 비교관찰한 결과, 수술시간, 수술 1일과 2일의 흉관 배액량, 흉관 거치기간, 수혈 수와 수혈량, 수술 중 실혈량, 수술 후 합병증 등에서 양군간에 차이가 없었다. 이상의 결과를 볼 때 근육보존수직개흉술도 후측개흉술과 마찬가지로 폐절제술시 안전하게 사용될 수 있다고 본다.

• 한국수학사학회지
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• 제25권4호
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• pp.53-67
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• 2012

오늘날, 우주비행궤도의 정밀계산은 매우 실용적인 학문이 되었다. 프엥카레의 천체역학의 주요 키워드는 적분불변, 주기해, 점근해, 특성지수, 단일값을 갖는 새로운 적분의 불가능성등으로 볼 수 있다. 적분불변은 모든 시간에 걸쳐서 일정한 적분 값을 유지하는 것을 말한다. 곡선의 호상에서 취한 적분은 2, 3차원으로 확장하였다. 고유치는 궤적의 형식에 따라서 분류되는 바 매듭, 초점들, 말 안장점, 중심과 같은 것이다. 주기해에서는 고유값에 해당하는 특성지수에 따라서 주기해를 갖는다고 하였다. 주기해의 안정성은 특성지수의 성질을 조사하는 것과 동일한 것이다. 분지라고 불리는 천체궤도의 카오스적 존재 가능성을 프엥카레는 예외적 궤도의 존재로 주장하였고, 이는 아다마르의 견해대로 우연에 의한 확률적 궤도의 존재를 말하는 것이다. 호모크리닉점의 존재는 삼체문제의 이중 점근해를 말하고, 이것은 궤적이 카오적임을 말해주는 것이다. 주어진 조건에 따라서 엑스포넨셜 함수의 고유값인 특성지수가 계속 변함으로, 매우 작은 간격에서도 분지들은 얻게 되고, 원래의 주기와는 다소 멀어지는 것이다. 주기해의 안정성문제는 특성지수를 연구하는 것과 같다. 프엥카레는 궤적의 거동이 선형변환의 고유값 성질에 의존하고 이 고유값들과 서로 다른 특이점들 사이에 매우 밀접한 관련이 있음을 발견하였다. 뷔른스, 질덴, 순드만, 힐, 다윈, 벌코프, 하이테커, 아다마르등의 이론전개는 프엥카레의 이론과 불가분의 관계를 갖는다.

• 한국지진공학회논문집
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• 제12권1호
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• pp.79-87
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• 2008

구조물의 내진 성능 평가는 구조물에 가해진 지진력에 대한 변위요구와 같은 구조물의 성능 평가를 필요로 한다. 증분동적해석(IDA)은 지진하중에 대한구조물의 성능 평가를 위해 최근에 알려진 해석 방법이다. 이 방법은 구조물의 탄성 단계에서부터 항복, 파단에 이르기까지 지반가속도의 증가 수준에 따른 구조물의 전체 거동을 파악할 수 있는 방법이다. 대부분의 구조물들은 강한 지진을 받을 경우, 비선형 거동의 변형이 예상된다. 여러 가지 비선형해석법 가운데 구조물의 내진역량을 계산하기 위한 가장 정확한 방법은 비선형 시간이력해석(NRHA)이긴 하나 많은 시간과 노력이 요구되고 있다. 따라서 구조물의 비선형 거동을 보다 간편하게 예측하기 위한 정확하고 실용적인 비선형 약산해석법에 관한 연구들이 활발히 진행되고 있다. 비선형 모드중첩법(UMRHA)은 pushover곡선으로부터 구한 등가단자유도계를 비선형 시간이력해석 또는 응답스펙트럼을 이용하여 구조물의 비선형 응답을 구할 수 있는 방법이다. 직접스펙트럼해석법(DSA)은 pushover 해석으로부터 구조물의 선형 진동주기와 항복강도를 구한 다음, 반복계산 없이 비선형 응답을 직접 산정하는 약산법이다. 본 연구에서는 내진성능의 증분동적해석을 위한 비선형 약산법의 정확성과 신뢰성을 비교 검토한다.

• Annals of Rehabilitation Medicine
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• 제39권6호
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• pp.957-963
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• 2015

Objective To compare the pain-reducing effect of forest bathing alone versus forest bathing in combination with stretching and strengthening exercises in patients with chronic posterior neck pain. Methods Sixty-four subjects with posterior neck pain that had lasted more than 3 months were enrolled. They were randomly divided into a forest bathing alone (FBA) group and a forest bathing with exercise (FBE) group; each group included 32 subjects. All subjects from both groups walked every morning in the forest for about 2 hours for 5 days. In the afternoon, the FBE group did a stretching and strengthening exercise for about 4 hours; the FBA group had free time in the woods. Visual analog scale (VAS) on one day, VAS over the previous week, neck disability index (NDI), EuroQol 5D-3L VAS (EQ VAS) and index (EQ index), McGill pain questionnaire (MPQ), the number of trigger points in the posterior neck region (TRPs), and the range of motion of the cervical spine were evaluated on the first and last day of the program and compared between the two groups. Results The number of TRPs were significantly reduced in the FBE group compared with the FBA group (p=0.013). However, the other scales showed no significant difference between the two groups. Conclusion When patients with chronic posterior neck pain underwent a short-term forest bathing (less than 7 days) program, FBE was more effective in the reduction of the number of TRPs than FBA. However, all other pain measurement scales we evaluated showed no statistically significant difference between the two protocols.

• 한국연극학
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• 제53호
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• pp.167-202
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• 2014

When video composes mise-en-scene during the performance, it reflects the aspect of contemporary image culture, where the individual as creator joins in the image culture through the device of cell phone and computer remediating the former video technology. It also closely related with the contemporary theatre culture in which 1960's and 1970's video art was weaved into the contemporary performance theatre. With these cultural background, theatre practitioners regarded media-friendly mise-en-scene as an alternative facing the cultural landscape the linear representational narrative did not correspond to the present culture. Nonetheless, it can not be ignored that video in the performance theatre is remediating its historical function: to criticize the social reality. to enrich the aesthetic or emotional reality. I focused video in the performance theatre could feature the object with the image by realizing the realtime relay, emphasizing the situation within the frame, and strengthening the reality by alluding the object as a gesutre. So I explored its two historical manuel. First, video recorded the spot, communicated the information, and arose the audience's recognition of the object to its critical function. Second, video in performance theatre could redistribute perceptual way according to the editing method like as close up, slow motion, multiple perspective, montage and collage, and transformation of the image to the aesthetic function. Reminding the historical function of video in contemporary performance theatre, I analyzed two shows, Schaubuhne's Hamlet and Lenea de Sombra's Amarillo which were introduced to Korean audiences during the 2010 Seoul Theatre Olympics. It is known to us that Ostermeir found real social reality as a text and made the play the context. In this, he used video as a vehicle to penetrate the social reality through the hero's perspective. It is also noteworthy that Ostermeir understood Hamlet's dilemma as these days' young generation's propensity. They delayed action while being involved in image culture. Besides his use of video in the piece revitalized the aesthetic function of video by hypermedial perceptual method. Amarillo combined documentary theatre method with installation, physical theatre, and video relay on the spot, and activated aesthetic function with the intermediality, its interacting co-relationship between the media. In this performance theatre, video has recorded and pursued the absent presence of the real people who died or lost in the desert. At the same time it fantasized the emotional aspect of the people at the moment of their death, which would be opaque or non prominent otherwise. As a conclusion, I found the video in contemporary performance theatre visualized the rupture between the media and perform their intermediality. It attempted to disturb the transparent immediacy to invoke the spectator's perception to the theatrical situation, to open its emotional and spiritual aspect, and to remind the realities as with Schaubuhne's Hamlet and Lenea de Sombra's Amarillo.

• 한국연극학
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• 제49호
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• pp.133-169
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• 2013

Reexamining Brecht's theoretical hypotheses in terms of cognitive science, this essay arrived at several temporary interpretations. Cognitive science implies that empathy can precede the rational understanding in Verfremdungseffekt. The spectator tends to simulate the unfamiliar incident and character and feels the consequential embodied emotion that leads to the cognitive understanding. The similar situation can be found in social gestus. According to cognitive science, gesture(social gestus) is simulated in the mirror-neuron of spectator, arousing consequently the embodied emotion that triggers the succeeding understanding. The spectator apts to experience and feel physically the moving gesture before decoding it as a social signification. Brecht's intention that attempts to reveal the duality of actor and character by eliminating the fourth wall is negated by cognitive science. According to the theory of conceptual blending, the spectator under the eliminated fourth wall mixes actor and character, and simulates this blending image so that he experiences it imaginatively. As such, another kind of illusion can be formed when a fourth wall is collapsed. Meanwhile, the critical thinking of spectator Brecht wanted can be hard to occur during the performance. It is necessary for the spectator to recollect the bygone dialogue and action in terms of social context as if he presses the pause, stopping the playback while watching a play in video. In this respect the social meaning Brecht intended can be achieved more effectively by the stop motion like tableau. It would not only give the time for the spectator to consider the implied social signification, but also make him possible to decode a semiotic meaning as if interpreting a still picture. Or it can be delivered by the dialogue that expresses the playwright's critical judgement. In this case, the subject of critical thinking is not the spectator but the author. The alternative explanation that the cognitive science suggests illuminates theoretically the reasons why Brecht's theory fails to be realized in practice. In a sense, Brecht's theory is nothing but a theoretical hypothesis. It takes the premise that the emotion hinders the rational thinking, understanding emotion and reason oppositively like Plato. This assumption is negated easily by the recent cognitive science that sees the reason as a by-product of physical experience including emotion. The rational understanding, in this sense, begins from the embodied emotion. As such the cognitive science denies the dichotomy of emotion and reason that Brecht adopted. The theoretical hypothesis of cognitive science makes us recognize again the importance of bodily experience in theatre. In theatre the spectator tends to experience physically before decoding the intellectual meaning. The spectator Brecht wanted, therefore, is far from the reality. The spectator usually experiences and reacts physically before decoding the meaning critically. Thus Brecht's intention can be realized by the embodied emotion resulted from simulation. This tentative interpretation suggests that we need to pay more attention to the empirical study of spectatorship, not remaining in a speculative study.

• 한국전산구조공학회논문집
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• 제31권6호
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• pp.347-352
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• 2018

본 논문에서는 이중질량을 갖는 랙시스템의 마찰거동을 고려한 지진응답해석 기법에 관하여 연구하였다. 마찰 거동을 모사할 수 있는 비선형 동적 시간이력해석 알고리즘을 개발하였다. 이중질량체 간의 미끄러짐과 일체화거동은 비선형 마찰모델로서 고려하였으며, 이를 적절히 모사하기 위한 수치해석기법을 개발하였다. 개발된 알고리즘을 이용하여 랙시스템의 지진 응답에 대한 매개변수연구를 수행하였다. 랙시스템의 피해에 큰 영향을 미칠 것으로 예상되는 주요 인자로 랙구조체 질량에 대한 적재질량체의 질량비와 두 질량체 사이의 마찰 계수를 선정하고, 질량비와 마찰계수를 변화시켜 가면서 최대 변위응답의 경향성을 분석하였다. 수치 모사 결과로 부터, 이중질량으로 모델링된 랙시스템의 변위응답은 구조물의 고유진동수가 커질수록 감소하는 경향을 확인할 수 있었다. 이 연구를 통하여 제시하는 방법은 랙시스템의 마찰거동을 미끄러지는 거동을 적절히 모사할 수 있으며, 이로부터 내진 성능평가를 위한 효율적 수치해석 기법으로 활용될 수 있을 것으로 판단된다.

• 대한족부족관절학회지
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• 제22권4호
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• 한국산학기술학회논문지
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• 제19권12호
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• pp.931-937
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• 2018

봉합사는 단순한 접합용로 뿐만 아니라 한방, 미용 심지어 성형 분야에도 사용하고 있다. 특히 미용 성형 분야에 인기를 끌고 있다. 본 논문에서는 기존에 많이 사용했던 PDO 봉합사보다 강도 더 좋은 PCL 및 PLLA 봉합사를 제조하였다. 이들의 수축 특성을 알기 위해 PCL 및 PLLA 봉합사의 수축률, 인장강도 및 연신율을 측정하였다. 또한 직경 및 표면을 보기 위해 SEM을 분석하였다. 수축률은 온도 상관없이 일정기간 지나면 안정화 되다. 또한 온도 높을수록 수축 증가율이 높아진다는 것을 확인할 수 있다. 그리고 유리온도의 전후 온도에 따른 기계적 특성의 변화율이 다르게 나타나는 것을 확인할 수 있다. 또한 온도 높을수록 분자운동 더 빨라지고 인장강도 낮아진다. PCL 및 PLLA 봉합사의 직경은 봉합사의 수축률과 상반관계로 나타나는 것을 확인할 수 있다. 그리고 PLLA 봉합사의 멸균온도는 $45^{\circ}C$로 설정하고 PCL 봉합사의 멸균온도는 $35^{\circ}C$로 설정하는 것이 가장 적절하다고 사료된다.