• Archives of Plastic Surgery
• /
• 제47권5호
• /
• pp.404-410
• /
• 2020

Background Some patients who need surgery refuse a blood transfusion because of their religious beliefs or concerns about blood-borne infections. In recent years, bloodless surgery has been performed successfully in many procedures, and is therefore of increasing interest in orthognathic surgery. Methods Ten Jehovah's Witnesses who visited our bloodless surgery center for orthognathic surgery participated in this study. To maintain hemoglobin (Hb) levels above 10 g/dL before surgery, recombinant erythropoietin (rEPO) was subcutaneously administered and iron supplements were intravenously administered. During surgery, acute normovolemic hemodilution (ANH) and induced hypotensive anesthesia were used. To elevate the Hb levels to >10 g/dL after surgery, a similar method to the preoperative approach was used. Results The 10 patients comprised three men and seven women. Their average Hb level at the first visit was 11.1 g/dL. With treatment according to our protocol, the average preoperative Hb level rose to 12.01 g/dL, and the average Hb level on postoperative day 1 was 10.01 g/dL. No patients needed a blood transfusion, and all patients were discharged without any complications. Conclusions This study presents a way to manage patients who refuse blood transfusions while undergoing orthognathic surgery. rEPO and iron supplementation were used to maintain Hb levels above 10 g/dL. During surgery, blood loss was minimized by a meticulous procedure and induced hypotensive anesthesia, and intravascular volume was maintained by ANH. Our practical approach to orthognathic surgery for Jehovah's Witnesses can be applied to the management of all patients who refuse blood transfusions.

• 동의신경정신과학회지
• /
• 제26권1호
• /
• pp.39-48
• /
• 2015

Objectives: This study was conducted to analyze the hwa-byung, self-perceived health, life-stress, social support, depression, and factors affecting on suicidal ideation in community dwelling elders. Methods: This study was a cross-sectional descriptive study. The subjects were 165 elderly in I city. The data was collected from November $21^{st}$ to December $5^{th}$ of 2014 by using structured questionnaire. T-test, Pearson's correlation coefficients, and stepwise multiple regression were performed by SPSS/PC 17.0. Results: There were more females than males in hwa-byung (t=.-3.068, p=.003). In the visit parent, more than once a month was a significantly higher in social support (t=.3.333, p=.001). Hwa-byung (t=.-2.577, p=.011), life-stress (t=.-3.800, p=.001), depression (t=.-2.776, p=.006), and suicidal ideation (t=.-4.316, p<.001) were shown to be high in the elders with lower level of living. Subjects with health insurance had high self-perceived health (t=-3.800, p=.001) and low hwa-byung (t=-4.102, p<.001), life-stress (t=-4.482, p<.001), depression (t=-5.296, p<.001), and suicidal ideation (t=.-2.152, p=.036), according to the type of insurance. In the correlation, sleeping hours (r=-.180, p=.020), self-perceived health (r=-.364, p,.001), and suicidal ideation had negative correlation; hwa-byung (r=.404, p<.001), life-stress (r=.300, p<.001), social support (r=-.310, p<.001), depression (r=.423, p<.001) and suicidal ideation had positive correlation. Factors affecting the suicidal ideation in community dwelling elders were depression (${\beta}$=.42, p<.001), hwa-byung (${\beta}$=.23, p=.004), social support (${\beta}$=-.18, p=.012), and level of living (${\beta}$=.24, p=.001). Discussion: For the prevention of elderly suicide, it is necessary to care for psychosocial status and solve economic difficulties through social support.

• 한국직업건강간호학회지
• /
• 제21권3호
• /
• pp.258-265
• /
• 2012

Purpose: The purpose of this study is to identify the influence of job stress and empowerment on nursing performance of clinical nurses working in small and medium hospital. Methods: The empirical data were collected from a self-administered survey using a structured questionnaire with 404 nurses working in 4 medium-sized hospitals (less than 300 beds), located in I-city. The data were analyzed using stepwise multiple regression with the SPSS/WIN 17.0 program. Results: There were significant differences in nursing performance depending on general characteristics (age, marital status, religion, shift work, education level, position, clinical experience, department, and monthly salary). Empowerment correlated with nursing performance. Factors influencing on nursing performance were empowerment, clinical experience, job stress, and marital status with $R^2$ value of 36.3%. The most influencing factor was empowerment (${\beta}$=.47), followed by clinical experience (${\beta}$=.24), job stress (${\beta}$=.20), and marriage (${\beta}$=.12). Conclusion: It is needed to implement specific empowerment strategy, control job stress, and reward experienced and married nurses working in medium-sized hospital for improving nursing task performance.

• 한국임상수의학회지
• /
• 제25권5호
• /
• pp.400-404
• /
• 2008

10살된 암컷 요오크셔테리어(체중 3 kg)가 심한 호흡곤란 청색증, 간헐성 발작 증상으로 진료가 의뢰되었다 신체검사 결과 지속성 맥박결손을 동반한 불규칙 서맥이 부정기적으로 관찰되었다. 심전도 검사에서 고도의 방실차단이, 방사선검사에서 중증 기관허탈이 진단되었다. 피부경유 심박조절 하에 자동확장 기관내 스텐트를 성공적으로 장착할 수 있었다.

• 설비공학논문집
• /
• 제23권11호
• /
• pp.733-740
• /
• 2011

To analyze the cooling performance in the refrigerator truck according to frost growth, the analytical model of refrigeration system was developed under frost and non-frost condition using EES. The system performance was analyzed with outdoor temperature, storage temperature, outdoor front air velocity and compressor speed in order to investigate the system performance characteristics with operating conditions. Besides, the system performance under frost condition was compared with that under non-frost condition. As a result, the frost thickness was 0.9 mm when the refrigerating capacity of frost condition was decreased by 30%. The maximum of the system COP was shown at compressor speed of 1500 rpm for non-frost and frost condition, simultaneously. The performance under frost condition was more sensitive to the operating condition compared to that under non-frost condition.

• 한국경제지리학회지
• /
• 제15권3호
• /
• pp.404-423
• /
• 2012

본 연구의 목적은 기업의 네트워킹 활동 현황을 분석하고 기업의 네트워킹 활동에 영향을 미치는 기업특성 변수를 분석함으로써, 기업의 네트워킹 활동 촉진을 위한 정부의 적절한 개입전략을 마련하는데 기여하고자 하는 것이다. 본 연구는 기업의 네트워킹 활동으로서 정부의 네트워크 형성 정책 참여 여부를 종속변수로 한다는 점을 고려하여 이항로짓모형을 활용하며, 기업의 네트워킹 활동을 산학 협력 연계망 구축 사업 참여, 지역혁신센터사업 참여, 그리고 핵심 기술 확보 방법으로서 네트워킹 활동 및 미래의 필요 기술 확보 방법으로서 네트워킹 활동 등으로 파악하며, 이들 각각을 종속변수로 하는 모형을 설정하고 계수 값을 추정하였다. 기업의 네트워킹 활동에 영향을 미치는 중요한 변수는 전반적으로 기업의 연구능력과 정보 자원에 대한 개방성, 그리고 정부 지원 사업 활용 경험 등으로 요약할 수 있을 것이다. 기업의 적극적인 연구개발네트워킹을 촉진하기 위해서 정부는 기업이 연구시설을 갖추고 연구 인력을 고용하며, 연구개발에 투자하는 등 흡수 능력을 갖추도록 유인하는 것이 필요한 것으로 파악된다. 또한 산업공학 전공 코디네이터를 양성함으로써 다양한 정보에 대한 기업의 개방성 향상과 기업의 정부 지원 사업 활용을 촉진할 수 있을 것이다.

• 한국물환경학회지
• /
• 제36권5호
• /
• pp.392-404
• /
• 2020

The focus of this study was to quantify the thermal stratification and analyze the relationship between the stratification structure and the tributaries to understand flow variations in the Paldang Reservoir. The vertical distribution of the temperature and density gradients, and the depth and thickness of the thermocline were quantitatively calculated using a lake physics tool (rLakeAnalyzer) and high-frequency monitoring data. Based on a density gradient of 0.2 kg/㎥/m, the thermocline was formed from mid-May to early-September 2019 and the other periods were weakly stratified or mixed. The thickness of the thermocline was developed until 4.7 m and the depth of the thermocline was formed at a depth of 3 - 6 m at the front of the Paldang Reservoir. During the formation of the thermocline, the Namhangang and Gyeongancheon tributaries with relatively high water temperature (low-density) flowed into the upper layer of the reservoir, and the Bukhangang tributary with low water temperature (high-density) mainly affected the lower layer of the reservoir. This is because the density currents were formed due to the difference in the water temperature of the tributaries. The findings of this study may be used for constructing high-frequency monitoring and quantitative data analyses of reservoirs.

• Journal of Chest Surgery
• /
• 제55권5호
• /
• pp.397-404
• /
• 2022

Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.

• 한국기술혁신학회:학술대회논문집
• /
• 한국기술혁신학회 2016년도 춘계학술대회 논문집
• /
• pp.404-430
• /
• 2016

본 연구는 과학기술계 정부출연 연구기관 평가에서 논문의 질적 평가를 위해 새로 도입된 피인용도 지표가 성과지표의 구성요건 중 적시성을 충족할 수 있는가라는 문제의식에서 출발하였다. 이에 피인용 반감기와 즉시성 지수 등 논문의 주기적 특성을 분석 활용하여 실질적인 질적 성과체계로 전환하기 위한 기관평가의 개선방향을 제시하고자 한다. 연구 결과로 기술의 발달과 의존성이 높아짐에 따라 학문의 변화속도 또한 빠르게 변화하고 있으나, 공공기술은 타 분야에 비해 인용속도가 느리고, 산업과 연관된 분야는 지식이전 속도가 빠른 것으로 분석되었다. 또한, 학문분야 특성에 따른 피인용 주기는 차이가 없었으며, 각 분야의 질적으로 우수한 논문의 평가 시 피인용 지수의 타당성을 확보하기 위해서는 6년정도의 기간이 누적된 데이터가 필요한 것으로 분석되었다. 분야별 질적 성과평가를 위해 필요한 피인용의 시간적 특성을 기술통계적으로 도출한 결과를 반영하여 임무중심형 연구기관 평가의 문제점을 도출하였다. 이를 개선하기 위한 객관적이고 타당한 질적 평가를 위한 정책적 대안을 평가주기적, 평가기준적, 평가관리적 관점으로 제시하였다.

• 대한화학회지
• /
• 제36권6호
• /
• pp.812-817
• /
• 1992

Fluorometholone $(C_{22}H_{29}FO_4)$, M.W. = 376.5, monoclinic, $P2_1$, a = 6.410(4), b = 13.431(3), c = 10.996(3)$\AA$, $\beta$ = 92.81$(3)^{\circ}$, Z = 2, F(000) = 404, T = 292K, $\lambda$(Mo-$K_\alpha$) = 0.7107$\AA$, $\mu$ = 0.57$cm^{-1}$, $D_c$ = 1.32 $g/cm^3$, $D_m$ = 1.31 $g/cm^3$. 최종 R값은 1769개의 측정가능 회절반점들에 대하여 0.032 이었다. A 고리는 평면을 이루고 있으며, B 고리는 대칭성이 좋은 의자형이고, C 고리는 약간 찌그러진 의자형이다. D 고리는 13$\alpha$-14$\beta$-half-chair와 13$\alpha$-envelope의 중간형태이다. C(16)-C(17)-C(20)-O(20) torsion angle 값이 $-7.9^{\circ}$로 9-fluoro-6-methylprednisolone 분자 I 와 II의 $-31.9^{\circ}$와 $-16.5^{\circ}$보다 낮은 값을 보여준다.