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A Survey on the Performance of Surgical Hand Scrubs (의사와 간호사의 외과적 손씻기에 관한 지식, 태도 및 실천에 대한 조사 연구)

  • 윤혜상
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.591-604
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    • 1996
  • The surgical hand scrub (SHS) is the single most important procedure in the prevention of post-operative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative th atre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative th atres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive stat-istics and Chi-squre test. The results of the study are summarized as follows : 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P=.005). 2. Nurses and doctors had some knowledge of slip-ping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included : 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses (56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest(nurses : 95.7%, doctors : 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.

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STUDY ON THE PROPERTIES OF GYPSUM-BONDED DENTAL INVESTMENTS (치과용 석고계 매몰재의 특성에 관한 연구)

  • Kim, Kyoung-Sun;Woo, Yi-Hyung;Choi, Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.29 no.1
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    • pp.139-165
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    • 1991
  • The properties of a investment material can be described by the consistency at the slurry state, the setting time, the compressive strength and the thermal expansion during the casting. In this study the effect of the production parameters which are included the ratio of quartz and cristobalite, the content of binder, the water powder ratio and the content and concentration of additives on the properties of the gypsum-bonded investments has been investigated with help of the consistency test, the vicat needle test, the compressive strength test, the thermal expansion test, x-ray diffraction and DTA thermal differential test. The experimental results showed that the constitution of a investment with W/P ratio of 0.34, 30% of gypsum, 0.8% aluminium sulfate, 2% magnesium sulfate, 0.6% sodium phosphate was adapted for the properties of the KDA Spec. No. 13 type I investment. The important experimental results are summarized as follows. 1. The consistency of the investment decreased with increasing amount of aluminium sulfate and decreasing amount of sodium phosphate. An addition of magnesium sulfate up to 2% an increase of the consistency was shown. But 3% magnesium sulfate in investment showed a decrease of consistency. The consistency did not vary significantly with a variation of the content of gypsum and cristobalite and the W/P ratio. 2. Aluminium sulfata and the magnesium sulfate promoted the hardening and the aluminium phoshpate delayed the hardening. The setting time increased with amount of gypsum. The effect of the matrix on the setting time was insignificant. With the W/P ratio of 0.34 the setting time was 14 min. 3. The compressive strength decreased with the amount of aluminium sulfate up to 0.25% and increased with the amount of aluminium sulfate greater than 3%. The compressive strength decreased as decreasing the amount of magnesium sulfate and gypsum and as increasing the W/P ratio. The effect fo the refractory on the compressive strength was also not significant. With the W/P ratio of 0.34 the compressive strength was $34Kg/mm^2$. 4. The 1st thermal expansion was found at the temperature near $250^{\circ}C$ and the steady state or the contraction stage was found at the temperature between $250^{\circ}C$ and $500^{\circ}C$. After this stage the 2nd thermal expansion took place at the temperature near $500^{\circ}C$. The amount of thermal expansion increased with decreasing the content of magnesium sulfate, aluminium sulfate and gypsum and the W/P ratio. And the amount of thermal expansion increased as the content of sodium phosphate ad cristobalite. With the W/P ratio of 0.34 the amount of total expansion was 1.2%.

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A Study on the Origination of Backcountry Litter in Moaksan Provincial Park (모악산도립공원의 산쓰레기 발생특성)

  • Rho, Jae-Hyun;Huh, Joon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.35 no.5
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    • pp.64-72
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    • 2007
  • This study investigated the types, forms, and origination of litter found along one hiking course in Moaksan Provincial Park, 'Jungin-ri Course'(entrance-ridge-valley-peak). In addition, a survey was conducted to understand hikers' litter control awareness in order to determine possible backcountry litter control measures. The following are the results of this study: 1. For the litter Sequency investigation, 199 recyclable pieces of litter were found on the mid-slope(61.6%), 89 by the entrance(27.6%), 19 in the valley(5.9%) and 16 on the peak(4.9%). A total of 323 pieces of litter were found. Paper materials were the most common, followed by plastic containers such as PET bottles and yogurt containers. Of particular interest, 288 papers and cans were found on the mid-slope(46.9%). By the entrance, more plastics and bottles were found. 2. There were 614 pieces of flammable litter collected and only 19 pieces of non-flammable. Most of the flammable litter, including snack pacts, plastic bags, processed lumber, cigarette butts, tissues, cigarette boxes, and fabric was found on the mid-slope. 3. Very little food waste was found throughout the whole site proving that the policy prohibiting hikers from cooking and eating at the designated sites has been effective. However, food waste is difficult to find because it naturally decays with time. 4. $X^2$-test was used to find different types of litter and their verified origination frequency. It was found that recyclable litter, and food waste took about 1%. In addition, recyclable litter, especially bottles, was found relatively frequently by the entrance. Flammable litter was found most often at the peak. 5. The questionnaire results showed that 48.2% of the respondents "shorten their hiking journey and purchase food outside the entrance" and 29.6% said that they "bring a packed meal from home". Only 8.2% said that they "cook something when an appropriate location is found". At the Jungin-ri course, a few hikers brought their own food to eat or cook, but most hikers purchased something to eat onsite. 6. The results of the question about having experience littering while hiking showed that 19.3% litter and 79.2% do not. Those that responded "yes" gave various reasons for littering. 63.6% claimed, "there are no designated trash containers". 15.9% said they litter subconsciously. Finally, 3.2% insist that they litter "because food naturally decomposes". 7. As a result of the overall satisfaction according to the Likert scale and the analysis with an average of 14 variables, it was found that the average "toxic litter control convenience" was 2.41 with very low satisfaction. Thus, the results indicate the importance of providing appropriate back country litter control facilities.

Study on the Manufacturing Process of Complex Oxide by Co-Roasting Process and Magnetic Properties Mn-Zn Ferrite (분무 배소법에 의한 복합산화물의 제조공정 및 Mn-Zn ferrite의 자기 특성에 관한연구)

  • 유재근;이경익;이성수
    • Resources Recycling
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    • v.8 no.4
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    • pp.45-56
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    • 1999
  • The purpose of tlus sludy was to preparc raw material powder for Mn-Zn iclrile, h m mined mill scale and fero-Mn, usins a co-spray roasting process The mill scale and ferra-Mn uscd in this raalins process was rcf~nedb y mesn-ns of a slxc~apl rxcss ~nvolvinm~a te~ialsc ontalning imp~u-ltleso r less than 100 pprn In this study an effeclive spray roaster system. wllich produces fme complex oxide powder, collects produccd ~owder.,m d prcvel~tse ~~llssiooifi HCI gas. was also manufactured. By means of spray~ngp urifcd raw malerial solu~lionl nln a manufacued high tcmpervture rumace. &-ferrite powder and a comnpleu o ~ d e powder of Fe,O; and M,x203 were manufactured. The chmcterlstics of the composllion. surface urca, and p'miicle size dismbulion or the produced powder were exmined. ptoduced powdcr was then ~ m e dwi tli ZnO powder. aid olher addilives of defined cornposnion, and Mn-Zn femite cares werc praiuccil by meuns of Sorlning and closely controlled sintering processes. The magpelic p~oprlieso f c olo~ss, initlal permeability. mauin~u~mnn agnehc flux. coz~civcr orcc and residual magnccic flux for the above cores we,= measured, and fmm Il~ase I-csulls the eflicacy of lhe co-spray roasling pncess to pl.ellare raw material powder lor Mn-Zn ferntc was established

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Synthesis and Spectroscopic Characterization of Manganese(II), Iron(III) and Cobalt(III) Complexes of Macrocyclic Ligand. Potential of Cobalt(III) Complex in Biological Activity

  • El-Tabl, Abdou S.;Shakdofa, Mohamad M.E.;El-Seidy, Ahmed M.A.
    • Journal of the Korean Chemical Society
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    • v.55 no.6
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    • pp.919-925
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    • 2011
  • A new series of manganese(II), iron(III) and cobalt(III) complexes of 14-membered macrocyclic ligand, (3,6,10,13,16,19-hexaazabicyclo[6.6.6]icosane-1,8-diamine) have been prepared and characterized by elemental analyses, IR, UV-VIS, $^1H$- and $^{13}C$- NMR spectra, magnetic susceptibilities, conductivities, and ESR measurements. Molar conductance measurements in DMF solution indicate that the complexes are electrolytes. The ESR spectrum for cobalt(III) complex in $CD_3OD+10%D_2O$ after exposure to $^{60}Co-{\gamma}$-rays at 77 K using a 0.2217 M rad $h^{-1}$ vicrad source showed $g_{\perp}$ > $g_{\parallel}$ > $g_e$, indicating that, the unpaired electron site is mainly present in the $d_z2$ orbital with covalent bond character. In this case, the ligand hyperfine tensors are nearly collinear with ${\gamma}$-tensors, so there is no major tendency to bend. Therefore, little extra delocalization via the ring lobe of the $dz^2$ orbital occurs. However, the ESR spectrum in solid state after exposure to $^{60}Co-{\gamma}$-rays at 77 K showed $g_{\parallel}$ > $g_{\perp}$ > $g_e$, indicating that, the unpaired electron site is mainly present in the $d_x2_{-y}2$ ground state as the resulting spectrum contains a large number of randomly oriented molecules provided that, the principle directions of g and A tensors. Manganese (II) complex 2, $[H_{12}LMn]Cl_4.2H_2O$, showed six isotropic lines characteristic to an unpaired electron interacting with a nucleus of spin 5/2, however, iron(III) complex 3, $[H_{12}LFe]Cl_5.H_2O$, showed spectrum of a high spin $^{57}Fe$ (I=1/2), $d^5$ configuration. The geometry of these complexes was supported by elemental analyses, IR, electronic and ESR spectral studies. Complex 1 showed exploitation in reducing the amount of electron adducts formed in DNA during irradiation with low radiation products.

The Study on Relation between Cervical Lateroflexion and Upper Limb Numbness of Patients without Disc Herniation after Traffic Accident (교통사고 이후 디스크 탈출이 없이 상지 저림을 호소하는 환자의 경추 측굴과 상지 저림에 관한 연구)

  • Park, Hyun-Min;Park, Ji-Yong;Kim, Dong-Sub;Kim, Eun-Soo;Kim, Mi-Riong;Cho, Nam-Hoon;Jeong, Hoon;Seong, Ik-Hyun;Kim, Min-Woo;Hong, Nam-Jung;Ha, In-Hyuk;Lee, Jin-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.21-29
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    • 2013
  • Objectives : The purpose of this study is to investigate the relation between cervical spine lateroflexion and upper limb numbness after whiplash injury by traffic accident. Methods : Outpatients who visited Jaseng korean medicine hospital after traffic accident took cervical MRI. Patients who had Normal disc and bulging disc were reviewed to measure the cervical lateroflexion by C2-C7 Cobb's angle & scalenus muscle's length through neutrality AP X-ray views. For statistics, we used SPSS version 18.0 for windows. Results : Groups classified into difference of scalenus muscle's length were showen statistical significance than into cobb's angle. Means of numbness group's length difference are $4.18{\pm}2.26mm$ and that of non-numbness group is $1.59{\pm}1.17mm$. Unilateral numbness group had greater angle and longer of length's difference than non-numbness group. Conclusions : The more severe the lateroflexion of the upper extremity numbness occurs well. Group classifed into difference of scalenus muscle's length has more tendency of occurrence of upper limb numbness than that into cobb's angle. And upper limb numbness occurs more frequently at the same direction of lateroflexion.

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The Measurements of Energy and Distribution of Scattered Electrons in Therapeutic X-Ray Beam (치료 방사선 선속(Flux)에 포함된 산란전자의 분포와 에너지 측정)

  • Vahc, Young-Woo;Park, Kyung-Ran;Ohyun Kwon;Lee, Yong-Ha;Kim, Tae-Hong;Kim, Sookil
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.1-8
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    • 2002
  • Accurate knowledge of the distribution of contamination electrons ( which comes from mainly gantry head by Compton scattering, pair production, and tray: henceforth called leptons ) at the surface and in the first centimeters of tissue is essential for the clinical practice of radiation oncology. Such lepton tends to reduce or eliminate the ‘skin-sparing’ advantage of megavoltage photon beam radiotherapy, This information is needed to prescribe a absorbed dose to a skin volume at a few millimeter depth in high energy therapeutic radiation photon beam All experiments were done with 15 MV photon beam from a dual energy linear accelerator (Clinac 1800, Varian). Field size is defined by ranged from 10.0$\times$10.0 to 30.0$\times$30.0 $\textrm{cm}^2$. The absorbed dose and distribution of leptons in therapeutic radiation beam (15 MV) are investigated by means of variable blocked beams of 30.0$\times$30.0 $\textrm{cm}^2$ and dose beam profiles partly removed leptons with a copper plate. A numerous leptons mainly are distributed as shape of broad cone in the central photon beam and leptons path length in the water are shorter than 2.5 cm because of the leptons energy having around 3.0 MeV. These results clearly appears that the subtraction of leptons from the total depth dose curve not only lower the absolute dose in the buildup region and surface dose, it also causes a shift of d$_{max}$ to a deeper depth.

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Improvement of Pregnancy Rates by Coculture of Human Embryos with Cumulus Cells in Glucose and Phosphate Free M-TALP Media (Glucose와 Phosphate가 제거된 M-TALP 배지에서의 난구세포 공배양에 의한 임신율 향상에 관한 연구)

  • Chung, B.S.;Chang, W.H.;Lee, M.H.;Kim, J.Y.;Bang, J.H.;Kim, K.H.;Suh, T.K.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.75-81
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    • 1999
  • The beneficial effect of glucose and phosphate ions in culture medium on the development of human embryos in vitro has not been fully elucidated. The purpose of this study was to evaluate the influence of fertilization and culture of embryos in glucose/phosphate-free m-TALP medium on pregnancy rates in IVF-ET program. The patients in 244 IVF-ET cycles received GnRH agonist + HMG regimens. A does of 10,000 IU HCG was administered when two or more dominent follicles reached 18mm in diameter. Thirty-six hours after HCG, oocytes were recovered transvaginally using ultrasound guidance. Aspirated oocytes were matured for 4 to 6 h in TCM-199 supplemented with 10% follicular fluid (FF). Insemination was carried out with 50,000 motile spermatozoa in TCM-199 + 10% FF or m-TALP + 5% FF + 5% fetal cord serum (FCS) according to experimental design. After 6 h, oocytes were washed 3 to 4 times and cultured in each fresh medium. After 20 h, oocytes were freed from cumulus/corona cells and examined for the presence of pronuclei. Fertilized oocytes were transferred into each co-culture drops and cultured for further incubation. On day 3, embryo transfer was performed with grade 1 and 2 embryos. Monolayers for co-culture of embryos were prepared by plating $1{\times}10^5$ cumulus cells/ml in 10ul drop of TCM-199 + 10% FF or m-TALP + 5% FF + 5% FCS media 24 h prior to the onset of co-culture. Development to 4 to 16 cell stage was observed at 70x magnification following two days of incubation. Pregnancy was confirmed by detecting increasing serum ${\beta}$-hCG concentrations for 11 days following embryo transfer. Data were analyzed by ${\chi}^2$-test. Oocytes from 244 IVF-ET cycles were randomized. The number of cycles and mean age of patients were 97 and 147, 31.3 yrs and 31.2 yrs for TCM-199 (control) and m-TALP groups, respectively. The mean number of retrieved oocytes/cycle, fertilization rates, number of embryos transferred/ET and pregnancy rates were 11.1 and 10.3, 65.1% and 67.3%, 4.1 and 4.7, 28.9% and 43.8% for TCM-199 and m-TALP groups, respectively. Differences in the pregnancy rates were found between control and m-TALP groups (p<0.05). The pregnancy rate of patients divided according to maternal age groups of ${\leq}30$, 31-35, $36{\leq}$ were 44.4% and 49.0%, 26.1% and 41.3%, 29.2% and 41.2% for control and m-TALP groups, respectively. These data indicate that culture of human embryos in glucose/phosphate-free m-TALP medium improves pregnancy rates.

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Cytogenetic Study and Clinical Features in Patients with Klinefelter's Syndrome and Y Chromosomal Abnormalities (Klinefelter 증후군 및 Y염색체 이상으로 진단된 환자들의 염색체 결과 및 임상 양상)

  • Moon, Shin-Yong;Choi, Seok-Tae;Ko, Hee-Jung;Oh, Sun-Kyung;Han, Jung-Ho;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.43-54
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    • 1999
  • Klinefelter's syndrome is a very important disease in gynecologic endocrinologic fields, because the patients with this karyotype complain of infertility, azospermia and ambiguous genitalia. Y chromosome is an important chromosome which determine genetic sex and the structure of gonad and genitalia. In this study, to elucidate the cytogenetic characteristics and clinical features of Klinefelter's syndrome and Y chromosomal abnormalities in Korea, we studied 303 cases of Klinefelter's syndrome and 11 cases of Y chromosomal abnormalities which were diagnosed by chromosomal analysis at the Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University for 12 years from January 1984 to December 1996. The results of this study showed as follows: 1. In a total of 9275 cases, there were 303 cases (3.3%) of Klinefelter's syndromes, 11 cases (0.1%) of Y chromosomal abnormalities. 2. In 102 cases of patients showed typical clinical features of Klinefelter's syndrome, 101 cases (99%) of them were diagnosed to Klinefelter's syndrome in karyotyping. 3. In 303 cases of Klinefelter's syndrome, there were 277 cases (91.4%) of 47,XXY complement, 16 cases (5.3%) of mosaicism, 2 cases (0.7%) of 48,XXXY, 5 cases (1.7%) of 48,XXYY and 3 cases (1.0%) of 49,XXXXY. 4. In 303 cases of Klinefelter's syndrome, 284 cases (93.7%) of them were diagnosed after puberty and only 19 cases (6.3%) of them were diagnosed before puberty. 5. In 303 cases of Klinefelter's syndrome, there were 146 cases (48.2%) of patients with infertility-associated chief complaints, 101 cases (33.3%) of patients with typical clinical features of Klinefelter's syndrome, 22 cases (7.3%) of patients with ambiguous genitalia. 6. In patients with Klinefelter's syndrome, 48,XXYY and 49,XXXXY had serious symptoms such as mental retardation, developmental delay, Down syndrome-like features, congenital anomalies, but 48,XXYY and other mosaicisms had infertility-associated symptoms or ambiguous genitalia. 7. The 8 cases of polysomy Y (XYY complement) showed several serious symptoms such as Down syndrome-like features, mental retardation, fragile X syndrome-like feature, congenital anomalies, ambiguous genitalia which could be detected before puberty.

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동굴생물의 생태적 특성과 분포

  • 김병우
    • Proceedings of the Speleological Society Conference
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    • 1994.05a
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    • pp.106-110
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    • 1994
  • $\bigcirc$ 동굴생물은 식물과 동물, 미생물로 크게 구분되지만 태양광선이 완전히 차단된 동굴내 환경에서는 동굴 동물들이 주종을 이루고 있다. $\bigcirc$ 동굴내의 동물에 관한 연구는 1966년 고씨동굴, 용담굴을 시발로 고수굴, 천동굴, 노동굴, 백룡굴, 대이굴, 환선굴 등 강원도내에 분포하는 동굴 중 약 30%정도는 동물을 포함한 생물상이 조사되었다. $\bigcirc$ 강원도의 동굴동물로서 확인된 것온 9종 30목141종이며 강별로는 곤충강이 9목 50종 주형강이 4목 49종 갑각강이 6목 18종의 순으로 우세하고 목별로는 거미목이 15과 39종, 톡토기목이 7과 20종, 딱정벌레목이 8과 15종으로 우세한 편이다 (남, 1987). $\bigcirc$ 동굴생물에 관한 연구는 육상생태계와 격리된 환경에서 생리, 생태적 적응을 통한 종의 분화나 유전, 진화문제를 추구하며 지하생태계와 육상생태계의 생물적인 유연관계 규명에 중요한 분야로 인정되며 아울러 독특한 특성을 지닌 동굴생물의 보존을 위한 방안과 노력이 일부동굴의 개방 및 개발에 앞서 더욱 구체적으로 모색되고 증대되어야 한다. $\bigcirc$ 동굴환경의 주요 특성은 첫째 햇빛이 차단되어 암흑상태이며, 둘째 내부습도가 높고 기온이나 수온의 연중변화가 심하지 않고, 셋째 먹이연쇄에 필수적인 영양공급원이 제한되어 있다. 따라서 광합성작용으로 성장하는 녹색식물은 태양광선이 유입되는 곳이나 인공조명시설 지역을 제외한 곳에서는 서식이 불가능하고 대형동물이나 초식동물은 생존이 어렵다. $\bigcirc$ 동굴내에는 환경에 적응하는 종들만이 서식할 수 있고 이들을 생태적 특성에 따라 세가지로 구분 할 수 있다. 환경적응 요인으로는 광도, 습도, 온도 영양공급원과 섭식장소, 수중생물의 경우는 특히 수온, 수량 영양원등이다.(중략)다. 본 연구의 접근방법으로는 ASRS의 개념적인 Reference Model을 수립하고 이 Reference Model에 대한 Formal Model로 DEVS(Discrete Event System Specification)을 이용하여 시스템을 Modeling하였다. 이의 Computer Simulation을 위하여 DEVS형식론 환경에서의 Simulation Language인 DEVSim ++ⓒ를 이용하여 시스템을 구현하였다.. 실형 결과로는 먼저 선형 상미분방정식의 예로 mass-damper-spring system, 비선형 상미분방정식의 예로는 van der Pol 방정식, 연립 상미분방정식의 예로는 mixing tank problem 등을 보였으며, 그의 공학에서 일어나는 여러 가지 문제들도 다루었다.화물에 대한 방어력이 증가되어 나타난 결과로 여겨지며, 또한 혈청중의 ALT, ALP 및 LDH활성을 유의성있게 감소시키므로서 감잎 phenolic compounds가 에탄올에 의한 간세포 손상에 대한 해독 및 보호작용이 있는 것으로 사료된다.반적으로 홍삼 제조시 내공의 발생은 제조공정에서 나타나는 경우가 많으며, 내백의 경우는 홍삼으로 가공되면서 발생하는 경우가 있고, 인삼이 성장될 때 부분적인 영양상태의 불충분이나 기후 등에 따른 영향을 받을 수 있기 때문에 앞으로 이에 대한 많은 연구가 이루어져야할 것으로 판단된다.태에도 불구하고 [-wh]의미의 겹의문사는 병렬적 관계의 합성어가 아니라 내부구조를 지니지 않은 단순한 단어(minimal $X^{0}$ elements)로 가정한다. 즉, [+wh] 의미의 겹의문사는 동일한 구성요 소를 지닌 병렬적 합성어([$[W1]_{XO-}$ $[W1]_{XO}$ ]$_{XO}$)로 그리고 [-wh] 의미의 겹의문사는 중복된 발은을 지닌 한 단어로 ([W]$_{XO}$

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