• 한국응급구조학회지
• /
• 제6권1호
• /
• pp.153-168
• /
• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• 대한예방한의학회지
• /
• 제7권1호
• /
• pp.123-132
• /
• 2003

It is considered to be important to create aesthetically beautiful style through the change of external shape, however for the hair stylists, whose beauty expression is through hair, the role of hair doctor is becoming even more important with focus to improve the hair healthiness. Hair clinic is management of hair and scalp. It is the management process of preventing damages, while improving and cultivating healthy and shiny hair. The current concept in hair management is moving from simple hair styling to emphasis at hair management. As far as hair management is concerned, it usually includes treatment tools such as shampoo, conditioner, hair treatment and scalp scaling system, which is used for diagnosis of hair condition in order to treat the scalp. As the interest of hair healthiness becoming more wide spread, so does the breadth of clinic menu. The wide choice is to fulfill the profound desire of people, whose demands are simply to have variety in their choice. This is resulting in faucets of new value-added and differentiated products. The values that make-up the hair styles consist of mainly design (trend, preference), function(styling, management convenience) and clinic(hair quality improvement, damage repair). Shampoo and conditioner have gone beyond their original function of cleansing to providing combinational functions of treatment, to care and remedy, and advanced massage effectiveness. These are, to name a few that seem to go beyond their original function to satisfy the mental healthiness in people, the King Kong shampoo of shampooings in forward-backward manner, 5-minute shampoo massage that applies sports and relaxation massage, scalp acupunctural message and aural(ear) massage. More and more people are complaining about the damaged hair and hair loss problems due to perms, dyeing and bleaching of hair, in addition to natural scalp and hair damaging factors. Such complaints have stimulated many beauty products and various hair treatment systems being introduced with focus to provide nutrition and prevent damages to scalp and hair. As the living standards improve and the desire of people is to pursue differentiated lives, their demand also increases in hair styling products to fulfill the needs of healthy and aesthetical aspects of their lives.

• Journal of Chest Surgery
• /
• 제32권6호
• /
• pp.567-572
• /
• 1999

배경: 선천성 식도 폐쇄증의 수술적 교정은 많은 개선을 보였으나 아직도 사망률과 합병증률이 높은 상태이다. 방법: 1992년 1월부터 1997년 3월까지 본 동아대학교 병원 흉부외과학 교실에서는 27명의 선천성 식도 폐쇄증을 수술적 치료하였기에 이를 후향적으로 분석하고자 하였다. 결과: 남아가 21명 여아가 6명이었으며 평균 출생시 체중은 2.62$\pm$0.38 kg이었다. 원위부 기관식도루를 가진 식도폐쇄증이 24명이었고 나머지 3명은 순수 식도 폐쇄증이었다. Waterston의 위험군 분류상 A군이 4명, B군이 18명, C군이 5명이었다. 18명에서 동반 기형을 가졌으며 심혈관계 이상이 가장 흔한 동반 기형이었다. 식도 폐쇄증의 상하 식도 맹단 간의 거리는 1 cm이내의 short gap이 9명, 1내지 2 cm의 medium gap이 8명, 2 cm이상의 long gap이 7명, 3.5 cm 이상의 ultra-long gap이 3명이었다. 수술은 순수 식도 폐쇄증의 3례에서는 단계적으로 위루술 및 경부식도조루술을 시행하였고 나머지 24례는 모두 경흉강적 도달법으로 일시적 근치 교정술을 시행하였다. 추적기간 중 27명 중5명이 사망 하였는데 수술과 관련된 사망은 2명으로 그 중 1명은 급성 신부전으로 사망하였고, 1명은 문합부 누출로 인한 농흉 발생으로 사망하였다. 3명의 후기 사망이 있었는데 1명은 순수 식도 폐쇄증으로 식도-위-대장 문합술을 시행하였으나 인슐린 의존성 당뇨병으로 술후 29개월 째 사망하였고 1명은 동 괴사성장염(necrotizing enterocolitis)으로 사망, 나머지 1명은 \ulcorner선 확장술의 합병증으로 인해 술후 220일 째 십이지장 천공으로 인한 폐혈증으로 사망하였다 사망례의 분석을 통해 사망률에 영향을 미쳤던 요인들을 살펴 보았는데 gap length가 long gap이상일 경우가 사망률에 영향을 미치는 요소로서 통계적 유의성(p value<0.05)을 보였다. 결론: 수술적교정과 관련된 합병증률은 높은 편이나 이것이 수술사망률과 직결되는 것은 아니다. 전체적인 생존율은 효과적인 동반기형의 치료와 적극적인 수술후 관리가 병행될 때 더욱 향상시킬 수 있을 것이다.

• Journal of Chest Surgery
• /
• 제46권5호
• /
• pp.340-345
• /
• 2013

Background: This study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results. Methods: Thirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of $16.5{\pm}9.7$. Group II comprised 14 female and 3 male patients with an average age of $18.5{\pm}9.8$ showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was $1.8{\pm}0.2$. The average pulmonary artery pressure was $35{\pm}10$ mmHg. Following the diagnosis, performing elective surgery was planned. Results: No significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM. Conclusion: To conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.

• Journal of Chest Surgery
• /
• 제8권2호
• /
• pp.149-152
• /
• 1975

In spite of great advances in surgical treatment during past several decades, surgery of the trachea failed to develop correspondingly, partly because of relative rarity of the tracheal lesions and partly because of difficulties in surgical technique and anesthesia. Surgical diseases of the trachea are largely obstructions due to neoplasm or cicatrical stenosis and tracheal malacia. The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tubes, has produced, apparently with increasing frequency, tracheal stenosis, tracheomalized tracheal erosion. Surgery is presently the only reasonable way to treat stenotic lesions of the tracheobronchial tree. In the case of tumors, the current trend has been that of radical excision. Primary end-to--end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, for decades it was believed that a maximum of four tracheal rings only might be excised and primary healing achieved with safety. A great variety of procedures, developed by numerous investigations and directed at tracheal substitution, have almost invariably met with discouraging results. A meticulous study done by Grillo and associates on autopsy specimens has shown that an average 6.4cm of mediastinal trachea can be safely resected by full mobilization of the right lung and transplantation of the left main bronchus into the bronchus intermedius. Recently, we experienced a case of successful resection of a tumor of the tracheal carina and primary tracheo-left main bronchial anastomosis at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul. The patient, a 29-year-old man, was admitted to the hospital with complaints of dyspnea and cough. On admission, chest film showed hydropneumothorax on the right. After closed thoracostomy, hydropneumothorax disappeared, but hazy densities, developed in the right middle and lower lung fields, resisted to treatment. Bronchoscopy uncovered irregular tumor covering the carina and the right main bronchus, and biopsy indicated well differentiated squamous Cell carcinoma. Operation was performed on July 2, 1975. A right postero-lateral thoracotomy was used. Excision involved the lower trachea, the carina, the left main bronchus and the right lung. This was followed by direct anastomosis between the trachea and the left main bronchus. Bronchography was done on 17th postoperative day revealed good result of operation without stricture at the site ofanastomosis. About one month after the operation symptoms and signs of bronchial irritation with dyspnea developed, and these responded to respiratory care. On 82nd postoperative day, sudden dyspnea developed at night and the patient expired several hours later. Autopsy was not done and the cause of death was uncertain.

• 한국건설관리학회논문집
• /
• 제14권2호
• /
• pp.3-11
• /
• 2013

최근 핵가족화, 맞벌이 부부의 증가로 인해 장시간 보육시설에 맡겨지는 영유아의 수가 증가하고 있으며, 보육시설의 중요성이 증대되고 있다. 특히, 외부환경에 민감한 영유아들에게 보육시설의 물리적 환경은 필수적인 관리대상이다. 현재, 국 공립 보육시설은 시설운영 및 유지관리비를 지방자치단체로부터 지원받고 있으나, 불공평한 지원문제를 가지고 있다. 왜냐하면, 시설규모나 유지관리 항목에 따른 시설 개 보수비 산정기준이 부족하고, 보육시설 운영유지를 위해 사용되는 보육시설 세출 예산과목 중 시설비와 시설 장비 유지비가 현실적이지 않기 때문이다. 이러한 이유로 한정된 예산으로 보육시설의 유지보수 항목을 적절하게 배분할 수 있는 방안이 요구된다. 따라서 본 연구에서는 국 공립 보육시설물의 실내외 시설 설비 등 33개의 운영유지항목을 정리하고, 설문조사를 통해 각 운영유지 항목의 중요도를 산정하였다. 이를 통하여, 실무자가 적정한 시설운영유지항목을 바탕으로 한정된 예산으로 보육시설 운영유지를 효율적으로 관리할 수 있도록 지원하고자 하였다.

• Archives of Plastic Surgery
• /
• 제44권3호
• /
• pp.202-209
• /
• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

• 대한구순구개열학회지
• /
• 제7권1호
• /
• pp.1-16
• /
• 2004

본 연구에서는 구순접합술의 효과를 알아보기 위하여, 일측성 완전구순열을 가진 5명의 환아에서 Millard의 high haU-underminded adhesion과 Seibert 의 lip adhesion을 이용한 구순접합술후 Millard 변법을 이용한구순성형술을 시행하였다. 구순접합술은 상악치조분절 간의 관계를 개선해 주고 구순성형술을 쉽게해주며 최종적인 구순성형술 후 더욱 좋은 결과를 나타냈다. High kalf-underminded adhesion과 Seibert의 lip adhesion은 둘 다 넓은 구순열을 하는데 유용한 방법이며, 특히 Seibert의 lip ahesion은 강한 접합력을 얻을 수 있고 변위된 비중격의 개선 효과가 있으며 보다 심미적인 상순의 연속성을 얻게 해 주었다. 이상의 결과에서 넓은 완전구순열 환아에서 구순성형술에 앞서 구순접합술을 시행하면 상악치조분절 간의 관계를 개선시키고 구순성형술 후 최종적인 결과를 향상시킴을 알 수 있다.

• 헤리티지:역사와 과학
• /
• 제46권4호
• /
• pp.78-89
• /
• 2013

국내 출토 손상된 장신구 유물들의 안전한 보존처리를 위해서 비파괴 분석과 파괴 분석을 통해 재질 확인이 정확하게 이루어져야 하며 그 결과에 따라 손상 원인과 보존처리 방안을 검토하여 보존처리에 임하여야 한다. 따라서 본 연구에서 2008년 6월 금산사 미륵전(彌勒殿) 좌협시보살(左脇侍菩薩)의 보수공사 중 발견된 손상 유물 11점을 재질 분석(자외선 조사, SEM-EDS 분석, FT-IR microscope 분석)한 결과 물리적 화학적 특성이 호박과 일치함을 알 수 있었다. 또한 출토된 대부분의 호박유물의 표면이 균열(龜裂)과 박락(剝落)되었는데 그 원인으로 C=C결합의 산화로 색이 어두워지는 현상으로 유추된다. 그러므로 손상된 호박유물의 보존처리는 무극성 용제(Xylene)에 희석한 Paraloid B67 강화제를 사용하는 것이 적절하다고 판단되어 물리적으로 취약한 호박유물 표면에 Paraloid B67 강화용액으로 보존처리를 실시하였으며 이에 대한 보존과학적 기초자료를 이 글에서 제공하고자 한다.

• Journal of Forest and Environmental Science
• /
• 제16권1호
• /
• pp.17-33
• /
• 2000

강릉시 시범 공설묘지 조성사업은 경사 $30^{\circ}$의 표고차가 심한 산지를 절 성토하여 계단식 묘역단을 조성하는 공사로 수직고 15m 이상의 대절토 및 성토부가 산재하고 있다. 특히 묘역단장후 주변 유입수 및 표면 유출수에 의한 비탈면 붕괴, 묘역단 유실 등의 피해가 발생할 경우 보수 또는 보강이 사실상 어려운 실정이며, 사회적 여론으로 확대될 가능성이 크므로 비탈면 보호에 필요한 녹화공법을 검토하였다. 구체적인 연구내용으로는 설계도면 및 현장답사를 통한 문제 비탈면 추출, 비탈면의 물리적 특성과 식생의 생육상황 파악, 비탈면 주변부의 식생조사와 유용식생 선발, 비탈면의 토양조건 분석 및 비탈면 토사의 기본불성 조사 등이며, 이를 기초로 하여 비탈면 현황 및 문제점을 파악하고, 그 대안을 제시하였다.