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한국 독사교상의 혈액응고장애 특성 및 항사독소 사용의 효율성
이병준(Byoung Joon Lee),홍성일(Sung Il Hong),김해성(Hae Sung Kim),김태화(Tae Hwa Kim),이정훈(Jeong Hoon Lee),김한준(Han Joon Kim),류병윤(Byoung Yoon Ryu),김홍기(Hong Ki Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1
Purpose: Snake venom induced coagulopathy is a major cause of both morbidity and mortality among affected patients. The effects of venomous factors to coagulation cascade and fibrinolysis were verified by analyzing the hematological data and clinical features of envenomed patients, and the efficacy of blood products transfusion and antivenin against a Korean snakebite clarified. Methods: A retrospective study was conducted on 57 patients, admitted to the Department of Surgery of Chuncheon Sacred Hospital, between July 2002 and October 2005. According to the guidelines for assessing the severity of North American envenomination, the patients were divided into three groups according to severity, and the clinical course, DIC profile and usages of blood products and antivenin then analyzed. Results: Of the 15 patients in the severe group (26.3%), 9 (60.0%) developed severe coagulation abnormalities, similar to DIC. No substantial bleeding or thrombic event manifested. All the patients with initial hypofibrinogenemia (33.3%) and unmeasured PT/aPTT during the 2nd to 4th hospital days (46.7%) progressed to severe coagulopathy. On average, these patients received transfusions of 18.4±6.1 pints of FFP and 14.4±14.9 pints of platelet product. The average amounts of antivenin applied were 1.2±0.4, 1.7±0.5 and 2.8±0.8 vials for the Minimal, Moderate and Severe groups, respectively. There was no death due to a Korean snakebite during this period. Conclusion: Korean snake venom is assumed to be a complex mixture of anticoagulant, platelet active and fibrinolytic venom. The discrepancy between abnormal coagulopathy and the clinical course explains venom induced DIC-like syndrome. Hypofibrinogenemia is the most reasonable predictor of DIC-like syndrome. Abrupt prolongation of PT/aPTT during the 2nd to 4th hospital days must weigh against thrombocytopenia. An early antivenin injection, along with the proper use of blood products, could improve the clinical course of envenomed patients.
이병관(Byoung Kwan Lee),장성건(Seong Geon Jang),황다혜(Da Hye Hwang),김진현(Jin-hyun Kim),김소연(So Yun Kim),이종현(Jong Hyun Lee),이병준(Byung Joon Lee) 국립공원연구원 2022 국립공원연구지 Vol.13 No.1
다도해해상국립공원의 진도 남동리 조간대 지형변화와 퇴적환경을 파악하기 위하여 지상라이다(Lidar) 및 무인 드론을 이용하여 지형을 관측하고 퇴적물을 채취하여 입도분석을 하였다. 조간대 생태계 교란식물인 갯줄풀(Spartina Alterniflora) 제거 전보다 제거 한 이후 평균고도는 0.1m(2cm/yr) 정도 낮아졌다. 제거 전 갯줄풀이 주로 서식했던 지역인 조간대의 남동쪽은 고도가 낮고 이중 또는 다중모드의 입도분포를 보이고 주로 세립한 니질퇴적상이 우세하였다. 이에 비해서 조간대 북서쪽은 고도가 높고 3Ø 정도 더 조립한 사질퇴적상을 나타냈다. 이는 갯줄 풀을 제거하는 과정에서 표층퇴적물이 교란되면서 일부가 유실되고 비교적 세립한 니질퇴적물의 재동 및 재부유작용에 의한 결과로 해석된다. To study Geomorphology of intertidal flat around southeastern of Jindo was measurement using terrestrial Lidar and drone and sedimentary environment analysed grain size of surface sediment in the Dadohaehaesang National Park. Compared to average height of intertidal flat was decreased more than 0.1m(2cm/yr) after removed Spartina Alterniflora of invasive salt marsh vegetation species. In southeastern site of intertidal flat before invasive salt marsh vegetation removal was lower height and distributed bimodal/ multimodal of finer mud facies. On the other hand, in northwestern site of intertidal flat after removed that was higher height and distributed of 3Ø more coarser sand facies. This results showed reworking and disturbance from resuspension of loosely finer sedimentary environment during removed then.
서해중부 태안해안의 현장 부유입자물질 분포와 거동 연구
이병관 ( Byoung Kwan Lee ),장성건 ( Seong Geon Jang ),김진현 ( Jin-hyun Kim ),황다혜 ( Da Hye Hwang ),김소연 ( So Yun Kim ),최윤영 ( Yun-young Choi ),이병준 ( Byung Joon Lee ) 한국환경기술학회 2020 한국환경기술학회지 Vol.21 No.6
In-Situ Suspended Particulate Matter(SPM) concentration of the water column and particle size distribution above the middle layer and bottom layer were measured in the Taean-Haean National Park, West Coast of Korea. The short-term series of in-situ suspended particulate matter concentration, total volume concentration, beam attenuation coefficient, mean grain size, floc size and distribution have been ensemble averaged according to tidal variation. Time variation of in-situ particle size and concentration shows bottom layer supplies relatively fine-grained particles with compared to middle layer. This explains a good correlation between sediment concentration and beam attenuation coefficient due to well defined, monotonous size distribution. Abundance of small microfloc and large macroflos with time and water column size distribution indicated the difference between organic matter in marine snow of turbidity maximum near-bottom layer and fine grain primary particles of water column. The particles supplied toward lower water column from upper water column during low tide showed a multi-modal distribution with two-three peak at coarse fraction, possibly due to the resuspension and the flocculation associated with marine biological activity and the increased shear velocity at near bottom, break-up of large flocs. This study can be used qualitative and quantitative analysis of in-situ fine suspended sediment distribution, resuspension and flocculation, land(fresh water) and marine(sea water) based source of suspended particulate matters, according to marine environmental relationship and global climate change.
학습목표영역에 따른 이러닝 컨텐츠 전달 유형별 학습 효과성과 선호도에 대한 연구
유병민 ( Byeong Min Yu ),이병준 ( Byoung Joon Lee ) 한국농촌지도학회 2014 농촌지도와 개발 Vol.21 No.4
본 연구는 이러닝 환경에서 학습 목표 영역별 콘텐츠 전달 전략에 따른 학습효과와 선호도의 차이 분석을 목적으로 수행되었다. 이를 위해 182명의 고등학교재학생을 대상으로 세가지 학습 목표영역과 두가지 이러닝 콘텐츠 전달 전략을 제작하여 이러닝 수업을 실시 후 학습효과와 선호도를 측정하였다. 연구결과 인지적 영역과 심동적 영역에서는 이러닝의 전달 전략에 따라 서로 다른 학습효과를 나타냈다. 인지적 영역에서는 학습자 중심형 전달전략이 교수자 중심 전달전략보다 높은 학습효과를 보였으며 심동적 영역에서는 반대로 교수자 중심 전달이 더 높은 학습효과를 나타냈다. 선호도 부분에서도 인지적 영역의 경우 학습자 중심 콘텐츠 전달방식이 교수자 중심보다 학생들이 선호하는 것으로 나타났으며 심동적 영역의 경우는 교수자 중심의 콘텐츠 전달 방식을 더욱 선호하는 것으로 나타났다. 연구결과는 이러닝 설계 시 학습효과와 선호도를 증진시키기위해서는 프로그램의 학습목표 영역을 고려하여야 한다는 것을 보여주고 있다. The purpose of this study are to figure out whether there are the meaningful differences between learner’s learning achievements and contents preference in accordance with the delivery strategies (instructor- focused model, learner-focused model) of learning materials suggested by Bloom in web-based instruction, and to suggest the various options on the contents delivery strategies to improve the learner’s learning achievements of each learning domains. Learning domains were divided by the cognitive domain, the affective domain, and the psychomotor domain. The result of research with 182 learners showed that learner- focused model in the cognitive domain caused higher learning achievements and preference than instructor-focused model. And instructor-focused model in the psychomotor domain compared with learner-focused model caused higher learning achievements and preference. However, there were less meaningful differences in the affective domain. In other words, learner-focused model is appropriate to the feature of the cognitive domain while instructor-focused model is appropriate to the feature of the psychomotor domain. The results suggest that delivery strategies should be chosen by domains of learning contents in order to improve learner’s learning achievements in web-based instruction. Learner-focused delivery strategies in the cognitive domain and instructor-focused delivery strategies in the psychomotor domain need to be considered positively. Delivery strategies should be studied and developed in order to lead higher learning achievements and preference.