연명치료중지시 의사의 역할과 의무

고윤석 대한의사협회 2009 대한의사협회지 Vol.52 No.9

Patients should be treated with dignity and respect toward the end of their lives, being freed from unnecessary and painful life-sustaining therapy in hospitals. In Korea, the quality of endof- life (EOL) care has been variable, a major factor being the physicians’ perception to the care. A firm consensus of EOL care decision-making has not yet explicitly stated in Korean law and ethics until recently. However, movements to make a law of so-called “the death with dignity act” are presently making its way to the National Assembly, initiated by a law case that allowed the hospital to withdraw mechanical ventilator support per request by the patients’ family of a permanently vegetative patient. Socially agreed guidelines for EOL care can facilitate clinical decision process and communication between health service provider and the patient or his/her family. At the same time, EOL care should be individualized also in the same line of guideline to meet patient’ and patient’ family wish regarding the withdrawal of life-sustaining therapy. The painful EOL care experience of the loved one remains in the memory of the relatives who live on. Physicians should identify, document, respect, and act on behalf of the hospitalized patients’ needs, priorities, and preference for EOL care. It has been advocated that competent patients can express their right of self-determination on EOL care through advance directives in Western countries. Advance directives are considered as a tool to facilitate EOL decision making. However, there are barriers to adopt the advance directives as a legitimate tool for an EOL decision making in Korea. For one thing, the reality of death and dying is rarely discussed in our society. In addition, the discussion about EOL care with chronically and critically ill patients has been considered as a taboo in the hospitals. In spite of these difficulties, physicians could do better EOL care by the open communication with patients or with their surrogates. Through the communication, physician should set a goal how to manage the EOL patient. The set goal should be shared among the caregivers to achieve the maximum benefit of the patient. The lack of open discussion with patient prior to EOL care results in inappropriate protraction of a patient’s dying process. In summary, physicians, who know the clinical significance of delivering treatments to EOL patients, should play a central role in assisting patients’ and their families’ to make the best decision on EOL care. Moreover, the concerted actions to improve EOL care in our society among general public, professionals, stakeholders for EOL care, and governmental organizations are required to address ongoing social requests, although a policy or a guideline is made in this time.

圓佛敎 四恩思想의 科學的 照明

高允錫 원광대학교 원불교사상연구원 1994 원불교사상과 종교문화 Vol.17·18 No.-

스마트 주택 자동화를 위한 주택 전기과부하 경보 성능 평가 시스템 개발

고윤석 한국전자통신학회 2019 한국전자통신학회 논문지 Vol.14 No.2

In this paper, a digital home electric overload alarm system based on DSP for smart home automation which can minimize electrical fire damage caused by an home electrical overload was made experimentally. To verify the validity of the home electrical overload alarm technology, an electric overload alarm performance evaluation system which can generate artificially the electrical overloads was designed, developed, and constructed, and the effectiveness of the overload alarm developed by the overload test was verified. In particular, an overload test EMTP model based on EMTP-RV was developed, and simulation and measurement results obtained from the overload test were compared, and the reliability of overload performance verification results was confirmed. 본 논문에서는 주택 전기 과부하로 인한 전기화재 피해를 최소화할 수 있는 스마트 주택 자동화를 위한 DSP 기반의 디지털 주택 과부하 경보기를 실험 제작하였다. 그리고 주택 과부하 경보 기술의 유효성을 검증하기 위해서 인공적으로 과부하를 발생시킬 수 있는 하나의 전기 과부하 경보 성능 평가 시스템을 설계, 개발, 구축하고, 과부하 시험을 통해 개발된 주택 과부하 경보기의 유효성을 검증하였다. 특히, EMTP-RV를 이용하여 과부하 시험 모델을 개발하고 과부하 시험을 모의, 계측결과와 비교함으로서 과부하 성능 검증결과의 신뢰성을 확인하였다.

Comparison of Left Ventricular Hypertrophy, Fibrosis and Dysfunction According to Various Disease Mechanisms such as Hypertension, Diabetes Mellitus and Chronic Renal Failure

고윤석,정해억,박만원,백주열,김범준,임상현,장기육,오용석,윤호중,백상홍,정욱성,승기배,김재형,윤성규 한국심초음파학회 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.4

Background: Left ventricular hypertrophy (LVH) has been known as an important predictor of prognosis of cardiovascular disease. Carboxy-terminal propeptide of procollagen type I (PIP) is related with myocardial fibrosis. We sought to analyze the differences in the characteristics of LVH, myocardial fibrosis, and LV functions among hypertension (HBP), diabetes mellitus (DM) and chronic renal failure (CRF). Methods: We enrolled consecutive patients with LVH. Patients were grouped as HBP (n=50), DM (n=41), CRF (n=31). Age and sex-matched normal control was also enrolled (n=32). Echocardiography and blood sampling for serum PIP level measuring was performedin all participants. Results: There were no differences in baseline characteristics except systolic blood pressure among four groups. In three patients groups, their LV mass indices were significantly increased than control. Serum PIP level in CRF was much higher than others (CRF 1505.5 vs. HBP 868.7 vs. DM 687.5 vs. control 826.4, p<0.0001). LV diastolic and systolic function evaluated by E’, E/E, S’ and midwall fractional shortening was significantly decreased in three patients groups. However, LAVi was significantly elevated and LV ejection fraction was significantly decreased in CRF compared to others. In correlation analysis, indices of diastolic function were weakly, but statistically correlated with PIP (E’: r=0.234, p=0.006; LAVi: r=0.231, p=0.006). Conclusion: In CRF, LV function was more deteriorated and serum PIP was more elevated when compared to HBP or DM. Therefore, myocardial fibrosis may play an important role to LV dysfunction as well as LV hypertrophy in CRF in some degree.

아크고장 검출 기능을 가지는 지능형 분전반 개발

고윤석,이서한 한국전자통신학회 2016 한국전자통신학회 논문지 Vol.11 No.1

This paper aims at the prototype-making of the intelligent switchgear with arc fault diagnosis function required to prevent the electrical fire. The main control unit of the intelligent switchgear consists of a single-phase power management device and a arc fault diagnosis device. The prototype of the single-phase power management device and the prototype of the arc fault diagnosis device in this paper. In the device, the cooperation function with the arc fault diagnosis device is developed to transmit the cause of the electrical fire to the remote server system. 본 논문에서는 주택의 전기화재 방지를 위해 아크고장전류로부터 아크 진단 기능을 가지는 지능형 분전반이 개발된다. 지능형 분전반의 주 제어장치는 단상전력관리를 지원하는 단상 전력관리 장치와 아크전류로부터 아크 고장을 진단하기 위한 아크 진단 장치로 구성된다. 본 논문에서는 단상 전력관리 장치와 아크진단장치의 시작품이 설계, 제작되며, 전기화재의 원인을 분전반으로부터 원격 서버 시스템에 전송하기 위해서 주제어장치와 아크 고장 진단 장치와의 연동기능이 개발된다.

에너지 저장 시스템의 전력계통 적용사례분석

고윤석 한국전자통신학회 2016 한국전자통신학회 논문지 Vol.11 No.1

Because a progressive tax of home electricity rates is charged and a continuous rise of industrial electricity rates is expected in order to solve the global warming, the high oil prices and the serious power shortage problem, the efforts to apply the energy storage systems which can significantly improve the energy usage efficiency to the smart grid are trying newly. In this study, characteristics of the secondary battery which can be used as energy storage devices, the structure and operation principle of a lithium-ion battery, and the concept of energy storage systems are research and analyzed. In addition, in this paper, the base technologies which are required to apply to the energy storage system to electric power system are established by studying about installation location and application methodology of energy storage system to electric power system. 지구 온난화, 고유가 그리고 심각한 전력난 문제를 해소하기 위해, 가정용 전기요금 누진제 적용과 함께 산업용 전기요금의 지속적인 상승이 이루어지고 있어 에너지 이용 효율을 크게 개선할 수 있는 에너지 저장 시스템을 스마트 그리드에 적용하기 위한 노력들이 새롭게 시도되고 있다. 본 연구에서는 에너지 저장 장치로 활용될 수 있는 리튬이온 전지의 구성 및 동작원리, 에너지 저장 시스템의 전력계통 적용 분야, 배터리 에너지 컨버터 기술, 그리고 적용사례를 연구함으로서 에너지 저장 시스템을 전력계통에 적용하는 데 필요한 기반 기술을 확립한다.

열전 냉각기의 모델링 및 열전달 해석에 대한 연구

고윤석,Ko, Yun-Seok 한국전자통신학회 2014 한국전자통신학회 논문지 Vol.9 No.11

열전 냉각기는 냉온 정밀온도제어가 가능하고, 소형화 및 경량화가 가능할 뿐만 아니라 기계적인 진동이 없어 신뢰성을 높일 수 있다는 장점 때문에 다양한 분야에 적용이 시도되고 있다. 하지만 열적 모델링 및 해석이 요구되기 때문에 적용분야에 최적한 열전 냉각기를 설계하는 것은 쉽지 않다. 따라서 본 연구에서는 SINDA/FLUINT 해석법을 이용하여 열전 냉각기 모델링과 크기 결정 문제 그리고 열적해석 등을 연구함으로서 열전 냉각기의 적용을 위한 기반기술을 확립하고자 한다. The thermoelectric cooler is receiving great interest because of advantages such as the precise temperature control capability, the compact and lightweight cooler, and the mechanical vibrationless structure which enhances the reliability compared with the existing vapor compression cooler. However, it is not easy to design the optimal thermoelectric cooler which appropriate to the application because the thermal analysis should be necessary required. Accordingly, this paper studies the methodology of the modelling, sizing and thermal analysis of the thermoelectric cooler using SINDA/FLUINT analysis tool.

심포지엄 : 의료현장에서 부딪히는 생명윤리의 범주와 해결방안

고윤석 대한내과학회 2010 대한내과학회지 Vol.79 No.20

MFC 기반 하이브리드 전자보오드 검사를 위한 규칙기반 솔루션 설계

고윤석 대한전기학회 2005 전기학회논문지 D Vol.54 No.9(D)

This paper proposes an expert system which is able to enhance the accuracy and productivity by determining the test strategy based on heuristic rules for test of the hybrid electronic circuit board producted massively in production line. The test heuristic rules are obtained from test system designer, test experts and experimental results. The guarding method separating the tested device with circumference circuit of the device is adopted to enhance the accuracy of measurements in the test of analog devices. This guarding method can reduce the error occurring due to the voltage drop in both the signal input line and the measuring line by utilizing heuristic rules considering the device impedance and the parallel impedance. Also, PSA(Parallel Signature Analysis) technique is applied for test of the digital devices and circuits. In the PSA technique, the real-time test of the high integrated device is possible by minimizing the test time forcing n bit output stream from the tested device to LFSR continuously. It is implemented in Visual C++ computer language for the purpose of the implementation of the inference engine using the dynamic memory allocation technique, the interface with the electronic circuit database and the hardware direct control. Finally, the effectiveness of the builded expert system is proved by simulating the several faults occurring in the mounting process the electronic devices to the surface of PCB for a typical hybrid electronic board and by identifying the results.

기초과학 교육이념의 허와 실

고윤석,Go, Yun-Seok 한국과학기술단체총연합회 1983 과학과 기술 Vol.16 No.9