림프절 종창의 임상적 관찰

김삼용,김현수,김종숙,박상준,최지영,윤환중,조덕연 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Objectives : Clinical management of patient with lymphadenopathy requires judicious judgement of clinicians. Careful evaluation of lymph node enlargement by various clinical parameters will help to disclose the etiology of lymph node enlargement. This study was conducted to identify the clinical manifestations and etiology of lymphadenopathy in korean patients. Methods : A total 192 patients with lymph node enlargement were studied retrospectively. All patients who underwent excisional lymph node biopsy during the period from January 1992 to July 1994 were included. The lymph node biopsy and clinical records were reviewed and patient characteristics were analyzed by various clinical parameters. Results : A female predominance was noted in lymphadenopathy of tuberculosis (58.5%), Kikuchi's syndrome (70%). In lymphadenopathy of nonspecific, tuberculosis, kikuchi syndrome, per centage of patients younger than 40 years of age were 84.5%, 75.6%, 100%, respectively. In lymphadenopathy of tuberculosis and metastatic cancer, the duration of lymphadenopathy below 30days were 51.2%, 73.9%, respectively. The two most common etiology of cervical lymphadenopathy were nonspecific lymphadenitis (47.7%) and tuberculous (26.8%). The two most frequent etiology of supraclavicular lymphadenopathy were nonspecific lymphadenitis (46.3%) and metastatic lymphadenopathy (26.8%) and the most common etiology of axillary lymphadenopathy was nonspecific lymphadenopathy (34.5%). The most common frequent of lymph node enlargement with size below 1㎠ was nonspecific lymphadenitis, while above 2.25㎠ it was metastatic lymphadenopathy. Conclusion : Careful evaluation regarding patient age, sex, size of lymph node, consistency, location of lymph node, presence or absence of systemic symptoms should be pursued before performing a biopsy and management.

소아 Mycoplasma Pneumoniae에 의한 폐렴의 임상적 고찰

김상갑,노상현,정은경,윤중근,김용태,박영봉 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

The author determined mycoplasma antibody titer in 127 cases of pneumonia who were admitted to the pediatric ward of Chosun University Hospital from December, 1989, to Novemver, 1990, and clinical investigation and statistical analysis were performed between mycoplasma antibody positive group and negative group. The following results were obtained: 1) In 127 cases of children with pneumonia, incidence of mycoplasma antibody positive cases was 22.8%(29/127). 2) Comparison of mean age between mycoplasma antibody positive group and negative group revealed significantly older in positive group than negative group (5.9±2.8 years, 2.7±3.5 years respectively), 3) The sex ratio was 1:1.23 in mycoplsma antibody positvie group and 1.6:1 in negative group. 4) There was no significant difference in the clinical symptoms and the physical signs betweem both groups. 5) There was no significant difference in total leukocyte count and ESR between both groups. 6) On radiological findings, the bronchopneumonia was significantly related to mycoplasma antibody positive group.

캡슐내시경과 단일풍선 소장내시경으로 진단된 공장의 간질종양 1예

송도경,심기남,태정현,김경진,송명은,송하응,윤혜원,정가영,정정화 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.2

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4×2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.

한국형 지원고용 모델개발을 위한 시설적 연구

나운환,이성일,정명현 대구대학교 특수교육재활과학연구소 2000 再活科學硏究 Vol.16 No.1

이 연구는 지원고용의 한국적 모델개발을 위한 연구로 연구방법은 문헌조사에 의해 이루어졌다. 현황에 있어서는 우리 나라의 경우는 소집단모델, 미국의 경우는 개별배치모델이 적합모델이라고 볼 수도 있으나 이렇게 단정적으로 결론을 내리기에는 여러 가지 한계가 있다. 즉 지원고용 모델 적용은 모든 장애인에게 일률적으로 특정 모델을 적용하는 것은 문제가 되며 내담자의 안정성, 비용/편익, 독립적·생산적 요인, 지역사회 자원활요, 서비스의 질, 진로발달과 성공적인 고용기회, 내담자외 기대만족이라는 요인들이 상호 복합적으로 검토된 이후 결정되어야 하는 것이다. 다만 이러한 요인들을 검토해 볼 때 미국의 경우는 개별배치모델이 우리 나라의 경우는 소집단 모델이 유리할 것으로 보는 것이다. 따라서 지원고용의 한국적 모델을 제시한다는 본 연구는 네 가지 모델 중 어떤 모델이 한국에 가장 적합할 것인가를 제시하기보다는 일단 소집단모델이 실태를 통해 본 결과 가장 유리하지만 모델을 결정할 때는 지원고용 실시기관, 내담자, 지역사회의 노동시장들에 대한 정확한 진단이 선행된 후 결정하는 것이 가장 바람직할 것이라는 것으로 결론을 내리고 싶다. 끝으로 결론을 보다 효과적으로 달성하기 위해서는 모델 결정에 중요한 역할을 미칠 수밖에 없는 재활상담사들의 다음과 같은 역할을 강조하고 싶다. 첫째, 지원고용의 이념을 상담사가 분명하게 이해해야 한다. 둘째, 철저한 개별화가 이루어져야 한다. 셋째, 고객선택주의에 대한 확신이 있어야 한다. 넷째, 지속적인 재정지원 및 확보방안이 있어야 한다. 다섯째, 수행 프로그램에 대한 과정평가가(process evaluation) 이루어져야 한다. 여섯째, 프로그램의 유연성을 가져야 한다. 일곱째, 상담사의 지속적인 훈련과 재교육이 이루어져야 한다. The purpose of this study is developing a model of the supported employment in Korea. The concept of supported employment has been apart of the explosion of knowledge in the services delivery system for persons with severe disabilities. The recent literature suggest, the different program models. There are no set rules or criteria for selecting one supported employment model over another. However, there are some guidelines which can be useful for the counselor as planning for the client's vocational options takes place. A services of guidelines framed in question format are the client most comfortable with, cost/benefit. independent and productive, local resourcement, service quality, opportunity for employment, consumer desire etc. Although four major supported employment service delivery models currently predominate, these are undergoing changes to meet the needs of workers with disabilities and conditions of local labor markets. There is no one 'best' supported employment model: Individual at a given time in a certain local economy. In conclusion, suggest of this study are guidelines for deciding which supported employment option to select in Korea. ① What work arrangement is the client most comfortable with? ② What will one model cost versus another model? ③ Which model will allow the client to be most independent and productive? ④ What is the availability of different models in the local community? ⑤ What is the quality of the vendor service available? ⑥ What model seems to provide the greatest opportunity for closure and successful career advancement? ⑦ What model provides the level of security that the consumer desires?

암 병동 간호사의 통증관리에 대한 지식과 태도

공성화,방찌야,서민숙,현신숙,김희정,이미애1,이미애2,유현희,허재경,김은애,박경숙 성인간호학회 2004 성인간호학회지 Vol.16 No.1

Purpose: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. Method: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990). that was by Kim'(1997). Result: In terms of the nurses knowledge of pain management. the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids. 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016). years of experiences(p=.002), experience of cancer pain education(p= .001). Conclusion: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.

Combined Optimal Design of Flexible Beam with Sliding Mode Control System

JUNG-HYEN PARK,SOON-HO KIM 한국해양공학회 2003 韓國海洋工學會誌 Vol.17 No.4

In order to achieve the desired lightweight and robust design of a structure, it is preferable to design a structure and its control system, simultaneously, which is termed the combined optimal design. A constant-cross-sectional area cantilever beam was chosen as the optimum design method. An initial load and a time-varying disturbance were applied at the free end of the beam. Sliding mode control was selected, due to its insensitivity to the disturbance, compared with other modes. It is known that the sliding mode control is robust to the disturbance and is uncertain, only if a matching condition is met, after giving a switching hyper plane. In this study, the optimum method was used for the design of the switching hyper plane, and the objective function of the optimum switching hyper plane was assumed to be the objective of the control system. The total weight of the structure was treated as a constraint, and the cross sectional areas of the beam were considered as design variables, the result being a nonlinear programming problem. To solve it, the sequential linear programming method was applied. As a result of the optimum design, the effect of attenuating vibrations has been substantially improved. Moreover, the lightweight design of the structure became possible as a result of the relationship of the weight of the structure to the control objective function.

Optimal Structural Design for Flexible Space Structure with Control System Based on LMI

Jung Hyen Park,Kyeum Rae Cho 대한기계학회 2002 KSME International Journal Vol.16 No.1

Structure-Control Combined Design with Structure Intensity

JUNG-HYEN PARK,SOON HO KIM 한국해양공학회 2003 韓國海洋工學會誌 Vol.17 No.5

This paper proposes an optimum design method of structural and control systems, using a 2-D truss structure as an example. The structure is subjected to initial static loads and disturbances. For the structure, a FEM model is formed. Using modal transformation, the equation of motion is transformed into modal coordinates, in order to decrease D.O.F. of the FEM model. To suppress the effect of the disturbances, the structure is controlled by an output feedback H∞ controller. The design variables of the combined optimal design of the control-structure systems are the cross sectional areas of truss members. The structural objective function is the structural weight. The control objective function is the H∞ norm, the performance index of control. The second structural objective function is the energy of the response related to the initial state, which is derived from the time integration of the quadratic form of the state in the closed-loop system. In a numerical example, simulations have been perform. Through the consideration of structural weight and H∞ norm, an advantage of the combined optimum design of structural and control systems is shown. Moreover, since the performance index of control is almost nearly optimiz, we can acquire better design of structural strength.

Structure-Control Combined Optimal Design of 3-D Truss Structure Considering Initial State and Feedback Gain

JUNG-HYEN PARK 한국해양공학회 2003 韓國海洋工學會誌 Vol.17 No.4

This paper proposes an optimum, problematic design for structural and control systems, taking a 3-D truss structure as an example. The structure is subjected to initial static loads and time-varying disturbances. The structure is controlled by a state feedback H∞ controller which suppress the effects of disturbances. The design variables are the cross sectional areas of truss members. The structural objective function is the structural weight. For the control objective, we consider two types of performance indices. The first function represents the effect of the initial loads. The second function is the norm of the feedback gain. These objective functions are in conflict with each other but are transformed into one control objective by the weighting method. The structural objective is treated as the constraint. By introducing the second control objective which considers the magnitude of the feedback gain, we can create a design to model errors.

Trade credit, group affiliation and credit contraction: Evidence from the 1997 Korean financia crisis

( Jung Hwan Hyen ) 한국국제경제학회 2015 한국국제경제학회 동계학술대회 Vol.2015 No.-

This paper uses unique trade credit information to investigate how the 1997 financia CrISIS shocks affect trade credit behavior in Korea during the crisis and the subsequent financia and corporate reform period. I uncover evidence that cash-rich chaebol firm increased the amount of trade credit provided to clients affiliate with them, while liquid chaebol firm also received more trade credit from non-affiliate suppliers to redistribute the liquidity to their constrained affiliates In addition, constrained chaebol-affiliate firm resorted to trade credit extended by suppliers, irrespective of their affil ation. Non-chaebol firm with large cash holdings provided more liquidity to clients affiliat d with them, while constrained non-chaebols only received more trade credit from suppliers affiliat d with them. The results suggest that trade credit played a crucial role in the internal capital markets of chaebols during the credit crunch and that constrained nonchaebol firm experienced the most severe credit contractions.