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U.S. Power Penetration through the Military Bases in Guam
남궁곤,이설형 서울대학교 국제학연구소 2012 Journal of International and Area Studies Vol.19 No.2
The purpose of this study is to provide an interpretation of the power penetration delivered through the United States’ overseas military bases. This study specifically concentrates on the military bases in Guam. The penetration of U.S. power into the Guam economy delivers three results. First of all, military bases boost the island’s economy. Secondly, the bases bring economic structural change to Guam. Such change is shown through the average hourly wages among industries. Lastly, as the military bases increase in size, the functions of foreign companies enlarge as well. The increase of foreign companies can be traced back to the enlargement of military contracts awarded by the Department of Defense. Along with the economic influence, the military base in Guam is interpreted to influence the island’s identity indication. In this study, U.S. military bases in Guam have been explained as a method of United States’ power implementation into the economic sphere and the island’s identity. In sum, the military bases affect the economic growth, economic structure, and the generation gap towards identity indication.
신장 ; 혈액투석 환자에게서 Biohole(TM) 쐐기를 이용한 Buttonhole 천자법의 임상적 유용성
최수정 ( Soo Jeong Choi ),이설형 ( Seol Hyoung Lee ),조은희 ( Eun Hee Cho ),오혜란 ( Hye Ran Oh ),김은정 ( Eun Jung Kim ),박무용 ( Moo Yong Park ),김진국 ( Jin Kuk Kim ),황승덕 ( Seung Duk Hwang ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Background/Aims: Buttonhole cannulation has been popular because it provides an easy puncture, is less painful, and requires less time for hemostasis. However, the technique requires a skilled staff and a long time to form the tract. A new buttonhole technique using Biohole(TM), which shortens the time needed for tract formation, has been introduced in Europe, North America, and Japan. Methods: We prepared a cannulation tract using the buttonhole technique and Biohole(TM) over a two-week period and compared the 12-week outcomes between patients who underwent the rope-ladder versus buttonhole techniques. Results: The 40 patients (27 males) had a mean age of 49.1±14.2 years. Thirteen and 27 patients were cannulated with the rope-ladder and buttonhole techniques, respectively. Patients who underwent the buttonhole technique had more initial pain than did those who received the rope-ladder technique (p=0.044). The Biohole(TM) procedure improved puncture pain (5.6 vs. 3.4, p=0.003) and shortened hemostasis time (1.8 vs. 1.3, p=0.001). Over a two-week period, patients using Biohole(TM) experienced dislocation (20.8%), bleeding at peg sites (8.6%), and pain during peg change (2.4%). Over the 12 week study period, patients who underwent the buttonhole technique had insignificantly less pain than did those who received the rope-ladder technique (p=0.088), but the former had less bleeding time than the latter (p=0.000). One patient who received the buttonhole technique experienced one episode of infection (p=0.327). Conclusions: The new buttonhole technique using Biohole(TM) is safe and useful in the short term. A long-term, larger, multicenter study is required to confirm these results. (Korean J Med 2012;82:307-312)
단일 혈액투석 기관에서 Buttonhole 천자의 경험
최수정 ( Soo Jeong Choi ),조은희 ( Eun Hee Cho ),이설형 ( Sul Hyung Lee ),오혜란 ( Hye Ran Oh ),김종혜 ( Jong Hye Kim ),박무용 ( Moo Yong Park ),김진국 ( Jin Kuk Kim ),황승덕 ( Seung Duk Hwang ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
목적: Buttonhole 천자는 혈액투석 시에 같은 부위를 천자해 천자가 쉽고, 통증이 적으며, 지혈이 빠른 장점들이 있어 국내에선 최근에 저자들에 의해 소개되었다. 방법: 2011년 7월부터 12월까지 buttonhole을 만들고 2013년 2월까지의 buttonhole 천자를 받았던 환자에게서 감염, 입원 및 동정맥루 사건을 조사하여, 동일 환자의 1년 전 ropeladder법으로 투석한 기간의 자료와 비교 분석하였다. 결과: 총 48명(남자 34명, 나이 49.4 ± 13.8세)이 buttonhole 술기를 시작하였고, 3명은 buttonhole을 만들지 못하였고, 3명은 이식, 1명은 전원으로 buttonhole 술기를 중단하였다. Buttonhole 천자를 지속한 41명의 15.1 ± 4.7개월 추적기간에 13명(29.2%)에서 감염이 발생하였고, 동정맥루 국소감염 5명, 폐렴 3명, 균혈증 2명, 봉와직염 1명, 간농양 1명, 골수염 1명 순이었다. 이들의 rope-ladder 천자 기간과 buttonhole 기간의 감염, 입원, 동정맥루 사건은 유의한 차이가 없었다. 결론: Buttonhole 천자는 rope-ladder천자에 비해 감염, 입원 및 동정맥루 사건의 유의한 차이가 없다. Background/Aims: The buttonhole technique, in which needle insertion during cannulation is always into the same site, confers advantages including ease of cannulation, ease of achieving hemostasis, and reduced pain compared with rope-ladder needling. We introduced the buttonhole technique in hemodialysis patients experiencing pain during needling. None of the disadvantages associated with the buttonhole technique, such as infection or access events, were observed, due to the short duration of the study. Methods: Patients undergoing buttonhole needling were observed prospectively. Data were collected on the following parameters: infectious complications, hospitalizations and access events. We compared buttonhole and rope ladder needling using baseline data. Results: A total of 48 patients (34 males; mean age = 49.4 ± 13.8 years) were enrolled. Seven patients were excluded: in three patients, the buttonhole technique failed to form a tract, three others underwent kidney transplantation, and one was lost to follow-up. The remaining 41 patients were followed for 15.7 ± 4.7 months. Thirteen patients suffered infections, as follows: local infections (n = 5), pneumonia (n = 3), bacteremia (n = 2), cellulitis (n = 1), osteomyelitis (n = 1), and liver abscess (n = 1). There were no significant differences between the rope-ladder and buttonhole needling techniques in rates of infection, hospitalization or vascular access events. Conclusions: The infection rate and access event frequency associated with buttonhole needling did not differ in relation to that of rope-ladder needling. (Korean J Med 2014;87:574-578)