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한상진,장효석,조준한,오주석,윤일수,Han, Sangjin,Chang, Hyoseuk,Cho, Junhan,Oh, Juseok,Yun, Ilsoo 한국ITS학회 2020 한국ITS학회논문지 Vol.19 No.5
많은 나라에서 정규 운전면허 발급 기준을 만족시키지 못할 때, 특정한 조건을 만족시키는 경우에서만 운전을 허용하는 조건부 운전면허제도를 운영하고 있다. 우리나라에서는 시각, 청각, 신체 활동 등에 어려움을 겪는 사람들이 특별히 운전할 수 있도록 자동차의 구조를 개선하거나 신체 활동 보조수단을 이용하는 조건으로 면허를 발급하고 있다. 하지만 고령 운전자가 늘어나면서 기존 조건부 운전면허의 허용 조건을 다양화하자는 주장이 제기되고 있다. 본 연구는 외국의 다양한 조건부 운전면허제도 운영 사례를 벤치마킹하여 고령자를 위한 조건부 운전면허제도의 개선 방향을 모색하고자 한다. 특히 우리나라에 없는 조건부 운전면허 조건인 시간 제한, 공간 제한, 속도 제한, 도로 제한, 차량 제한, 개인 맞춤형 등 차원에서 주요 특징을 국제 비교를 통하여 도출하고자 한다. 조건부 운전면허제도의 허용기준 다양화는 고령자뿐만 아니라 차를 운전하지 않으면 일상생활에 어려움을 겪는 모든 운전자들에게 혜택이 될 것으로 기대된다. Some drivers cannot meet the standards for a full driver's license and many countries allow them to drive a vehicle as long as they can satisfy certain conditions. Korea has mainly issued conditional driver's licenses to the disabled only after supplementary devices are attached either in the vehicle or in their bodies. However, it is becoming important to issue a conditional driver's license to other types of drivers, including the elderly as the population ages in the country. This study aims at improving the current practice of issuing conditional driver's licenses by benchmarking various types of conditional licenses in other countries. In particular, various conditions such as time, space, driving speed, road type, vehicle type, and specific individual conditions are compared. Issuing a conditional driver's license to various types of drivers should be beneficial, not only to elderly drivers but also to drivers who cannot live without a vehicle.
투석식 초여과를 이용한 간경변 환자에서의 저항성 복수의 조절
한상진(Sang Jin Han),정의훈(Eui Hun Jeong),백광호(Gwang Ho Baik),윤동석(Dong Seok Yoon),김명빈(Myung Bin Kim),고문수(Moon Soo Koh),구자룡(Ja Ryong Koo),장웅기(Ung Ki Jang),김동준(Dong Jun Kim) 대한내과학회 1997 대한내과학회지 Vol.53 No.5
N/A Background: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. Methods: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. Results: The mean ultrafiltration time was 231±28min, ultrafiltrated volume was 5.15±1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5±23.7㎎/dL to 25.7±20.2㎎/dL; serum aldosterone level decreased from 807.3±301.1pg/ml to 431.1±187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67±0.28g/dL to 1.90±1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. Conclusion: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.