자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

Film Session Q&A 2 : 05 ; How to remove a huge ovarian tumor in single port laparoscopic surgery using XXXL endopouch

( Jin Hwa Lee ),( Ga Won Yim ),( Eun Ji Nam ),( Sung Hoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: Demonstrate a new instrument, technique or procedure 방법: In this video, we showed how to remove huge ovarian tumors in sinlgel port laparoscopic surgery by SW KIM`s method. SW KIM`s method is the technique to put a huge ovarian tumor into a specially designed extremely large endopouch (XXXL: 30x30㎠sized) using two conventional laparoscopic needle holders and one laparoscopic grasper and gravity by changing the patient`s position. After identifying the infundibulopelvic and uteroovarian ligaments salpingooophorectomy including huge ovarian tumor was performed by LigaSure. And then ovarian tumor was located in the pelvic cavity by changing the patient`s position into reverse-trendelenberg position and a XXXL endopouch was inserted and un-rolled inside the abdominal cavity. To insert a huge tumor into the XXXL endopouch, the endopouch was opened in triangular shape. Bilateral apex of baseline of trianglular opening of the endopouch was hold by two needle holders and then the upper apex was hold by a grasper. After holding three point of endopouch opeing, the patient`s position was changed into deep trendelenberg postion, then the tumor came into the endopouch by gravity. While changing the patient`s position, 2 needle holders and a graspers were moved into the pelvic cavity from the abdominal cavity. Aftere identifying the tumor inside the endopouch, tumors could be removed through the single port opening site or transvaginally in laparoscopic hysterectomy case without spillage of ovarian tumor. 결과: The advantage of SW KIM`s method is to remove ovarian tumor without spillage in a single port laparoscopic surgery by putting it into the large endoscopic bag despite narrow space. 결론: Using a specially designed 30×30 cm sized XXXL Endopouch and SW Kim`s technique, huge ovarian tumors could be removed without spillage in single port laparoscopic surgery.

민성휘(閔聖徽) 가문의 장서 연구 -7대손 민경속(閔景涑)과 유만주(兪晩柱)의 서적 왕래를 겸하여-

김영진 ( Kim Young-jin ),안정은 ( Ahn Jeong-eun ) 한국한문학회 2020 韓國漢文學硏究 Vol.0 No.80

본고는 조선시대 서책문화, 그 가운데 ‘私家藏書’에 대한 사례 연구를 여흥민씨 閔聖徽(1582~1648) 가문을 대상으로 한 것이다. 연구의 주안점은 두 가지인데 첫째는 민성휘 개인이 본격적으로 형성한 ‘사가장서’의 실체와 특징이고, 둘째는 민성휘의 7대손 閔景涑(1751~1794)의 장서다. 후자의 경우엔 벗 兪晩柱(1755~1788)와의 사이에 이루어진 書冊 相互 借覽과 문학, 학술 담론을 중심에 두었다. 민성휘의 1628년 明 使行에서의 서책 구입과 민경속과 유만주의 교유는 기존 연구성과가 있다. 본고는 기존 성과 위에 민성휘 윗대 아랫대의 저술 및 장서 현황, 소론 당파보인 『簪譜』 및 민경속의 인척 鄭堉이 편찬한 印譜 『圖書譜』, 任天常의 『試筆』 등의 신자료를 추가하여 이 가문의 장서 형성 과정과 그 학술 문화사적 특성을 보다 구체화하였다. 우선 민성휘의 『肅敏書目』을 재검토하고 현존하는 민성휘 장서인이 압인된 책들을 조사하여 관련 방증을 하였다. 또한 민성휘가 수집한 장서와 서책에 대한 관심이 가까이는 민성휘의 『松京訪碑錄』, 閔晉亮의 『唐詩類選』, 閔周冕의 『(新纂)東京誌』로 이어졌고, 멀리는 7세손 민경속의 『知先錄』과 『迂叟謾錄』 및 『輸廫故人錄』, 8세손 閔魯行의 『名數咫聞』과 『咫聞別集』 등으로 이어졌음을 논하였다. 민경속과 유만주 사이에 1785년부터 1787년까지 3년간 지속된 서책 교류를 총정리하였다. 이 둘의 진지하고 진솔한 학술교류는 방문 외에 양가 장서 및 서화의 상호 대차와 감상을 기본으로 하였는 바 두 가문의 당파와 교유권의 차이로 인해 수장 자료의 성격차이 역시 컸다. 이 점이 상대방의 호기심을 일으키고, 부족한 면을 충족시켜 주면서 서로의 성장에 밑거름이 되었다. 민경속의 인척으로 특히 주목되는 것이 ‘江華學’으로 널리 알려진 전주이씨 덕천군파와 연일정씨 鄭夏彦 후손가다. 연일정씨는 또 자하 신위와 연결되어 이후 민노행이 추사 김정희와 교류를 갖게되는 계기가 되었다. 민성휘가의 『서책목록』이 발견되지 않았고, 이 가문의 장서도 다 흩어졌다는 제약과 한계 속에서도 여러 자료의 편린들을 찾아내어 민씨가의 학술문화사적 의의를 추출하여 보았다. 이 과정에서 兪晩柱의 『欽英』이 갖는 서적문화사에서의 높은 의의를 재삼 확인할 수 있었다. 여흥민씨가의 장서와 그것의 학술문화사적 효용은 ‘조선시대 사가장서’의 한 실상과 의미 부여를 하였다는 데에 의의가 있다 하겠다. This thesis focused on the book culture in the Choseon Dinasty period, particularly with the emphasis laid on the family of the Yeoheung Mins by way of the case study on the collection of books at the private family of Seong-Hui Min(1582~1648) of the Yeoheung Mins. The main emphasis is two and the first is the substance and characteristics of ‘the collection of books at private family’ purposefully formulated by the individual Seong-Hui Min and the other is the collection of books of the 7^th descendant Gyeong-Sok Min(1751~1794). In the latter case, the focus was laid on the mutual borrowing and reading of the books and academic discourse with his friend Man-Ju Yoo(1755~1788). The purchase of books by Seong- Hui Min in his envoy trip to Ming in 1627 and the exchange between Gyeong-Sok Min and Man-Ju Yoo were greatly facilitated by Ha-Ra Kim. On top of the achievements of Ha-Ra Kim, this thesis carried out a more realistic review of the background of the formulation of the collection of books at this family and the academic and cultural historical characteristics with reference to the significant new data such as the writings and the status of book collections, the newsletter of Soron Party 『Jambo』, the book of impressions of seals 『Doseobo』 published by Yook Jeong who was a member of Yeonil Jeongs which was a relative family of Gyeong-Sok Min and others. First, this thesis aimed to establish the circumstantial evidence by conducting a review of 『Sukminseomok』 written by Seong-Hui Min and investigating the books belonging to the extant collection of books of Seong-Hui Min. It was verified that most of the pressing books from the extant collection of Seong-Hui Min are wood-block print books from Ming and discussed that the books were scattered from early stages. In addition, it was discussed that the attention to the collections and books established by Seong-Hui Min extended closely to 『Songgyeongbangbirok』 by Seong- Hui Min, 『Dangsiyuseon』 by Jin-Yang Min and 『(New Publication) Donggyeongji』 and remotely to 『Jiseonrok』, 『Osumyeonrok』 and 『Suyogoinrok』 by the 7^th descendant Grong-Sok Min and 『Myeongsuchimun』 and 『Jimoonbyeoljib』 by the 8th descendant No-Haeng Min. The thesis made an aggregate summary of the exchange of books between Gyeong-Sok Min and Man-Ju Yoo which lasted for 3 years from 1785 to 1787. The earnest and sincere academic exchange between them revealed the differences in the books and paintings stored due to the differences in faction, relatives and others apart from the collection of books in each family and these differences made great contribution to their mutual growth by invoking the intellectual curiosity and supplementing the deficient parts of each. The books of Gyeong-Sok Min can be divided between those inherited and those collected by oneself and in regard of the latter it was confirmed that the relative share of the books from Choseon Dynasty was much increased and that the relative families the Jeonju Lees (Deokcheongun family branch - Ganghwahak) and the Yeonil Jeongs inflicted a great influence on the procurement of books. By way of the connection with Jaha Wui Shin, the Yeonil Jeongs offered the opportunity for No-Haeng Min to have exchanges with Chusa Jeong-Hee Kim. Even under the limitation and restriction that 『List of Books』 of the family of Seong-Hui Min was not discovered and the collection of books of the family was all scattered around, the academic and cultural historical implications of the books of the Mins was extracted by discovering the partial fractions of a diversity of data. In this process, the high cultural historical value of the literatures retained by 『Heumyeong』 by Man-Ju Yoo could be ascertained anew. This thesis has the meaning that it highlighted the fact that the collection of books at the Yeoheung Mins and their academic and cultural historical utility reveal a realistic aspect of the ‘collection of books at private families in Choseon Dynasty Period’ and also that it gave such a meaning.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

장기간의 에어로빅스 운동이 골형성 및 각종 호르몬과의 상관관계

김종인,김은희,김주혁,김수진,김도형,장성동 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

Selected girl mid㎗e school of 14- and 15- years-old who got 35% body fat rate and are obese, and have them aerobics exercise for 20 weeks, the conclusion on the matter of change between Osteoporosis and Hormones showed. The contents of Calcium has significant difference(p<.05) between 9.38±0.34㎎/㎗ pre-exercise and 9.34±0.29㎎/㎗ post-exercise, and the contents of Glucose has significant difference (p<.05) between 78.0±5.38㎎/㎗ pre-exercise and 81.3±5.91㎎/㎗ post-exercise. parathyroid hormone (PTH) is shown as 11.2±3.06pg/㎖ at pre-exercise arid 13.8± 4.41pg/㎖ at post-exercise, hyperparathyroidism and osteoporosis (Osteocalcin) is shown as 6.04±3.56ng/㎖ at pre-exercise and 5.29±4.92ng/㎖ at post exercise, there is no significant difference. Deoxypyridinoline is shown as like 8.18±2.43nM/mMcre pre-exercise arid 9.97±2.76nM/mMcre post-exercise, Alkaline phosphatase (ALP), which has an effect on the born disease, is shown 229.7±61.66[U/㎖ pre-exercise and 224.3±8.27 [U/㎖ post-exercise, there is significant difference(p<.0l). There is significant difference (p<.05) between Growth Hormone and Parathyroid hormone(PTH) which is bone absorption hormone, the Osteocalcin which is the mark of born-formation, there is no significant difference among the index of born formation mark, lipid, and hormones.

매복된 상악 중절치의 교정적 견인을 이용한 치험례 : CASE REPORT

김종식,김은정,김현정,남순현,김영진 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.1

치아 매복이란 여러 가지 이유로 구강 점막이나 악골내에서 치아가 맹출하지 못하고 있는 상태를 의미한다. 상악 중절치 매복의 원인은 치아종, 과잉치, 공간의 상실, 선행유치의 만기잔존 또는 조기상실, 선행유치의 외상으로 인한 치관이나 치근의 기형, 치배의 이소위치 등이 있다. 매복된 상악 중절치의 경우, 측절치가 빠르게 근심으로 이동하여 공간을 상실하고, 정중선의 변이가 발생하며, 낭종을 형성할 가능성도 있다. 따라서, 매복치의 조기 진단과 그에 따른 적절한 처치가 즉각적으로 이루어져야 한다. 일반적으로 매복의 정도가 심하지 않거나, 각화조직에 의해 매복이 초래된 경우 외과적인 노출만으로도 맹출을 유도할 수 있지만, 외과적인 노출후에 일정기간의 관찰에도 맹출이 되지 않는다거나, 치아의 맹출 방향이 자가 교정될수 없을 정도로 심하게 변위되어 있는 경우, 매복의 위치가 너무 심부에 있는 경우에는 교정적 견인을 시도하는 것이 바람직하다. 본 증례는 매복된 상악 중절치 중 일정기간의 주기적 관찰후 맹출이 기대되지 않았기에, 교정적으로 견인하여 치료하였으며, 치료후 다소의 지견을 얻었기에 보고하는 바이다. A tooth impaction means a state that a tooth does not erupt out of oral mucosa or alveolar bone for many reasons. The reasons for an impaction of the Maxillary central incisor are an odontoma, supernumerary tooth, space loss, prolonged remaining or early loss of a preceding deciduous tooth, abnormalities of crown or root caused by trauma of a deciduous tooth and an ectopic position of a tooth germ. In the case of the impacted maxillary incisor, a rapid mesial movement of a lateral incisor leads a space loss and a midline deviation can be happened. Furthermore, it can cause a cyst. When we treated a patient with an impacted central incisor early, we could see a better prognosis. It means an early diagnosis and an exact treatment are very important. Generally if the impaction is not severe or it is caused by a keratinized covering tissue, a surgical exposure can induce an eruption easily but an orthodontic force is recommended when an eruption does not happen after a surgical method, when the eruption path is too transpositioned to be corrected spontaneously and when an impacted tooth is located so deeply. In the treatment using an orthodontic force, careful considerations about a root length, pulp, and a periodontal tissue can improve the periodontal and esthetic prognosis for the long follow-up results. This case is using an orthodontic traction following a periodic observation and in no expectation of spontaneous eruption. After treatment of this case, I have got some knowledges, so I report this case.

지역4-H조직의 내적 적합성에 관한 문화기술적 연구

김진모,김진군,전영욱,이정은,최영창,이은영 한국농업교육학회 2008 농업교육과 인적자원개발 Vol.40 No.2

이 연구의 목적은 지역4-H조직의 내적 적합성을 탐색하고 이를 기술하는데 있었다. 2006년 8월부터 10월까지 약 3개월 동안 지역4-H후원회 회장 및 임원진 3명, 지역4-H연맹 회장 1명, 학교4-H 지도교사 4명, 지역의 영농4-H회장 1명, 시·군 농업기술센터 소장 및 4-H담당자 9명을 주요 연구 참가자로 하여 심층면담을 통해 자료를 수집하였다. 수집한 자료를 분석한 결과는 다음과 같았다. 첫째, 지역4-H조직 관련자들이 인식하는 지역4-H조직의 주요성과 격차로, ① 민간4-H조직을 중심으로 한 자율적이고 독립적인 활동 부재, ② 지역4-H조직 간 다양한 종류의 협력 부재, ③ 지역사회에서 4-H활동에 대한 가치 인식 부족이 나타났다. 둘째, 지역4-H조직의 핵심 과업으로 ① 4-H의 가치 및 이념에 부합하고, 지역의 실정에 맞는 프로그램 확보, ② 지역4-H 조직 간 협력적 네트워크 확립, ③ 4-H에 대한 지역사회의 관심 및 지지 확보가 나타났다. 셋째, 지역4-H조직의 내적 부적합성으로는 ① 인원 확보의 어려움과 핵심과업에 대한 전문성 결여, ② 관료화되고 경직된 낡은 문화, ③ 조직적 자원의 축소 및 조직 간 낮은 네트워크의 수준이 도출되었다. The purpose of this study was to describe and understand internal fit in Local 4-H Organization. The main participants of this study were one leader and two members of Local 4-H Society for the support, one leader of Local 4-H Association, four School 4-H teacher, one leader of Local farm 4-H, 9 local agricultural extension workers. The data were collected through in-depth interview with them from August, 2006 to October, 2006. The Results from this study were as follow: 1. Key performance gaps of local 4-H organizations were identified: ① lack of local 4-H based activities, ② lack of various types of partnership between local 4-H organizations, ③ lack of understanding value of 4-H activities in the communities. 2. Key tasks of local 4-H organizations were identified: ① developing local 4-H programs based on 4-H's values and ideas, ② establishing the cooperative networks among local 4-H organizations, ③ ensuring the interest and support about 4-H in the communities. 3. Internal misalignments of local 4-H organizations were identified: ① difference of recruitment and lack of expertise, ② bureaucratic and rigid cultures, ③ decrease in organizational support and low level of network among organizations.