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Assisted Cough and Pulmonary Compliance in Patients with Duchenne Muscular Dystrophy
강성웅,강연승,문재호,유태원 연세대학교의과대학 2005 Yonsei medical journal Vol.46 No.2
The aim of this study was to investigate the factors affecting cough ability, and to compare the assisted cough methods in patients with Duchenne muscular dystrophy (DMD). A total seventy-one male patients with DMD were included in the study. The vital capacity (VC) and maximum insufflation capacity (MIC) were measured. The unassisted peak cough flow (UPCF) and three different techniques of assisted peak cough flow were evaluated. UPCF measurements were possible for all 71 subjects. But when performing the three different assisted cough techniques, peak cough flows (PCFs) could be obtained from only 51 subjects. The mean value of MICs (1801±780cc) was higher than that of VCs (1502±765cc) (p<0.01). All three assisted cough methods showed a significantly higher value than the unassisted method (F=80.92, p<0.01). The manual assisted PCF under MIC (MPCFmic) significantly exceeded those produced by manual assisted PCF (MPCF) or PCF under MIC (PCFmic). The positive correlation between the MIC, VC difference (MIC-VC), and the difference between PCFmic and UPCF (PCFmic-UPCF) was seen (r= 0.572, p<0.01). The preservation of pulmonary compliance is important for the development of an effective cough as well as assisting the compression and expulsive phases. Thus, the clinical importance of the inspiratory phase and pulmonary compliance in assisting a cough should be emphasized.
A Comparison of Cough Assistance Techniques in Patients with Respiratory Muscle Weakness
강성웅,김선미,최원아,원유희 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.6
Purpose: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. Materials and Methods: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependentNMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assistedby manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured usinga new device, the Cough Aid. Results: All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standarddeviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. Conclusion: In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.
강성웅,김갑수 한국정보교육학회 2016 정보교육학회논문지 Vol.20 No.3
본 연구는 PISA 2012 문제해결력 평가 문항 중 이산수학의 그래프 이론이 적용된 ‘TRAFFIC’ 문항을 바탕으로 총 19문항의 최단경로 탐색 검사 도구를 제작했고, 웹기반 컴퓨터 평가로 정보영재학생과 일반학생을 대상으 로 실시했다. 컴퓨터는 일상의 문제를 해결하는 과정에서 없어서는 안 될 중요한 기기이자 평가의 기반이 되는 매체로 자리 잡았고, 정보영재학생은 컴퓨터를 통해 문제를 해결할 수 있어야 하고, 컴퓨터가 절차를 수행할 수 있는 분명한 명령을 내려줄 수 있어야 한다. 또한, 컴퓨팅 사고가 어느 분야든 영향을 미치는 시대이기 때문에 학생들에게 새로운 교육적 자극을 줘야 한다. 최단경로 탐색 과정을 통해 문제해결에 걸린 시간과 정답률 간의 상관관계를 찾을 수 있었고, 노드와 엣지의 증가로 문항의 곤란도가 높아짐에 따라 노드가 문제해결에 영향을 크게 미치는 것을 찾을 수 있었다. 또한, 정보영재학생의 문제해결 과정에서 알고리즘적 사고 과정을 볼 수 있 었고, 정보영재학생의 인지적 특성인 ‘효율화 능력’과 ‘정보구조 기억력’을 확인할 수 있었다. This study has produced a checker of the shortest path search problem with a total of 19 questions as a web-based computer evaluation based on the ‘TRAFFIC’ questions of PISA 2012. It is because the computer has been settled as an indispensable and significant instrument in the process of solving the problems of everyday life and as a media that is underlying in assessment. Therefore, information gifted students should be able to solve the problem using the computer and give clear enough commands to the computer so that it can perform the procedure. In addition, since it is the age that the computational thinking is affecting every sectors, it should give students new educational stimuli. The relationship between the rate of correct answers and the time took to solve the problem through the shortest route search process showed a significant correlation the variable that affected the problem solving as the difficulty of the question rises due to the increase of nodes and edges turned out to be the node than the edge. It was revealed that information gifted students went through algorithmic thinking in the process of solving the shortest route search problem. And It could be confirmed cognitive characteristics of the information gifted students such as ‘ability streamlining’ and ‘information structure memory’.
Shape-Control of Strontium Titanate Nanostructures by a Surface-Capping Soft Chemical Process
강성웅,박배호,Inrok Hwang,Jinsik Choi,윤규식,Sahwan Hong,안상정,Yong-Il Kim 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.52 No.2
A surface-controlling soft chemical process is reported for tuning the morphologies of strontium titanate (SrTiO₃) nanostructures. The conventional surfactant-free soft chemical process produced polycrystalline SrTiO₃ nanoparticle aggregates generated by the dissolution-growth reaction. Alternatively, in order to synthesize single-crystal SrTiO₃ nanorods, we employed the surface-capping soft chemical process using a polyacrylic acid (PAA) polymer capping-reagent. The single-crystal SrTiO₃ nanorods prepared using PAA were observed to have facets with different diameters from a few nm to ~200 nm, lengths up to several μm, rectangular cross-sections, and crystal-axe perpendicular to the growth axis of the nanorods. A high-yield of nanorods over 90% was also obtained in the total volume of the product.
Respiratory Muscle Strength and Cough Capacity in Patients with Duchenne Muscular Dystrophy
강성웅,강연승,손홍석,박정현,문재호 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.2
The function of inspiratory muscles is crucial for effective cough as well as expiratory muscles in patients with Duchenne muscular dystrophy (DMD). However, there is no report on the correlation between cough and inspiratory muscle strength. To investigate the relationships of voluntary cough capacity, assisted cough techniques, and inspiratory muscle strength as well as expiratory muscle strength in patients with DMD (n= 32). The vital capacity (VC), maximum insufflation capacity (MIC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured. Unassisted peak cough flow (UPCF) and three different techniques of assisted PCF were evaluated. The mean value of MICs (1918±586 mL) was higher than that of VCs (1474±632mL) (p< 0.001). All three assisted cough methods showed significantly higher value than unassisted method (212±52L/min) (F= 66.13, p<0.001). Combined assisted cough technique (both manual and volume assisted PCF; 286±41L/min) significantly exceeded manual assisted PCF (MPCF; 246±49L/ min) and volume assisted PCF (VPCF; 252±45L/min) (F= 66.13, p<0.001). MIP (34±13cmH2O) correlated significantly with both UPCF and all three assisted PCFs as well as MEP (27±10cmH2O) (p<0.001). Both MEP and MIP, which are the markers of respiratory muscle weakness, should be taken into account in the study of cough effectiveness.