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뇌동맥류 환자에서 요골동맥 카테터 거치 후 발생한 가성동맥류
박찬홍,김봉일,강원재 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3
The arterial cannulation has been performed for continuous blood pressure monitoring and blood gas analysis in operating room. The radial artery, ulnar artery, dorsalis pedis artery and others have been used for the site of cannulation. Although arterial cannulation offers many advantages, complications can developed. The complications of arterial cannulation are pain on puncture site, hematoma, infection, and so on. However pseudoaneurysm is a rare complication. We experienced a case of pseudoaneurysm at the radial artery following catheter indwelling for 7 days in a 54-year-old rnale patient undergoing cerebral aneurysm clipping which was found at 84 days after operation. (Korean J Anesthesiol 2000; 38: 559~562)
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Enflurane 마취하 간절제술시 간혈류차단이 술후 간기능에 미치는 영향
박찬홍,김봉일,강원재 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.1
Background: The most common cause of postoperative hepatic dysfunction is decreased hepatic blood flow due to decreased cardiac output and vasoactive substance during anesthesia. It might be suggested that hepatic blood flow occlusion affects postoperative dysfunction. This study was designed to investigate this possible effect on postoperative liver function. Methods: Forty-seven patients; hepatic resection with temporarily hepatic vascular occlusion (Pringle's maneuver) under enflurane anesthesia were involved. The duration of liver ischemia was 44.2 20.0 min. Blood transfusions (8.3 5.1 pints) were administered to nine patients intraoperatively. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and total bilirubin (TB) were measured at preoperation, postoperative 6 hours, 1, 3, 7 and 14 days. Alkaline phosphatase (AP) was measured also but not at postoperative 6 hrs. Results: The values of postoperative AST, ALT, LDH were increased sharply but returned at postoperative 7th day. AP did not change significantly. TB levels rose for 7 days postoperatively and then fell. Conclusion: From these results, it is inferred that the effect of hepatic ischemic insult under enflurane anesthesia on postoperative liver function is not significant. (Korean J Anesthesiol 1999; 37: 19∼24)
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오창수,유인현,박규서,강원재 한국리스크관리학회 2013 리스크 管理硏究 Vol.24 No.2
국제회계기준 2단계가 도입될 경우 가장 크게 영향이 있을 것으로 보이는 분야는 부채평가부분일 것이다. 국제회계기준 2단계 수정된 공개초안에 따르면 이행현금흐름(fulfillment cash flow)의 각 요소는 매 보고기간 마다 재측정 되며, 해당 보험회사의 측정 시점의 최적 가정을 사용하여 산출하게 되므로 평가에 사용되는 경제적 가정 및 계리적 가정은 모두 lock-out방식의 가정을 사용해야 한다. 이와 같은 방식을 사용하는 경우 매기의 보험부채평가는 변동성이 심할 것으로 예상된다. 본 연구에서는 전환일의 영향을 분석하기 위하여 생명보험회사가 과거에 판매했던 주요상품들을 대상으로 IFRS4 하에서의 부채평가를 수행하였다. 부채평가액의 구성요소인 최적추정부채, 위험조정, 서비스마진 등을 추정하였으며 할인율의 변동효과를 보기 위하여 기타포괄손익(Other Comprehensive Income, OCI)으로 따로 계산하여 현행 책임준비금과 비교분석하였다. 본 연구 결과에 따르면 IFRS4 준비금은 현행 준비금보다 유배당 금리고정형 저축보험의 경우 49.20% 정도 큰 금액으로 나타나고 있으며 무배당 금리고정형 건강보험의 경우 35.01% 정도 큰 금액으로 나타나고 있다. 과거에 고금리로 판매되었던 상품이나 사차손이 발생하는 상품은 IFRS4 준비금 체계하에서는 현행 추정치를 사용하여야 하기 때문에 준비금에 많은 부담이 발생하는 것을 알 수 있으며 IFRS4 도입시 전환일에 보험사의 부담으로 다가올 것임을 알 수 있다. 본 연구에서는 현재 시점을 전환일로 볼 때 보험상품의 부채를 측정하고 그 구성 요소별로 추정하고 할인율의 변동효과를 기타포괄손익으로 따로 구분하여 추정한 후 현행 준비금과 비교분석을 해보았다는데 연구의의가 있을 것이다. When IFRS4 is introduced in Korea, valuation of liability is most influential to insurance industry. Currently used valuation of liability is lock-in method, but valuation method in IFRS4 will be lock-out method in which current assumptions are used. The fluctuation of values of liability is expected so serious that it will be very hard to manage the profit of the insurance company. In this study the valuation of liability for the major product of life insurance company was performed under the guidelines of IFRS4 revised Exposure Draft. IFRS4 reserve is decomposed in best estimate liability, risk adjustment and service margin. Other comprehensive income was estimated to calculate the effects of change of discount rate. The value of liability of both products considered in this study are very high compared with the current value of reserve. This means the introduction of IFRS4 will be very big burden on the transition date to insurance company which sold guaranteed fixed interest rate products or high loss ratio products such as cancer insurance.
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노인들의 생활체육 참여 욕구에 대한 노인체육지도자 역할모형 구축
안민주(Min Ju An),김홍식(Hong Sik Kim),강원재(Won Jae Kang),김공(Kong Kim) 한국사회체육학회 2010 한국사회체육학회지 Vol.0 No.41
This study has the purpose of providing a differentiated program accommodating the participational desire of physical activities in elderlies, and effective teaching methods, member management, improvement of drawbacks of teachers, expert teacher distribution, and additionally, the basic data for the smooth performance of the role as a teacher and measure for the initiation of physical activities in elderlies, by constructing a role template of teachers based on the participational desire of physical activities in elderlies. To achieve this purpose, the opinions of an elderly physical activity expert (university `elderly physical activity` department professor, researcher in its laboratory, administrative management employee, and site leader) on participational desire of elderlies in physical activities (reliance on teacher, HSP value, intention of continued participation, intention of conversion) was collected. 35 aspects based on the role of the teacher was acquired through similar delphi analyses, with the ultimate extraction of 27 aspects passing through an editing process of synthesis and separations. Further collection of subjective opinions have been executed from physical activity teachers, comparing with prior perceptions in which common positive opinions were seen, resulting in a more practical analysis of the role of an elderly physical activity teacher, leading to the construction of its template, giving the following conclusions. Firstly, the elderly physical activity teacher must induce motivation within the participating elderly. Secondly, the planning and preparation of classes must be thoroughly conducted. Thirdly, the teacher must induce recognition of the effect of exercise by the participating elderly. Fourthly, a sense of professionalism must be attained. Lastly, the teacher must induce recognition of the necessity of exercise by the participating elderly. Further concurrence of the role of the teacher included systematic process, providing of various information, understanding of the elderly, composition of class atmosphere, program development/distribution, maintenance of friendliness, responsibility, personalized teaching, goal proposal, providing of opportunities, and grasp of individual nature. On the other hand, an insufficient awareness of the role of a teacher was seen relating to member management.
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