Diazepam과 Lidocaine이 노인환자의 기관내삽관시 심전도 및 심맥관계에 미치는 영향

김경희,권성범,신용섭,최세진 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1

We selected at random 30 geriatric patients who had received operation under the general anesthesia with endotracheal intubation. The patients were divided into 3 groups. Group 1 (control) had received endotracheal intubation without diazepam and lidocaine. Group 2 had received endotracheal intubation with diazepam. Group 3 had received endotracheal intubation with lidocaine. The changes of arterial blood pressure and pulse rate, and the appearance of arrhythmia were compared in each group. The results were as follows : 1. The increase of blood pressure and heart rate were less in group 2, 3 than the control group which showed significant increase of blood pressure and heart rate with endotracheal intubation. 2. The incidence of arrhythmias with endotracheal intubation was less in group 2(20%), group 3(50%) than the control group(80%). 3. The electrocardiographic change in the group 2 and 3 were not significant compared to group 1(control).

화학공정 위험영향 평가기술에서의 다중요소분석기법을 이용한 사고시나리오 산정에 관한 전략

김구회,이동언,김용하,안성준,윤인섭 한국화재소방학회 2001 한국화재소방학회논문지 Vol.15 No.4

현재 전세계적으로 공장내(on-site)뿐만 아니라 공장외지역(off-site)에 대한 사고영향평가의 필요성이 대두되고 있으며, 공장외지 역에 대한 영향평가 수행후 이에 대한 적절한 비상계획을 제출하도록 하고 있고, 국내에서도 종합적위험관리체계(IRMS ; Integrated Risk Management System)를 PSM이나 SMS와 더불어 시행 준비중에 있다. 그러나 공장외지 역에 대한 위험영향 평가시 가장 먼저 결정되어야할 가상시나리오에 대한 기준이 체계적으로 마련되어 있지 않아 사용자나 분석자에 따라 평가결과가 다양하게 나오며, 또한 공정에서 발생할 수 있는 사고의 이상원을 정확하게 파악하지 못한다는 단점이 있다. 따라서 본 연구에서는 이러한 가상시나리오를 결정하는데 필요한 공정요소를 분석한 후, 분석결과에 따라 발생 가능하고, 먼저 고려되어야 할 시나리오를 산정할 수 있도록 전략을 제시하고자 한다. 분석된 공정요소들은 요소에 따른 가중치를 부여하여 위험등급을 결정한 후 등급에 따른 위험영향 평가를 수행하도록 한다. 분석의 결과는 가상시나리오의 신뢰성을 향상시킴으로써 위험영향평가가 과대평가되는 것을 방지하고, 공정의 설계나 비상계획의 수립시 효과적이고 적절한 대책마련을 유도할 수 있다. This article proposes a strategy for producing accident scenarios in quantitative risk, which is performed in process design or operation steps. Present worldwide chemical processes need offsite risk assessment as well as on-site one. Most governments in the world require industrial companies to submit the proper emergency plans through off-site risk assessment. Korea is also preparing for executing Integrated Risk Management System along with PSM and SMS. However, there have been no systematic approaches and criteria for generating virtual accident scenarios, and it made impossible to get a unified or coherent assessment resell. Without the result, causes of accidents cannot be corralled precisely, To get over these shortcomings, this study analyzed process elements and then proposed a strategy for selecting and generating the accident scenario that is most likely to happen and should be foremost considered. The analyzed process elements are ranked and risk grades determined. According to the grades, risk assessment is performed. The result of analysis enhances the reliability of the generated risk scenario, and prevents some risks from being overestimated. The result should be helpful in process design and emergency planning. Keywords : Off-site risk assessment, Risk management program, Worst case scenario, ES(Equipment Screening) Method, Accident scenario selection

시상하부 과오종의 치료

김동석,박용구,최중언,정상섭 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

This study presents seven patients with hypothalamic hamartomas diagnosed on the basis of MRI. Histological confirmation was performed in one patient who underwent surgery. Four patients presented with epilepsy, including gelastic seizures. Other symptoms were behavior abnormalities in 3 patients and precocious puberty in 4 patients. We classify hypothalamic hamartomas into four subgroups according to MRI finding : Types Ⅰa lesions were less than 10㎜ in diameter and pedunculaedly attached to tuber cinereum of hypothalamus without hypothalamic displacement. Type Ⅰb lesions less than 10㎜ and mamillary body. Type Ⅱa lesions were more than 10㎜ in diameter and sessilely attached to hypothalamus with slight hypothalmic displacement and Type Ⅱb lesions more than 10㎜ and with marked displacement of hypothalamus. We could achieve good result with surgical resection in one patient with Type Ⅱb hamartoma associated with gelastic seizure that was unresponsive to medical treatment. We performed gamma knife ragiosurgery in three patients with gelastic seizure(2 patients with Type Ⅱa and 1 patient with Type Ⅱb) and three patients with precocious puberty(2 patients with Type Ⅰa and 1 patient with Type Ⅰb). The authors propose direct surgery as a treatment for this progressive syndrome and gamma knife radiosurgery as alternative treatment for high risk patients.

반발경도법에 의한 혼화재 및 섬유사용 콘크리트의 압축강도 추정

김정섭,신용석,노성열,김정훈 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.2

This study aims to estimate strength approximate to actual concrete strength by presenting appropriate rebound method strength estimation expression with admixtures (fly ash, blast furnace slag, silica fume) which are used as cement substitute and polypropylene fiber and steel fiber and owing to their s of cement owing to their equal conditions to blending characteristics of concrete used for domestic structures and their recyclable properties. In case of rebound hammering, equation by Japanese Architecture Society was estimated 26~40% higher than destructive strength and remaining suggested equation was estimated 2%~18% lower. In case of ultrasound velocity, equation by Japanese Architecture Society was estimated 4%~11% higher than destructive strength till 60 days of age, but as age progresses, is estimated to 15% lower than destructive strength and remaining suggested equation was estimated 3%~27% lower than destructive strength in almost age. In case of complex methods, all suggested equations were estimated to 24%~94% higher than destructive strength. Since application of existing expression of normal concrete against concrete using admixtures and fiber causes error rate, this study suggests the following estimation expression depending on the kind of admixtures and fiber of concrete using them and position of non-destructive experiment. C-N f_(cu)=1.6R-25.43(R²=0.90), C-FA f_(cu) = 1.07R-8.76 (R²=0.82), C-BF f_(cu)=1.46R-23.09(R²=0.92) C-SF f_(cu) = 1.55R-22.96(R²=0.89), C-PP f_(cu) = 1.16R-12.24(R²=0.73), C-S f_(cu)=0.99R-8.07(R²=0.86)

거대한 악하선관 타석 1례

김경일,심홍섭,김용기,도남용 조선의대 1996 The Medical Journal of Chosun University Vol.21 No.2

순환골재를 사용한 콘크리트 보의 구조적 특성에 관한 연구

김정섭,신용석,노성열 朝鮮大學校 建設技術硏究所 2007 建設技術硏究 Vol.27 No.1

This study identified materials and dynamic characteristics of reclaimed aggregates affecting reinforced concrete through materials and supplementary tests to use broken red bricks and waste concrete as substitutes of concrete and obtained the following results. As a result of the bending specimen test according to types of reclaimed aggregates, it was found that when normal concrete was compared with reclaimed concrete. RBA 30% specimen showed 99-104% of yield load and RCA 30% specimen showed 102-104% of yield load, which were the yield load and the largest yield load of normal concrete. Therefore, it is believed that RBA 30% and RCA 30% specimens has almost similar bending strength to ormal concrete. To sum up the results of material and supplementary tests, the mixed aggregates showed almost the same compressive strength and bending strength compared to that of normal concrete when 30% of broken red bricks and waste concrete were mixed. So this study suggests that they can be applied as thick aggregates.

폐결핵치료 중인 환자에서 Rifampicin에 의해 유발된 위막성 대장염 2예

김봉진,권균홍,임창섭,김자영,홍정범,옥미선,배용목,김지연 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Pseudomembranous colitis (PMC) is a disease caused by Clostridium difficile proliferation. The causative drugs are clindamycin, third-generation cephalosporins, flouroquinolone and so on. Rifampicin has been reported as a cause of PMC in the 1980s, and the frequency of PMC is increasing because rifampicin is a first line drug for anti-tuberculosis therapy. Two patients were recently admitted to our hospital due to watery diarrhea for 1 month and they were diagnosed with PMC by sigmoidoscopy. Their onset age were 74, 72 years old and latent period of symptoms were 60, 129 days, respectively. In one case, the patient displayed coexisting hypertension and diabetes. The clinical symptoms improved after discontinuing the rifampicin and then administering oral metronidazole. We report here on two cases presumed to be rifampicin-induced PMC.

비파괴 시험에 의한 혼화재를 사용한 콘크리트 압축 강도 추정에 관한 연구

김정섭,신용석 朝鮮大學校 建設技術硏究所 2005 建設技術硏究 Vol.25 No.1

This study made member specimen for taking specimen, core with the concrete mixing normal concrete, admixture and conducted the same air curing as field conditions. After performing destructive and nondestructive test by ages, estimate expression was suggested by analyzing correlations between compressive strength, rebound number and ultrasonic pulse velocity and the results are as follows. 1) As a result of comparing error rate of existing expressions and this estimation expression, error rate of this estimation is reduced compared to existing expressions and has higher reliability. 2) When conventional concrete expression is applied to admixture concrete, error rate occurs and then this study suggests the following estimation expressions depending on types of admixture concrete.

로스쿨에서의 실무역량강화를 위한 커리큘럼(교육과정)의 개선과제

김용섭 梨花女子大學校 法學硏究所 2013 法學論集 Vol.18 No.2

로스쿨의 성공여부는 그 커리큘럼이 우수한 법률가를 양성하는데 손색없이 구성되어 있으며, 교육내용이 얼마나 충실하게 이루어지는지 여부에 달려 있다. 로스쿨 교육이 3년간의 단기이면서 법학의 지식이 부족한 로스쿨생에게 실무교육을 내실화 해야 하기 때문에 법이론의 기초부터 실무적인 교육까지 과연 3년 안에 제대로 된 교육이 가능할 것인가 하는 비관론이 있을 뿐만 아니라 현재의 법령과 인가기준에 비추어 로스쿨에서의 필수과목의 학점이 35학점에 그치고 있어 실무적인 역량을 배양할 수 있는 커리큘럼이 편성되어 있다고 보기 어렵다는 비판론이 팽배해 있다. 그런데 로스쿨의 교육에 있어 학사관리가 엄격히 이루어 지지 않을 경우에는, 경쟁률이 매우 낮은 변호사시험에 합격하여 법조사회로 진출하게 되므로 로스쿨 출신 변호사에 대한 사회적 신뢰가 악화되는 문제점이 야기될 수 있다. 현재 3년의 로스쿨 재학기간동안 로스쿨별로 다양한 커리큘럼이 마련되어 있는 것 같이 보이지만 일부 특성화 프로그램을 제외하고는 25개 로스쿨이 대동소이한 커리큘럼을 운영하고있다. 로스쿨에서 필수과목이 35학점에 불과하여 변호사로 활동함에 있어 반드시 필수적으로 수강하여야 하는 행정구제법, 불법행위법, 형사증거법, 민사집행법, 각종 소송실무과목이 대부분의 로스쿨의 선택과목으로 되어 있어, 변호사로 활동함에 중요한 과목조차 제대로 이수하지 않고 로스쿨을 졸업하는 학생이 적지 않은 실정이다. 이러한 중요과목들을 이수할 수 있도록 하기 위해서는 필수과목학점을 60학점이 상으로 상향하거나 현행의 필수과목이외에 필수선택과목제도를 마련할 수 있도록 커리큘럼에 관한 인가기준을 완화하고 지나치게 학생의 자율에 맡기고 지나치게 선택과목이 많은 커리큘럼의 기본틀을 전면 재조정할 필요가 있다. 나아가 엄격한 상대평가제를 내용으로 하는 학사관리강화방안을 대안 없이 완화할 것이 아니라, 현재 일본에서 검토하고 있는 공통도달도 확인시험과 같은 유형의 시험을 도입하면서 학사관리강화방안을 점차 완화할 필요가 있다. 우리의 경우 로스쿨협의회 차원에서 1학년에서 2학년으로 올라가는 단계에서 공통적인 유급여부 판정을 위한 평가시험을 치르도록 하여 로스쿨 교육의 질적 수준을 유지함과 아울러 로스쿨 입학 이전에도 법학에 대한 충분한 준비를 하고 입학할 수 있도록 유도하여 로스쿨의 교육이 실무역량을 강화하는 방향으로 나아가도록 하는데 기여할 것이다. 끝으로, 로스쿨별로 교과목을 개설하더라도 다양한 교수법이 동원되지만 변호사시험 과목을 중심으로 교과목의 중요한 핵심사항인 공통적 도달목표인 최소한도의 기준(minimal standard)을 정하여 시행할 필요가 있다. Success of law school depends how well its curriculum is constructed to be suitable for educating excellent lawyers and how substantial the contents of education is. While the education period of law school is as short as 3 years, law school students relatively lack of law knowledge should be substantially taught jon training. Accordingly, there are many pessimistic views about whether the extensive education ranging from theories of law to job training can be well performed for such a short period. In addition, there are many criticisms that the current law school curriculum is not told to be formed to enable cultivation of practical competence because even the current laws and law school authorization standards provide for only 35 credits for required subjects. In the meantime, if educational affairs are not exactly administered at law school, a great issue may be caused resulting in loss of people’s reliability on law school graduate lawyers, as law school graduates can easily pass the examination for the bar whose competitive rate is very low. It seems that law schools have set up a variety of curricula for the 3 year period, but except for some specialized programs, 25 law schools operate almost same curricula. Required subjects of law school are given only 35 credits, and many important subjects such as Administrative Remedies Act, Injunctions in Tort Act, Police and Criminal Evidence Act, Civil Execution Act, various litigation practice subjects, etc. which are required to be necessarily taught to serve as a lawyer are classified as elective subjects at most law schools. Accordingly, it is real that not a few students graduate from law schools without completing even the subjects required for serving as a lawyer. In order to enable law school students to complete such important subjects, credits of required subjects shall be raised to more than 60 units, or the fundamental curriculum frame excessively allowing students self-control and elective subjects shall be wholly adjusted to enable law schools to introduce the required elective subjects system, even through mitigation of the current law school authorization standards. In addition, the current plan for intensifying administration of educational affairs focusing on the strict normative evaluation system shall not be mitigated without an alternative. The educational affairs administration of law school is required to be gradually mitigated only after introduction of a proven test system such as the common achievement evaluation test currently reviewed in Japan. In korea, it is recommended that the Law School Council administer an evaluation test to select flunkers for the first grade students to advance to the second grade, so as to keep the quality level of law school education and induce law school applicants to make enough preparation for law before entering law school. In the end, it will greatly contribute to advancement of law school education in the direction to step up practical competence. Finally, even though subjects are set up by individual law schools and teaching methods are different each other, it is recommended to set a minimal standard to be commonly satisfied at least for each of the subjects included in the examination for the bar.

Vinyl腐蝕法에 依한 在來山羊 脾柱靜脈의 區域的 走行에 關한 硏究

金鍾涉,金武剛,金容根,元鳳來 慶尙大學校 1972 論文集 Vol.11 No.-

The studies were conducted to observe the segmental running of splenic trabecular veins, employing the vinylite corrosion technique in sixty adult Korean goats, and the following results were obteined: 1. The splenic trabecular veins of the goat were collected into 5 chief Rami of the splenic veins(called Rr. superior, media et inferior, Vv. polares superior et inferior), and the splenic parenchyma was divided into 3-8 intralienal venous segments by the course of trabecular veins. 2. Each intralienal venous segment was divided into 2-4 minute segments, therefore 7-22 minute segments were observed in the spleen. 3. The anastomoses were found between segments or minute segments. 4. The splenic arterial and venous system of the Korean goat took a individual course in the splenic parenchyma respectively.