성대마비환자를 대상으로 시행한 후두근전도검사의 임상적 유용성

최홍식,최영준,문상우,김태만,최홍식,최영준,문상우,김태만 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.2

그레이브스병에서 치료에 따른 폐동맥압의 변화

남택만,조한수,이진서,송영림,김두만,두영철,박철영,정인경,홍은경,이성진,오기원,김현규,유재명,최문기,유형준,박성우 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경: 갑상선기능항진증에 의한 갑상선중독증 환자들은 호흡곤란을 호소하며, 그 원인으로 호흡근의 근력 약화, 좌심실부전으로 인한 폐모세혈관의 울혈, 기도저항의 증가, 갑상선종으로 인한 기관의 압박, 호흡기능 이상 등이 거론되고 있다. 폐동맥고혈압이 동반된 그레이브스병 환자가 여러 증례가 보고되었으며, 폐동맥고혈압 환자에게서 갑상선 자가항체와 갑상선기능저하증의 빈도가 높음이 알려지면서 갑상선중독증이 동반된 그레이브스병 환자에게서 관찰되는 호흡곤란의 한 원인으로 폐동맥압 증가가 작용할 가능성이 제시되고 있다. 이에 저자 등은 그레이브스병 환자를 대상으로 폐동맥압을 측정하고 치료 전후의 폐동맥압의 변화를 전향적으로 연구하였다. 방법: 갑상선중독증이 동반된 그레이브스병 환자와 정상 갑상선기능을 나타낸 대조군을 대상으로 갑상선기능검사 및 갑상선 자가항체를 측정하고, 심초음파를 이용하여 치료 전후로 폐동맥압을 측정하여 폐동맥압과 갑상선기능 및 갑상선 자가항체와의 관계, 폐동맥압의 변화 등을 관찰하였다. 결과: 1. 연구대상은 대조군 10명 (남녀비 1:9, 관해 상태의 그레이브스병 3명, 갑상선종 3명, 정상인 4명), 그레이브스병 환자 26명 (남녀비 7:19)이었다. 2. 대조군과 치료 전 그레이브스병 환자의 폐동맥압은 각각 23.5±2.32 mmHg, 29.6±10.3 mmHg이었고, 치료 전의 폐동맥압과 혈청 갑상선자극호르몬 결합억제 면역글로불린 (TBII) 농도는 유의한 양의 상관관계를 보였다. 3. 26명의 그레이브스병 환자 중에서 10명 (38.5%)이 폐동맥고혈압 (기준: 폐동맥압 > 30 mmHg)으로 진단되었다. 4. 치료 전후로 폐동맥압을 측정한 13명은 폐동맥압이 치료 전 29.6±10.3 mmHg에서 치료 후 폐동맥압 22.2±6.48 mmHg로 의미있게 감소하였다. 결론: 갑상선중독증을 보이는 그레이브스병 환자의 약 40% 정도에서 폐동맥고혈압이 발견되어 폐동맥고 혈압은 그레이브스병에 흔하게 동반하는 질환으로 생각된다. 향후 그레이브스병 환자에서 관찰되는 폐동맥압의 증가와 관련한 병인, 발생기전 및 임상적 의의 등에 대한 연구가 필요할 것으로 생각된다. Background: Exertional symptoms, dyspnea and impaired effort tolerance are common in patients with Graves' disease. Proposed explanations include: high-output left heart failure, ineffective oxygen utilization and respiratory muscle weakness. In addition, pulmonary hypertension has also been reported in patients with Graves' disease. A high prevalence of hypothyroidism and positive thyroid autoantibody were also observed in patients with pulmonary arterial hypertension. Therefore, the pulmonary artery pressure in patients with Graves' disease was evaluated. Methods: Two-dimensional and Doppler echocardiographic examinations (Hewlett Packard Sonos 2500) were performed to determine the pulmonary artery (PA) pressure in 26 Graves' disease patients, both before and after treatment (23 patients with propylthiouracil and 3 with RAI), and in 10 euthyroid controls. The changes in the PA pressure after treatment were evaluated in 13 patients with Graves' disease, who became euthyroid after treatment. Results: The pulmonary artery pressure was increased in the untreated Graves' disease patients compared to the normal controls (23.5±2.32 vs. 29.6±10.3 mmHg). 38.5% of the Graves' disease patients (10/26) showed pulmonary arterial hypertension (PA>30 mmHg) and the serum TBII level was higher in the Graves' disease patients with pulmonary arterial hypertension than in those with normal PA pressure (P<0.05). In the Graves' patients who became euthyroid after treatment, the PA pressure was significantly decreased. Conclusion: 38.5% of the untreated Graves' disease patients showed pulmonary arterial hypertension, and the pulmonary artery pressure was significantly decreased in those who became euthyroid after treatment. The pathogenesis and clinical importance of pulmonary arterial hypertension in Graves' disease requires further studies (J Kor Soc Endocrinol 18:465∼472, 2003).

치주질환 심도에 따른 조직내 림프구 및 NK 세포의 변화에 관한 면역조직학적 연구

최호근,이만섭,권영혁 慶熙大學校 齒科大學 1993 慶熙齒大論文集 Vol.15 No.1

고객만족을 위한 고객관계마케팅 운영에 관한 연구

최영만 東新大學校 2003 論文集 Vol.13 No.-

The prosperity of the company requires management techniques and new strategies to accomodate environment changes these days. The clients, one of the most important factors of company's environment, will have interests and fidelity towards the company through interaction of customer's satisfaction. This is called customer relation marketing as well as it is the aim of 21 century's marketing. The researcher focused on how the department industry will gain the competition power and to contribute the development of the department industries. To accomplish this objective, the researcher analyzed the "A" department store and the results of this study are as follows: First of all, " A" department store improved consumer's information power to cope with the time of consumer's right and strengthened the need of management of customer's satisfaction. Secondly, "A" department store targeted the residents who lived at least in the middle size of apartments and used customized relation marketing and target marketing. Thus this system improved the clients' and employees' satisfaction. Thirdly, the basis of the customer's satisfaction management in the "A" department store were based on the effective use of customer's relation marketing which is consist of customer's database system, positioning analysis system, appointment programs with customers, and material handling information system. As a conclusion, the researcher concluded that "A" department store sought the core of customer's satisfaction management as the change of retail environment and customer's spending pattern. This trend accelerates strategic direction of various business forms such as retail store, convenient store, super-market, internet electronic commerce, home-shopping as well as exiting department store. "A" department store also should make an continuous effort to maintain customer relation marketing for customized resource distribution support system and 24 hour customer service through two way communication channel as well as to develop the new marketing strategies.

대구지역 실내 외 공기중 주요 대기오염물질의 농도조사에 관한 연구

최진수,백성옥,김영민,박상곤,정점희,황승만 嶺南大學校 環境問題硏究所 1995 環境硏究 Vol.15 No.1

최근 현대인의 실내거주시간이 일상생활시간의 80% 이상을 차지할 정도로 크게 증가하면서 보건·위생학적 측면에서 실내공기질은 매우 중요한 관심사로 등장하게 되었다. 본 연구는 1994년 8월의 여름철과 1994년 12월 ∼1995년 1월의 겨울철에 대구를 중심으로 가정집, 사무실, 식당과 같은 3가지 유형의 일반주거환경 중 실내·외 공기를 대상으로 실행되었다. 측정항목으로는 RSP, CO, CO₂, NO₂등의 주요 기준성 오염물질과 Bioaerosol을 선정하였다. 본 연구의 결과, 각 성분대상물질의 실내·외 농도는 실내거주환경 및 여름과 겨울, 두 계절에 따라 영향을 받는 것으로 나타났으며 실내·외 농도비교에서 RSP, CO, CO₂의 실내농도는 대부분의 지역에서 실외에 비하여 높은 농도를 나타냈다. 각 실내거주환경에 따른 실내·외의 농도는 가정, 사무실에 비하여 식당에서 상대적으로 높은 농도를 나타냈으며 실내·외 농도비 또한 식당에서 상대적으로 큰 값을 나타냈다. 여름과 겨울의 두 계절에 따른 RSP, CO, CO₂의 실내·외 농도는 여름철에 비하여 겨울철에 더욱 높은 농도를 나타냈으나 Bioaerosol의 실내·외 colony/plate는 여름철에 더욱 높은 수치를 나타냈다. The study was carried out to investigate the concentrations of indoor air pollutants such as respirable suspended particulate (RSP), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂) and bioaerosol at homes, offices and restaurants in Taegu city. Indoor and outdoor concentrations of these pollutants were observed simultaneously from August 1994 for summer to January 1995 for winter. The results were summarized as follows : 1. Both in summer and in winter, the indoor concentrations of RSP, CO, and CO₂; were higher than the outdoor concentrations, the indoor concentrations of major air pollutants (RSP, CO, CO₂, NO₂) in restaurants were higher than those in homes and offices. 2. The indoor and outdoor concentrations of RSP, CO, and CO₂; in winter were significantly higher than those in summer, on the other hand. The CFU/plate of bioaerosol in winter was lower than that in summer. These results suggested that indoor levels of air pollutants were affected by various indoor characteristics such as smoking, cooking, ventilation rate, winter heating systems, and behavioral activity of occupants.

全般管理者로서 中間管理者의 役割 定立과 課題

崔敎元,崔永萬,宋京用 東新大學校 1998 論文集 Vol.10 No.-

In today's enterprises, the complexity and enlargement of the field of the work has led the organization to be specialized, and it makes the communication and the unity more difficult between the posts. Furthermore, the overflowing of informations and knowledges, which is caused by the sudden change of the industrial society, has had an important and direct affect to the manager's behavior and decision. We can see the importance of the middle manager's position in that (1) he has to harmonize not between the top manager and workers so much as between the other middle managers accomplishing their other parts. (2) he has to exchange and hold in common the other part's information and knowledge in the process of the harmonization. (3) he has to make a diagnose and develope the plan for the solution of it, as an organization integrator. In addition to these, the middle manager's job requires the persuading, negotiating, and adjusting skill for other people's action. Therefore, this study is based on the recognition that middle manager's role becomes significant in accordance with the management specialization and it is made so that the relations of the middle manager's role, function, responsibility, and authority may be clear and the middle manager's role be built up concretely as a coordinator and negotiator, linking the upper part with the lower part, not as a mere supervisor. But the responsibility and duty of this class is really unclean. The unbalance between its responsibility and authority gives rise to many problems. The condition of the middle manager is risky, which is caused by the change of the organization This ultimately acts as a cause of impediment and gives a serious effect on the growth of enterprises. So the key manipulating the effectiveness of the organization is correcting the role and function of the middle manager, not only as the bridge of the top management and the lower management but also as a responsible person who contributes to the development of the enterprise with the subordernite's ability concentrated.

세균성 뇌막염과 병발된 다엽성이면서 다발성인 화농성 뇌농양 1예

최용석,김정미,한영수,차경만,한정호,조은경,김두응 최신의학사 2004 最新醫學 Vol.47 No.1

鐵筋 콘크리트 有孔보의 거동에 관한 실험적 연구(Ⅱ)

최종만,이화직,하영철,곽윤근 國立金烏工科大學校附設生産技術硏究所 1994 産業技術開發硏究 Vol.10 No.-

Openings through beams are required for the passage of utility ducts and pipes, and they are freqently encountered in the design of modern buildings. They are particularly important in multistory buildings where the use of openings in beams can mean lower story heights, leading in turn to a multiplicity of savings. Therefore, the designers are often faced with the necessity of providing adequate openings in the buildings. However, provision of openings may cause problems of excessive cracking and deflection, and may severly affect the strength of a beam. An experimental investigation is carried out on twelve reinforced concrete beams with square openings. The size of opening, and it's location are considered as major variables. The specimens were tested under two point loading. Loads were usually applied in steps of 0.5 ton up to failure to observe the crack initiation and propagation, initial diagonal cracking, midspan deflection, concrete strain and reinforcement strain.

케이블 TV 광고의 활성화 방안에 관한 연구

崔永萬 東新大學校 1995 論文集 Vol.7 No.-

In the information age cable television broadcasting is the basis of information superhighway industries. This paper begins with the premise that cable television (CATV) advertising should be activated in order to keep the stable development of CATV. This paper consists of five chapters. Chaper 1 is the introduction, dealing with The objectives and methods of the study. Chapter 2 examines the concept,characteristics,and structure of CATV chapter 3 investigates the present situation and advertising enviroment of CATV in Korea. Chapter 4 comes up with the activating strategies of CATV advertising: the strategies of government and those of advertising industries. Finally, chapter 5 forms the conclusion. I suggest in this paper that the government and the advertising industries should work out these strategies: the government should amend the CATV laws and institutions to activate CATV, lower the deliberation standards of CATV advertising, and support CATV advertising by giving the advertising industries all kind of the possible benefit in tax, finance. The advertising industries should urge program providers to arrange the system interconnects to increase the number of audience, make the use of rational media mix as an advertisement-marketing strategy, and arrange the system-operator interconnects of broadcasting companies to raise the number of subscribers. In conclusion, if the above strategies are effectively put into practice, cable television will certainly attain its stable development through CATV advertising.

Videodensitometer를 이용한 치은연하소파술후 치간골 골밀도의 변화

최진근,이만섭,권영혁 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.1

The purpose of this study was to evaluate the changes of interproximal bone density by means of videodensitometer and to examine the clinical applicability of videodentitometer to assess the periodontal disease activity: Twelve interproximal sites, with periodontal pockets deeper than 5mm and vertical Loss of bone on standard dental radiograph, were treated by subgingival curettage. The papilla bleeding index, the plaque index, the degree of mobility, the depth of pockets, and the level of attachment were measured. Standardized reproducible radiographs were taken by using the occlusal stent with parallelling film holder. The density of the interdental bone was measured on the radiographs by a videodensitometer at three levels : the most 'superficial' level; the 'deep' level, arbitrarily 1.5mm below; and the `apical' level, where no bony changes were to be expected. The clinical parameter and the radiographical change were measured at initial, and 1 month, 3 months, and 6 months after treatment. The results were as follows 1. The papilla bleeding index and the degree of mobility decreased significantly until 3 months after subgingival curettage and showed the same level in the remaining experimental periods. 2. The pocket depth mainly decreased due to the gingival recession until 1 month after treatment, but to the attachment gain after 1 month. 3. The density of the interdental bone did not show a significance increase until 1 month after treatment, but showed a steady increase throughout the 6 months of observation. 4. The close relationships were shown between the decrease in pocket depth and the gain of attachment and the improvement of bone density at 6 months after treatment.