
http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Prognostic Factors of Neurological Complications in Spinal Surgeries
신원식,안동기,이정수,구기혁,유인선 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Retrospective study. Purpose: To determine prognostic factors of neurological complications (NCs) of posterior thoracolumbar surgeries. Overview of Literature: There have been few reports on the prognosis of NCs according to the causes and treatment methods. Methods: The subjects were 65 patients who had NCs for 19 years (1995–2013) after posterior thoracolumbar surgeries in Seoul Sacred Heart General Hospital. The degree of neurological injury was assessed using numeric scales as follows: G1, increased leg pain or sensory loss; G2, hemiparesis; G3, paraparesis; G4, cauda equine syndrome; and G5, complete paraplegia. The relative degree of neurological recovery was evaluated using four numeric scales as follows: Gr1, complete recovery; Gr2, almost complete recovery with residual sensory loss or numbness; Gr3, partial recovery with apparent neurological deficit; and Gr4, no recovery. The prognostic factors were investigated in terms of demographic and surgical variables that were available in a retrospective review. Results: The causes were as follows: epidural hematoma (EH), 25 patients (38.5%); insufficient decompression and fusion, 14 patients (21.5%); mechanical injury, 11 patients (16.9%); insufficient discectomy, four patients (6.2%); and unknown, 11 patients (23.1%). The grade of neurological injury was as follows: G1, 11 patients (16.9%); G2, 34 patients (52.3%); G3, 15 patients (23.1%); G4, three patients (4.6%); and G5, two patients (3.1%). Thirteen patients received conservative treatment, and 52 underwent revision surgeries. Neurological recovery was as follows: Gr1, 21 patients (32.3%); Gr2, 17 patients (26.2%); Gr3, 20 patients (30.8%); and Gr4, seven patients (10.8%). The prognosis depended on the causes (p=0.041). The subgroup analysis of the revision group revealed a significant correlation between the degree of neurological recovery and the timing of revision, irrespective of causes (r=0.413, p=0.002). Conclusions: The prognosis of NC depended on the causes. EH was the best and unknown was the worst prognostic factor. Revision should be performed as soon as possible for a better prognosis.

신상품 개발을 위한 TRIZ 모순해결 알고리즘: 키플링의 육하원칙과 도구-대상 분석의 연계과정을 중심으로
신원식,현정석,하환호 한국경영컨설팅학회 2022 경영컨설팅연구 Vol.22 No.1
Altshuller and his colleagues found that creative and innovative invention patents commonly resolved contradictions and established TRIZ. TRIZ is an acronym in Russian meaning ‘Theory of Inventive Problem Solving’. Leading domestic and foreign companies are actively introducing TRIZ to develop innovative new products. TRIZ proposes the separation principle and 40 invention principles as a way to solve the contradiction of the problem. For beginners to use TRIZ, the contents of TRIZ are vast and complex, so it is difficult for beginners to actually use TRIZ. This study presents an algorithm that defines the contradiction problem and derives a solution to the problem using the widely known Kipling's six-fold principle method, the tool-object analysis of value engineering that defines the contradiction problem. Applying Kipling's six-fold principle method has the advantage of analyzing the goal, solution, and time and space in which the problem occurs. In the process of applying Kipling's six-fold principle method, the goal of the contradiction problem (Why), what to achieve concretely the abstract goal of the system, and how as a means to achieve the goal of the system can be grasped. After applying Kipling's six-fold principle method, tool-object analysis can be used to understand how the components of a system interact. By understanding the components of the system and their interactions, it can be extracted the definition the structural relationship between the abstract goal of the contradiction problem and the concrete solution by these analyses. After they are done, a specific solution can be derived for solving the problem by using the time-tool table. Altshuller와 그의 동료들은 창의적이고 혁신적인 발명 특허들이 공통적으로 모순을 해결하였다는 사실을 알아내어 트리즈(TRIZ)를 정립하였다. TRIZ는 ‘발명 문제 해결 이론(Theory of Inventive Problem Solving)’을 의미하는 러시아어의 머리글자에 해당한다. 국내외 유수 기업들이 혁신적인 신상품 개발을 위해 TRIZ를 적극적으로 도입하고 있다. TRIZ는 문제의 모순을 해결하는 방법으로써 분리원리와 40 발명원리 등을 제시한다. 그렇지만 초보자가 TRIZ를 활용하기에는 TRIZ의 내용이 방대하고 복잡하여 실제적 활용에 많은 어려움을 겪는다. 이에 본 연구는 대중적으로 널리 알려진 키플링의 육하원칙 방법과 가치공학의 도구-대상 분석을 활용하여 모순문제를 정의하고 문제의 해결방안을 도출하는 알고리즘을 제시하였다. 키플링의 육하원칙 방법을 적용하면 문제의 목표와 해결수단 그리고 문제가 발생하는 시공간을 분석할 수 있는 이점이 있다. 키플링의 육하원칙 방법을 적용하는 과정에서 모순문제의 목표(Why), 시스템의 추상적인 목표를 구체적으로 달성하기 위한 무엇(What), 시스템의 목표를 이루기 위한 수단으로써 어떻게(How)를 파악할 수 있다. 이후 적용하는 도구-대상 분석은 시스템의 구성요소들이 어떻게 상호작용하는지 파악할 수 있다. 키플링 육하원칙 방법과 도구-대상 분석의 연계 과정은 모순문제의 추상적인 목표와 구체적인 해결수단 간의 구조적인 관계를 정의하게 하며, 이를 시간-도구 테이블에 적용하여 문제 해결을 위한 구체적인 해결안을 도출할 수 있다.
"위해성" 개념을 이용한 오염지역 정화 및 관리의 과학적 타당성
신원식,Shin, Won-Sik 한국지하수토양환경학회 2007 지하수토양환경 Vol.12 No.1
In the last decades, the decrease in biological or chemical availability of sorbed contaminants as contact time passed, is generally accepted. This phenomenon so called as "aging" or "sequestration" is known to directly affect risk of the contaminats. This was observed for mainly for hydrophobic organic contaminants (HOCs), but also reported for heavy metals. Aging is known to be directly related to sorption-desorption hysteresis, irreversible sorption, desorption-resistance, nonequilibrium sorption, etc. The decrease in bioavailability due to aging or sequestration indicates realistic decrease in risk potential. Recently a risk-based management concept by scientific evidences but not the simple measurement of contaminant concentration has been attempted to determine environmentally acceptable remedial endpoint. This is because selection of remedial endpoint based on not total concentration but the bioavailability and toxicity of contaminants can reduce both the treatment cost and remedial activities of the contaminated sites. The bioavailability and toxicity of the residual contaminants are highly affected by the fate and transport and also directly affect the exposure pathways and bioaccumulation of contaminants in the living biota. In this paper, scientific feasibility on the risk-based clean-up and management of contaminated sites is reviewed.
신원식,신근화 한국사회복지정책학회 2008 사회복지정책 Vol.32 No.-
This study attempts to analyze the subjective needs for residence and social welfare services by those aged who currently live or wish to live in the publically leased housings and those elderly who do not own home. A survey was taken to understand the characteristics and perceptional types of those low income earners aged more than 60 and live or wish to live in publically leased housings. The survey reviewed a group of 30 elderly and the survey results suggest Q methodology that covers facilities and space and welfare service aspects. The survey results concluded there are four subjective perception types by the elderly about publically leased housings. Type I is ‘economic support’ type and they exhibit the needs for a system which comprises job placement service and financial support rather than facilities that are available in publically leased housings. Type Ⅱ is ‘health conscious’ type and they are more interested in keeping their health conditions than economical aspects that they presented a need for health-care services and facilities. Type Ⅲ is ‘complex’ type and they are highly interested not only in the health-care facilities and environment for health management but also in social support such as leaving expenses and monthly subsidies. Type Ⅳ is ‘leisure welfare’ type and this type think positively of the household activity service, household meal service, exercise facilities, welfare and cultural leisure facilities. By understanding diverse needs of the elderly about publically leased housings, therefore, the findings should be taken into consideration appropriately and nationally in seeking solutions to housing problems because housing issues should be centered around the users. 본 연구는 공공임대주택에 거주하고 있는 노인들과 앞으로 공공임대주택에 입주하고자 희망하는 노인무주택자들을 대상으로 주거 및 사회복지서비스에 대한 주관적인 욕구를 분석하고자 하였다. 공공임대주택에 대한 시설・공간적인 측면과 복지서비스 측면에서 노인들의 주관적인 인식유형과 특성을 동시에 파악하고자 경남 진해지역 60세 이상 공공임대주택 거주자 및 저소득층 노인 무주택자 30명을 대상으로 Q 방법론을 활용하여 조사・분석하였다. 연구의 결과 공공임대주택에 대한 노인들의 주관적 인식유형은 네 가지로 분류되었다. 제 Ⅰ유형은‘경제적 지원형’으로 명명하였는데, 공공임대주택의 시설 측면보다는 소득향상을 위한 취업알선서비스와 경제적 지원을 뒷받침할 수 있는 제도가 필요한 유형이다. 제 Ⅱ유형은‘건강관리형’으로, 경제적인 지원보다는 건강을 유지할 수 있도록 서비스 및 시설을 요구하는 유형이다. 제 Ⅲ유형은‘복합형’으로 건강을 유지・관리하기 위한 서비스, 환경뿐만 아니라 주거비, 월세보조와 같은 지원을 원하고 있다. 제 Ⅳ유형은‘여가복지서비스형’으로 가사활동서비스, 가정식사서비스, 운동시설, 복지 및 문화여가시설 등에 대해서는 긍정적으로 인식하고 있는 반면 취업알선, 건강검진 및 24시 케어서비스 등에는 부정적으로 인식하는 것으로 나타났다. 이와 같이 공공임대주택에 대한 노인들의 주관적인 인식은 네 가지로 유형화되며 각각의 유형마다 독특한 구조적 특성이 있음을 알 수 있다. 공공임대주택에 대한 노인들의 다양한 욕구를 이해함으로써 기본적인 권리인 주거권으로서의 주택문제해결을 수요자 중심으로 제도화하고, 관련 서비스를 제공해야 할 것이다.