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폐경전 여성에서 자궁적출술 시행시 난소 보존여부와 관련된 비만의 관계
심재식,노인화,서경용,민지영,박창민,고일영,정창호 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8
Objectives:To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. Methods:581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. Results:All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. Conclusions:We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
중증 임신오조에 합병된 Wernickes Encephalopathy 1 예
심재식,노인화,서경용,박창민,고일영,정창호,송진범 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10
임신오조는 체중감소, 산-염기, 수분, 전해질의 불균형을 초래한는 심각한 상황으로 적절한 수액과 영양분의 공급이 되지 않으면 심각한 합병증을 초래하게 된다. 본 저자들은 임신오조에 합병되어 발생한 Wernicke 뇌병변 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Hyperemesis Gravidarum is definied as vomiting sufficiently pernicious to produce weight loss, dehydration, acid-base imbalance, electrolyte imbalance. In severe cases, it also leads to neurologic abnormality including confusion, gate disturbance, nystagmus, due to thiamine deficiency known as Wernickes encephalopathy. We have experienced a case of Wernickes encephalopathy associated with hyperemesis gravidarum and reviewed the Wernickes encephalopathy and new aspects of hyperemesis gravidarum.
최저생계비를 반영한 본인부담금 설계 모형 탐색 - 장애인활동지원제도를 중심으로-
이승기,심창호,류소영 한국장애인복지학회 2011 한국장애인복지학 Vol.- No.16
This article discusses the necessity of the change of current user fee's charging systems regarding personal assistance services for disabled people. The current system charges user fees on the basis of the roughly classified income levels, without the consideration of capacity of people's disposable income. Thus, the irrationality occurs like people with lower income pay more fees relatively than people with higher income. To overcome this problem, this article suggests a new model in which user fees should be charged on the basis of the disposable income with reflecting paying capacities of people compared to those of people with the highest income. The comparison between the current model and the new one about the amount of user fee shows that, under the current system, the majority of people with lower income expenses the fee above their paying capacities for personal assistance service. This result says that the current system needs to be changed to the system considering their paying capacity based on disposable income. 본 연구는 2011년 10월 5일부터 시행된 장애인활동지원에 관한 법률의 활동지원에 관한 본인부담금 부과체계를 현행의 단순한 소득구간 별 그리고 서비스 량 별 임의적 차등부과체계에서 최저생계비가 반영된 처분가능소득을 기준으로 부과하는 체계로 전환할 필요가 있음을 논의하였다. 처분가능소득을 기준으로 한 본인부담금 부과체계가 적용될 경우 현행의 활동보조서비스의 본인부담액이 상당부분 과다부과 되고 있음을 알 수 있었으며, 과소 부과된 경우는 전국 가구평균 소득의 150%~200%소득구간이면서 1등급인 구간과 200%초과 소득구간이면서 4등급, 3등급, 2등급, 1등급인 구간에 불과하였다. 이상의 결과는 현행 활동보조서비스의 본인부담금이 저소득계층일수록 그리고 활동보조서비스의 제공시간이 적을수록 많이 부담하는 구조라고 할 수 있다. 따라서 향후 본인부담금의 부과체계 검토 시 처분가능소득을 기준으로 한 부과체계로의 전환을 모색할 필요가 있음을 보여주고 있다.
손학식,심창호,김강현,김재철 한국에너지학회 2002 에너지공학 Vol.11 No.1
우리나라에 보급된 축냉시스템 이용효율 향상과 전력사용 합리화 방안을 제시함으로써 빙축열 시스템의 보급활성화를 통한 하절기 피크부하 경감에 기여코자 빙축열 설비의 성능시험을 실시한 결과 COP주간 3.8, 축열 3.0대비 30% 이상 성능이 감퇴한 주간 2.6∼3.4, 축열 2.1∼3.0정도로 냉동기가 가동되고 있으며, 축열율은 15개 건물 중 3개 건물(21.4%)만이 축열능력 대비 40% 이상의 축열을 실시하고 있는 것으로 분석되었다. 이처럼 운전성능 감퇴를 개선하기 위하여는 축냉(빙축열)설비 운전시 빈번히 발생하는 3-Way 밸브오동작, 냉각능력 감소, 팽창밸브 동작 부적절, 운전모드별 제어설정 오류 등에 의한 축냉능력 감퇴현상을 시정하고, 냉동기의 브라인배관 By-pass, Ice Slurry system운전모드별 배관분리, 냉온수펌프의 회전수제어 등의 배관계통 개선검토가 필요하며, 축냉(비축열) 시스템특징 별로는 Ice on Coil system은 냉방부하 확장성에 제약, Ice Ball system은 축열조의 수밀유지, Ice lens system의 제빙운전시 COP 저하, Ice Slurry system은 주간 운전시 저온운전에 따른 낮은 COP, Ice Harvest system은 Hot Gas 탈빙으로 동력손실증가 등에 대한 개선이 향후 축냉(빙축열)시스템의 운전성능 향상을 위해 필요한 것으로 도출되었다. The purpose of this study is to maintain high efficiency and reasonable use of cool thermal storage systems operated in the domestic building sector. As the result of efficiency test from the five types of operated cool storage systems on the condition that COP ranges are 2.6 to 3.4 during the day time and 2.1 to 3.0 during the night time and it decreased by more than 30% of rated COP given 3.8 to 3.0. The Analysis of cool storage rate shows that only 3 (21.4%) systems out of 15 buildings hold to over 40% capacity for its total capacity. To prevent the decrease in operating efficiency, it should correct the malfunction of 3-way valve and expansion valve and the mistake of control values for schedule program and increase cooling tower capacity. In order to improve piping line, it needs bypass brine line off refrigerator, separation of chilled water line with Ice Slurry system at day and night time and speed control of chilled and warm water pumps. This study does require the more studies on improving difficulty of increasing cooling load with Ice on Coil system, waterproofing with Ice Ball system, COP drop during the night time with Ice Lens, low operating temperature during the day time with Ice Slurry and increasing of Power loss due to hot gas de-icing with Ice Harvest in the future.