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생명기후분석시스템(BioCAS)을 이용한 폭염 건강위험의 검증 - 서울시 건물규모를 중심으로 -
김규랑 ( Kyu Rang Kim ),이지선 ( Ji-sun Lee ),이채연 ( Chaeyeon Yi ),김백조 ( Baek-jo Kim ),브리타얘니케 ( Britta Janicke ),아힘홀트만 ( Achim Holtmann ),디터쉐러 ( Dieter Scherer ) 한국환경영향평가학회 2016 환경영향평가 Vol.25 No.6
생명기후분석시스템(BioCAS)을 이용하여 서울시 전역의 폭염사례일 기온, 인지온도(PT), 초과사망률(rEM) 분포를 분석하였다. 분석 해상도는 25m 였으며, 사례일은 2012년 8월 5일이었다. 분석 결과는 관측된 사망률 및 내원환자수 자료와의 비교를 통해 평가되었다. 2004년에서 2013년의 폭염 원인인 사망률 자료와 2006년에서 2011년의 국민건강보험공단의 폭염 내원환자수 자료를 이용하여 행정구별 폭염 건강위험 자료를 추출하였다. 자료 비교를 위한 공간 해상도는 사망률 및 내원환자수 자료의 해상도인 행정구 단위였다. BioCAS에서 분석된 사례일 최고 인지온도 및 초과사망률 분포 자료는 행정구별 공간 평균, 최대, 최소 및 누적값으로 변환된 후 건강피해자료와 상관분석이 수행되었다. 분석 결과 일 최고 인지온도 및 초과사망률의 공간 평균값은 건강피해를 설명하지 못하는 것으로 나타났다. 대신 일 최고 인지온도의 공간 최솟값은 사망률과, 공간 최댓값은 내원환자수와 상관관계가 있는 것으로 나타났다(각각 r=0.53, r=0.42). 즉, 밀집된 건물에 의해 생겨나는 공간 최댓값은 낮 동안의 일사병 발생과 내원환자수 증가에 영향을 주었고, 식생에 의해 나타나는 공간 최솟값은 밤 동안의 열 스트레스를 감소시켜 사망률에 영향을 주었던 것으로 판단된다. 한편 분석된 초과사망률(rEM)은 공간 최댓값과 내원환자수가 상관관계가 있었지만(r=0.52) 사망률과의 상관관계는 인정되지 않았는데, 이것은 연령별 인구구성 차이에 따른 기저 폭염위험도 차이 등 행정구별 불균일성을 고려하지 못한 한계가 나타난 것으로 판단된다. 개별 건물과 식생의 열적 효과는 공간 평균보다 최대, 최소 등 그 분포가 중요한 것으로 나타났다. 이러한 고해상도 분석기술은 도시의 건강영향평가를 통해 도시개발에 관한 경제성 분석에 활용이 가능할 것으로 기대된다 The Bio-Climatic impact Assessment System, BioCAS was utilized to produce analysis maps of daily maximum perceived temperature (PT<sub>max</sub>) and excess mortality (rEM) over the entire Seoul area on a heat wave event. The spatial resolution was 25 m and the Aug. 5, 2012 was the selected heat event date. The analyzed results were evaluated by comparing with observed health impact data - mortality and morbidity - during heat waves in 2004-2013 and 2006-2011, respectively. They were aggregated for 25 districts in Seoul. Spatial resolution of the comparison was equalized to district to match the lower data resolution of mortality and morbidity. Spatial maximum, minimum, average, and total of PT<sub>max</sub> and rEM were generated and correlated to the health impact data of mortality and morbidity. Correlation results show that the spatial averages of PT<sub>max</sub> and rEM were not able to explain the observed health impact. Instead, spatial minimum and maximum of PT<sub>max</sub> were correlated with mortality (r=0.53) and morbidity (r=0.42), respectively. Spatial maximum of PT<sub>max</sub>, determined by building density, affected increasing morbidity at daytime by heat-related diseases such as sunstroke, whereas spatial minimum, determined by vegetation, affected decreasing mortality at nighttime by reducing heat stress. On the other hand, spatial maximum of rEM was correlated with morbidity (r=0.52) but not with mortality. It may have been affected by the limit of district-level irregularity such as difference in base-line heat vulnerability due to the age structure of the population. Areal distribution of the heat impact by local building and vegetation, such as spatial maximum and minimum, was more important than spatial mean. Such high resolution analyses are able to produce quantitative results in health impact and can also be used for economic analyses of localized urban development.
증례보고 : 악성고열증의 감수성 여부를 유전자 선별검사로 결정한 임상경험
이정우 ( Jeong Woo Lee ),이지선 ( Ji Sun Yi ),이준례 ( Jun Rye Lee ),김동찬 ( Dong Chan Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3
Malignant hyperthermia (MH) is a potentially fatal pharmacogenetic disorder manifested as a life threatening hypermetabolic crisis in susceptible individuals following exposure to inhalation anesthetics and to depolarizing muscle relaxants. The preoperative diagnosis of MH susceptibility is difficult. The gold standard for determination of MH susceptibility is the in vitro contracture test. However, it is invasive, requiring skeletal muscle biopsy and is not widely available. Recent advances in genetic testing for mutations that result in MH during anesthesia have helped some genetic test have limitations in clinical application due to the diversity of mutations. In Korea, we found the RYR1 genetic mutation by molecular genetic testing for MH susceptibility in a family for which MH had occurred. Based on the results of genetic testing, we could known MH susceptibility of 2 patients. We believe that the genetic testing for MH can be developed and used with some limitations in clinical settings in Korea. (Korean J Anesthesiol 2009;57:387∼91)
중학생의 과학 상상글쓰기 활동을 통한 상상물 제시 특성
김영실(Kim Young sil),정지현(Jeong Ji hyeon),허송이(Heo Song yi),이지선(Lee Ji sun),김성원(Kim Sung Won) 학습자중심교과교육학회 2015 학습자중심교과교육연구 Vol.15 No.7
본 연구에서는 중학교 2학년 학생 14명을 연구 대상자로 하여 과학 상상글쓰기 활동을 수행하였다. 학생들은 ‘반대로 상상하기’, ‘확대축소 상상하기’, ‘법칙 바꿔 상상하기’, ‘있고 없게 상상하기’의 네 가지의 상상글쓰기 활동을 통해 과학적 상상 력을 발현하도록 하였다. 이 활동을 통해 학생들은 다양하게 상상하여 여러 사물이 나 현상을 제시하였는데 몇 가지 특성들을 보여주고 있다. 학생들은 상상 글쓰기 활 동 수행 중 여러 상상물을 제시하면서, 의미 없는 순서로 상상을 나열하거나(단순 나열), 의미 있는 순서로 확장시키기도 하고(의미 확장), 상상을 제시한 순서가 비약 적이거나 직관적인 형태로 제시하기도 하는(직관적 상상) 세 가지의 특성을 보여주 었다. 먼저 ‘단순 나열형’은 상상물을 제시한 순서가 의미가 없으며 보통 과학적 개 념의 특징과 역할을 상기한 후 각각의 역할이나 특성을 조금씩 변화시키며 상상하 였으며, 키워드로 나열하거나 번호를 매겨 적는 등 특징을 보였다. ‘의미 확장형’은 단순히 상상물을 나열하는 것에서 더 나아가 각각의 상상물을 제시하는 순서가 의 미가 있다. 마지막으로 ‘직관적 상상형’은 흐름과 순서에 상관없이 비약적이거나 직 관적으로 상상하여 상상물을 제시한다. This study has a purpose to analyze scientific imaginations of middle school students through their writing skills. Scientific imagination means the ability to create new troubleshooting solution, which is un-experienced situation or phenomenon through their logical basis of scientific knowledge and experiences. In order to find out the characteristics in writing imaginative matters or phenomena, 14 members of 8th grade students are selected as subjects of the study, and activity models are developed to analyze for those activities. There are four types of activities; Imagine something conversely, imagine enlargement and reduction, imagine changed law, and imagine of with or without. Results of the study are analyzed for both each student and each activity. Only ten students are selected to observe whether their scientific imaginations are expressed or not. There are three types of imagining in science context writing: Simple listing, Meaning expanding, and Intuitive imagining. ‘Simple listing’ type of the students tends to present their imaginations in random orders, and they usually imagine scientific characteristics and role with gradual change after observing original scientific roles and characteristics. Moreover, they tend to list by keywords or numbers. It is one of the required conditions to list an amount of imagination for superb imagination. ‘Meaning expanding’ type of the students tends to not only list their imagination but also list that in order. It means that students imagine something in a variety of enlarged range and they could expand scope from self-centered. ‘Intuitive imagining’ type of the students tends to imagine intuitively and rapidly in any order.
초보자에서 ProSeal(TM) 후두마스크(LMA)의 집게손가락 삽입법과 도관 유도 삽입법의 비교
김유일 ( Yu Yil Kim ),이상귀 ( Sang Kyi Lee ),이지선 ( Ji Sun Yi ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.6
Background: Insertion of a ProSeal(TM) laryngeal mask airway (PLMA(TM)) by experienced users was more successful with using a catheter-guided (CG) technique than a digital technique. The purpose of this study is to assess the efficacy of the CG insertion technique for a PLMA(TM) by inexperienced personnel. Methods: Forty patients aged 18-65 yr and who were undergoing general anesthesia were randomly allocated to the index finger (IF) or CG insertion techniques for PLMA(TM) insertion. The IF technique was performed with the routine insertion technique. The CG technique was performed using a catheter inserted PLMA(TM), which was primed into the drain tube of the PLMA(TM) with using a soft flexible catheter. Successful insertion was primarily judged by the clinical function of the airway. The number of insertion attempts and the insertion time were recorded. Postoperative airway morbidity (sore throat, dysphonia, dysphagia) was assessed at 24 hr postoperatively. Results: The success rate was similar between the groups (IF, 18/20; CG, 15/20). The successful insertion time (the time to provide an effective airway) was similar between the groups but the insertion time at the first attempt was shorter for the IF technique (IF, 21.6±5.3 s; CG, 27.4±10.3 s). There were no differences between the groups for the postoperative airway morbidity. Conclusions: This study suggests that the CG insertion technique is not a useful alternative technique for inexperienced personnel. (Korean J Anesthesiol 2009; 56: 634~8)