53 research outputs found
๋ฌด์ธํญ๊ณต๊ธฐ ์ด์์ ์ํ ๋ฎ๊ฐ ๋ชจ๋ธ ๊ธฐ๋ฐ์ ๋๊ท๋ชจ ์ต์ ํ ๊ธฐ๋ฒ
ํ์๋
ผ๋ฌธ (๋ฐ์ฌ) -- ์์ธ๋ํ๊ต ๋ํ์ : ๊ณต๊ณผ๋ํ ์ฐ์
๊ณตํ๊ณผ, 2021. 2. ๋ฌธ์ผ๊ฒฝ.There is increasing interest in the unmanned aerial vehicle (UAV) in various fields of the industry, starting from the surveillance to the logistics. After introducing the smart city, there are attempts to utilize UAVs in the public service sector by connecting individual components of the system with both information and physical goods. In this dissertation, the UAV operation problems in the public service sector is modeled in the set covering approach. There is a vast literature on the facility location and set covering problems. However, when operating UAVs in the system, the plan has to make the most of the flexibility of the UAV, but also has to consider its physical limitation. We noticed a gap between the related, existing approaches and the technologies required in the field. That is, the new characteristics of the UAV hinder the existing solution algorithms, or a brand-new approach is required.
In this dissertation, two operation problems to construct an emergency wireless network in a disaster situation by UAV and one location-allocation problem of the UAV emergency medical service (EMS) facility are proposed. The reformulation to the extended formulation and the corresponding branch-and-price algorithm can overcome the limitations and improve the continuous or LP relaxation bounds, which are induced by the UAV operation.
A brief explanation of the UAV operation on public service, the related literature, and the brief explanation of the large-scale optimization techniques are introduced in Chapter 1, along with the research motivations and contributions, and the outline of the dissertations. In Chapter 2, the UAV set covering problem is defined. Because the UAV can be located without predefined candidate positions, more efficient operation becomes feasible, but the continuous relaxation bound of the standard formulation is weakened. The large-scale optimization techniques, including the Dantzig-Wolfe decomposition and the branch-and-price algorithm, could improve the continuous relaxation bound and reduce the symmetries of the branching tree and solve the realistic-scaled problems within practical computation time. To avoid numerical instability, two approximation models are proposed, and their approximation ratios are analyzed. In Chapter 3, UAV variable radius set covering problem is proposed with an extra decision on the coverage radius. While implementing the branch-and-price algorithm to the problem, a solvable equivalent formulation of the pricing subproblem is proposed. A heuristic based on the USCP is designed, and the proposed algorithm outperformed the benchmark genetic algorithm proposed in the literature. In Chapter 4, the facility location-allocation problem for UAV EMS is defined. The quadratic variable coverage constraint is reformulated to the linear equivalent formulation, and the nonlinear problem induced by the robust optimization approach is linearized. While implementing the large-scale optimization techniques, the structure of the subproblem is analyzed, and two solution approaches for the pricing subproblem are proposed, along with a heuristic.
The results of the research can be utilized when implementing in the real applications sharing the similar characteristics of UAVs, but also can be used in its abstract formulation.ํ์ฌ, ์ง์ญ ๊ฐ์์์ ๋ฌผ๋ฅ๊น์ง, ๋ฌด์ธํญ๊ณต๊ธฐ์ ๋ค์ํ ์ฐ์
์์ ์์ฉ์ด ์ฃผ๋ชฉ๋ฐ๊ณ ์๋ค. ํนํ, ์ค๋งํธ ์ํฐ์ ๊ฐ๋
์ด ๋๋๋ ์ดํ, ๋ฌด์ธํญ๊ณต๊ธฐ๋ฅผ ๊ณต๊ณต ์๋น์ค ์์ญ์ ํ์ฉํ์ฌ ๊ฐ๋ณ ์ฌํ ์์๋ฅผ ์ฐ๊ฒฐ, ์ ๋ณด์ ๋ฌผ์๋ฅผ ๊ตํํ๊ณ ์ ํ๋ ์๋๊ฐ ์ด์ด์ง๊ณ ์๋ค. ๋ณธ ๋
ผ๋ฌธ์์๋ ๊ณต๊ณต ์๋น์ค ์์ญ์์์ ๋ฌด์ธํญ๊ณต๊ธฐ ์ด์ ๋ฌธ์ ๋ฅผ ์งํฉ๋ฎ๊ฐ๋ฌธ์ ๊ด์ ์์ ๋ชจํํํ์๋ค. ์ค๋น์์น๊ฒฐ์ ๋ฐ ์งํฉ๋ฎ๊ฐ๋ฌธ์ ์์ญ์ ๋ง์ ์ฐ๊ตฌ๊ฐ ์งํ๋์ด ์์ผ๋, ๋ฌด์ธํญ๊ณต๊ธฐ๋ฅผ ์ด์ํ๋ ์์คํ
์ ๊ฒฝ์ฐ ๋ฌด์ธํญ๊ณต๊ธฐ๊ฐ ๊ฐ๋ ์์ ๋๋ฅผ ์ถฉ๋ถํ ํ์ฉํ๋ฉด์๋ ๋ฌด์ธํญ๊ณต๊ธฐ์ ๋ฌผ๋ฆฌ์ ํ๊ณ๋ฅผ ๊ณ ๋ คํ ์ด์ ๊ณํ์ ํ์๋ก ํ๋ค. ์ฐ๋ฆฌ๋ ๋ณธ ๋ฌธ์ ์ ๊ด๋ จ๋ ๊ธฐ์กด ์ฐ๊ตฌ์ ํ์ฅ์ด ํ์๋ก ํ๋ ๊ธฐ์ ์ ๊ดด๋ฆฌ๋ฅผ ์ธ์ํ์๋ค. ์ด๋ ๋ค์ ๋งํด, ๋ฌด์ธํญ๊ณต๊ธฐ๊ฐ ๊ฐ์ง๋ ์๋ก์ด ํน์ฑ์ ๊ณ ๋ คํ๋ฉด ๊ธฐ์กด์ ๋ฌธ์ ํด๊ฒฐ ๋ฐฉ๋ฒ์ ํตํด ํ๊ธฐ ์ด๋ ต๊ฑฐ๋, ํน์ ์๋ก์ด ๊ด์ ์์์ ๋ฌธ์ ์ ๊ทผ์ด ํ์ํ๋ค๋ ๊ฒ์ด๋ค.
๋ณธ ๋
ผ๋ฌธ์์๋ ์ฌ๋์ด ๋ฐ์ํ ์ง์ญ์ ๋ฌด์ธํญ๊ณต๊ธฐ๋ฅผ ์ด์ฉํ์ฌ ๊ธด๊ธ๋ฌด์ ๋คํธ์ํฌ๋ฅผ ๊ตฌ์ฑํ๋ ๋๊ฐ์ง ๋ฌธ์ ์, ๋ฌด์ธํญ๊ณต๊ธฐ๋ฅผ ์ด์ฉํ์ฌ ์๊ธ์๋ฃ์๋น์ค๋ฅผ ์ ๊ณตํ๋ ์์ค์ ์์น์ค์ ๋ฐ ํ ๋น๋ฌธ์ ๋ฅผ ์ ์ํ๋ค. ํ์ฅ๋ฌธ์ ๋ก์ ์ฌ๊ณต์ํ์ ๋ถ์งํ๊ฐ๋ฒ์ ํ์ฉํ์ฌ, ๋ฌด์ธํญ๊ณต๊ธฐ์ ํ์ฉ์ผ๋ก ์ธํด ๋ฐ์ํ๋ ๋ฌธ์ ํด๊ฒฐ ๋ฐฉ๋ฒ์ ํ๊ณ๋ฅผ ๊ทน๋ณตํ๊ณ ์ํํ๊ณ๋ฅผ ๊ฐ์ ํ์๋ค.
๊ณต๊ณต ์๋น์ค ์์ญ์์์ ๋ฌด์ธํญ๊ณต๊ธฐ ์ด์, ๊ด๋ จ๋ ๊ธฐ์กด ์ฐ๊ตฌ์ ๋ณธ ๋
ผ๋ฌธ์์ ์ฌ์ฉํ๋ ๋๊ท๋ชจ ์ต์ ํ ๊ธฐ๋ฒ์ ๋ํ ๊ฐ๊ด์ ์ธ ์ค๋ช
, ์ฐ๊ตฌ ๋๊ธฐ ๋ฐ ๊ธฐ์ฌ์ ๋
ผ๋ฌธ์ ๊ตฌ์ฑ์ 1์ฅ์์ ์๊ฐํ๋ค. 2์ฅ์์๋ ๋ฌด์ธํญ๊ณต๊ธฐ ์งํฉ๋ฎ๊ฐ๋ฌธ์ ๋ฅผ ์ ์ํ๋ค. ๋ฌด์ธํญ๊ณต๊ธฐ๋ ๋ฏธ๋ฆฌ ์ ํด์ง ์์น ์์ด ์์ ๋กญ๊ฒ ๋นํํ ์ ์๊ธฐ ๋๋ฌธ์ ๋ ํจ์จ์ ์ธ ์ด์์ด ๊ฐ๋ฅํ๋, ์ฝํ ์ํํ๊ณ๋ฅผ ๊ฐ๊ฒ ๋๋ค. Dantzig-Wolfe ๋ถํด์ ๋ถ์งํ๊ฐ๋ฒ์ ํฌํจํ ๋๊ท๋ชจ ์ต์ ํ ๊ธฐ๋ฒ์ ํตํด ์ํํ๊ณ๋ฅผ ๊ฐ์ ํ ์ ์์ผ๋ฉฐ, ๋ถ์ง๋๋ฌด์ ๋์นญ์ฑ์ ์ค์ฌ ์ค์ ๊ท๋ชจ์ ๋ฌธ์ ๋ฅผ ์ค์ฉ์ ์ธ ์๊ฐ ์์ ํด๊ฒฐํ ์ ์์๋ค. ์์น์ ๋ถ์์ ์ฑ์ ํผํ๊ธฐ ์ํ์ฌ, ๋ ๊ฐ์ง ์ ํ ๊ทผ์ฌ ๋ชจํ์ด ์ ์๋์์ผ๋ฉฐ, ์ด๋ค์ ๊ทผ์ฌ ๋น์จ์ ๋ถ์ํ์๋ค. 3์ฅ์์๋ ๋ฌด์ธํญ๊ณต๊ธฐ ์งํฉ๋ฎ๊ฐ๋ฌธ์ ๋ฅผ ์ผ๋ฐํํ์ฌ ๋ฌด์ธํญ๊ณต๊ธฐ ๊ฐ๋ณ๋ฐ๊ฒฝ ์งํฉ๋ฎ๊ฐ๋ฌธ์ ๋ฅผ ์ ์ํ๋ค. ๋ถ์งํ๊ฐ๋ฒ์ ์ ์ฉํ๋ฉด์ ํด๊ฒฐ ๊ฐ๋ฅํ ํ๊ฐ ๋ถ๋ฌธ์ ๋ฅผ ์ ์ํ์์ผ๋ฉฐ, ํด๋ฆฌ์คํฑ์ ์ค๊ณํ์๋ค. ์ ์ํ ํ์ด ๋ฐฉ๋ฒ๋ค์ด ๊ธฐ์กด ์ฐ๊ตฌ์์ ์ ์ํ ๋ฒค์น๋งํฌ ์ ์ ์๊ณ ๋ฆฌ์ฆ์ ๋ฅ๊ฐํ๋ ๊ฒฐ๊ณผ๋ฅผ ๋ํ๋ด์๋ค. 4์ฅ์์๋ ๋ฌด์ธํญ๊ณต๊ธฐ ์๊ธ์๋ฃ์๋น์ค๋ฅผ ์ด์ํ๋ ์์ค์ ์์น์ค์ ๋ฐ ํ ๋น๋ฌธ์ ๋ฅผ ์ ์ํ์๋ค. 2์ฐจ ๊ฐ๋ณ๋ฐ๊ฒฝ ๋ฒ์์ ์ฝ์ด ์ ํ์ ๋์น์ธ ์์์ผ๋ก ์ฌ๊ณต์ํ๋์์ผ๋ฉฐ, ๊ฐ๊ฑด์ต์ ํ ๊ธฐ๋ฒ์ผ๋ก ์ธํด ๋ฐ์ํ๋ ๋น์ ํ ๋ฌธ์ ๋ฅผ ์ ํํํ์๋ค. ๋๊ท๋ชจ ์ต์ ํ ๊ธฐ๋ฒ์ ์ ์ฉํ๋ฉด์, ํ๊ฐ ๋ถ๋ฌธ์ ์ ๊ตฌ์กฐ๋ฅผ ๋ถ์ํ์ฌ ๋ ๊ฐ์ง ํ์ด ๊ธฐ๋ฒ๊ณผ ํด๋ฆฌ์คํฑ์ ์ ์ํ์๋ค.
๋ณธ ์ฐ๊ตฌ์ ๊ฒฐ๊ณผ๋ ๋ฌด์ธํญ๊ณต๊ธฐ์ ๋น์ทํ ํน์ง์ ๊ฐ์ง๋ ์ค์ ์ฌ๋ก์ ์ ์ฉ๋ ์ ์์ผ๋ฉฐ, ์ถ์์ ์ธ ๋ฌธ์ ๋ก์จ ๋ค์ํ ๋ถ์ผ์ ๊ทธ๋๋ก ํ์ฉ๋ ์๋ ์๋ค.Abstract i
Contents vii
List of Tables ix
List of Figures xi
Chapter 1 Introduction 1
1.1 Unmanned aerial vehicle operation on public services 1
1.2 Facility location problems 3
1.3 Large-scale optimization techniques 4
1.4 Research motivations and contributions 6
1.5 Outline of the dissertation 12
Chapter 2 Unmanned aerial vehicle set covering problem considering fixed-radius coverage constraint 14
2.1 Introduction 14
2.2 Problem definition 20
2.2.1 Problem description 22
2.2.2 Mathematical formulation 23
2.2.3 Discrete approximation model 26
2.3 Branch-and-price approach for the USCP 28
2.3.1 An extended formulation of the USCP 29
2.3.2 Branching strategies 34
2.3.3 Pairwise-conflict constraint approximation model based on Jung's theorem 35
2.3.4 Comparison of the approximation models 40
2.3.5 Framework of the solution algorithm for the PCBP model 42
2.4 Computational experiments 44
2.4.1 Datasets used in the experiments 44
2.4.2 Algorithmic performances 46
2.5 Solutions and related problems of the USCP 61
2.6 Summary 64
Chapter 3 Unmanned aerial vehicle variable radius set covering problem 66
3.1 Introduction 66
3.2 Problem definition 70
3.2.1 Mathematical model 72
3.3 Branch-and-price approach to the UVCP 76
3.4 Minimum covering circle-based approach 79
3.4.1 Formulation of the pricing subproblem II 79
3.4.2 Equivalence of the subproblem 82
3.5 Fixed-radius heuristic 84
3.6 Computational experiments 86
3.6.1 Datasets used in the experiments 88
3.6.2 Solution algorithms 91
3.6.3 Algorithmic performances 94
3.7 Summary 107
Chapter 4 Facility location-allocation problem for unmanned aerial vehicle emergency medical service 109
4.1 Introduction 109
4.2 Related literature 114
4.3 Location-allocation model for UEMS facility 117
4.3.1 Problem definition 118
4.3.2 Mathematical formulation 120
4.3.3 Linearization of the quadratic variable coverage distance function 124
4.3.4 Linear reformulation of standard formulation 125
4.4 Solution algorithms 126
4.4.1 An extended formulation of the ULAP 126
4.4.2 Branching strategy 129
4.4.3 Robust disjunctively constrained integer knapsack problem 131
4.4.4 MILP reformulation approach 132
4.4.5 Decomposed DP approach 133
4.4.6 Restricted master heuristic 136
4.5 Computational experiments 137
4.5.1 Datasets used in the experiments 137
4.5.2 Algorithmic performances 140
4.5.3 Analysis of the branching strategy and the solution approach of the pricing subproblem 150
4.6 Summary 157
Chapter 5 Conclusions and future research 160
5.1 Summary 160
5.2 Future research 163
Appendices 165
A Comparison of the computation times and objective value of the proposed algorithms 166
Bibliography 171
๊ตญ๋ฌธ์ด๋ก 188
๊ฐ์ฌ์ ๊ธ 190Docto
Influence on the meridian electrical potential for ground connection and insulation in acupuncture practice
์๊ณตํ์ ๊ณต/์์ฌ[ํ๊ธ]์นจ์ ๊ณผ์ ์ ์์ ์ํฉ์ ์ ๊ธฐํ์ ๊ด์ ์์ ์ ๊ธฐํ๋ก์ ํ์ฑ ์ฌ๋ถ์ ๋ฐ๋ผ ์น๋ฃ ํจ๊ณผ๋ฅผ ์ ํ์ํค๋ ์์ธ์ด ๋ ์ ์๋ค. ์ด์ ๋ํ์ฌ, ํ์์ ์์ ์์ ์ ์ง๋ ์ ์ฐ๊ณผ ๊ฐ์ ์์ ์ํฉ ๋ชจ๋ธ์ ํตํด, ์ ์ง์ ์ ์ฐ์ด ์นจ ์๊ทน์ ์ํ ๊ฒฝ๋ฝ์ ์ ์์ฐจ ํ์ฑ ์ ๋์ ์ด๋ ํ ์ํฅ์ ์ฃผ๋์ง ๊ด์ฐฐํ์๋ค.์คํ๋ฐฉ๋ฒ์ 20๋(26์ธ ยฑ 5.3) ๋จ๋
๊ฐ๊ฐ 15๋ช
์ฉ 30๋ช
์ ๋์์ผ๋ก ๋์ผ์ธ์ด ์์ ํ์๋ค. ํ๊ฑฐํ(S39)์ ์๊ฑฐํ(S37)์ ์์นจํ์ฌ ์๊ฑฐํ์ (+)์ ๊ทน์, ํ๊ฑฐํ์ (-)์ ๊ทน์ ์ฐ๊ฒฐํ์ฌ ์กฑ์ผ๋ฆฌ(S36)๋ฅผ ํ์นจ ์๊ทนํ ๋ค ๋ ๊ฒฝํ๊ฐ์ ์ ์๋ฅผ ์ธก์ ํ์๋ค. ์ฐ์ ๋น์ ์ฐ ์์นจ์ผ๋ก ์๊ทนํ๋ฉด์ ๋ชจ๋ ๋น์ ์ง, ์์ ์ ์ ์ง, ํ์ ์ ์ง, ๋ชจ๋ ์ ์ง์ ๋ฐ๋ฅธ ์ ์๋ณํ๋ฅผ ์ธก์ ํ์๋ค. ์ดํ ์ ์ฐ ์์นจ์ ๋์ผํ ๋ฐฉ์์ผ๋ก ์ธก์ ํ์๋ค.์ธก์ ๋ฐ์ดํฐ๋ฅผ ํต๊ณ ์ฒ๋ฆฌํ ๊ฒฐ๊ณผ, ๋น์ ์ฐ ๋ชจ๋ ๋น์ ์ง๋ ํ๊ท ์ ์ 44.6ยฑ19.2ใถ๋ก ์(+)์ ๋ฐฉํฅ์ผ๋ก ์ฆ๊ฐํ์์ผ๋ฉฐ, ์นจ์ ์ก์๋ค ๋๋ ์๊ฐ์ ๋ฐ์ํ๋ peak๊ฐ ์ ์๋ 181.4ยฑ59.7ใถ๋ก ์ฆ๊ฐํ์๋ค. ํผ์์ ์๋ง ์ ์งํ ๊ฒฝ์ฐ๋ ํ๊ท ์ ์ 2.9ยฑ1.3ใถ, peak๊ฐ ์ ์๋ 16.4ยฑ11.9ใถ๋ก ์นจ์๊ทน์ ๋ํ ์ ์ํ ์ ์๋ณํ๊ฐ ๋ํ๋์ง ์์๋ค. ์์ ์๋ง ์ ์งํ ๊ฒฝ์ฐ๋ ํ๊ท ์ ์๋ -51.1ยฑ9.3ใถ๋ก ์(-)์ ๋ฐฉํฅ์ผ๋ก ์ฆ๊ฐํ์๊ณ , peak๊ฐ ์ ์๋ 367.4ยฑ27.8ใถ๋ก ์นจ์๊ทน์ ๋ํ ๊ฐ์ฅ ํฐ ์ ์์ ๋ณํ๊ฐ ๊ด์ฐฐ๋์๋ค. ๋ชจ๋ ์ ์ง๋ ํ๊ท ์ ์ 1.6ยฑ0.7ใถ, peak๊ฐ ์ ์๋ 3.3ยฑ1.9ใถ๋ก ์ ์๋ณํ๊ฐ ๋ํ๋์ง ์์๋ค. ์ ์ฐ ์์นจ์, ๋ชจ๋ ๊ฒฝ์ฐ์์ ์ผ์ ํ ๋ฐฉํฅ์ผ๋ก ์ง์ํ๋ ํ๊ท ์ ์ ํ์ฑ์ ์์๋ค. peak๊ฐ ์ ์๋ ๋ชจ๋ ๋น์ ์ง์ 7.8ยฑ2.6ใถ, ํผ์์ ์ ์ ์ง์ 4.7ยฑ2.2ใถ, ์์ ์ ์ ์ง์ 8.4ยฑ2.5ใถ, ๋ชจ๋ ์ ์ง์ 3.4ยฑ1.4ใถ๋ฅผ ๋ณด์๋ค.๋ฐ๋ผ์, ์นจ์ ๊ณผ์ ์์ ์์ ์์ ํผ์์ ์๊ฐ์ ์ ๊ธฐ์ ์ ์ง์กฐ๊ฑด๊ณผ ์ ์ฐ์ํ์ ๋ฐ๋ผ ํผ์์ ์์ ๊ฒฝ๋ฝ์ ์๋ณํ์ ๋ฏธ์น๋ ์ํฅ์ด ๋ค๋ฆ์ ํ์ธํ์๋ค. ์ด๋ฌํ ์กฐ๊ฑด์ด ์ ๊ธฐ์ ๊ด์ ์์, ์นจ์ ํจ๊ณผ์ ์งยท๊ฐ์ ์ ์ผ๋ก ์ํฅ์ ์ค ๊ฒ์ผ๋ก ์ฌ๋ฃ๋๋ค. ๋ํ, ์์ ์์ ํ์๊ฐ์ ์ ์ง์ฌ๋ถ๋ ์์ฒด ์ ์์ฐจ ๋ฐ ๋ฐฉํฅ์ ๊ฒฐ์ ํ๋ฉฐ, ์ ์ฐ์์นจ์ ์์ ์์ ํ์๊ฐ์ ๋ฏธ์ธํ ์ ์ ๊ธฐ์ ์ธ ์ ์๋ฅผ ๋ฐ์์ํฌ ๋ฟ, ์ด์ธ์ ์์ฒด์๋์ง ์ ๋ฌ์ ์ฐจ๋จํ๋ ์์ธ์ผ๋ก ๊ฒฝ๋ฝ์ ์์ ๋ํ ์ํฅ์ด ๋ฏธ์ฝํจ์ ํ์ธํ์๋ค.
[์๋ฌธ]Background: When a patient is positioned at insulated bed and practitioner is positioned at insulated floor, that condition could be a cause of lessening effect in acupuncture practice. We investigated how Ground connection and Insulation could influence on the electrical meridian potential between practitioner and patient during acupuncture practice.Method: We treated 30 normal healthy subjects with acupuncture and measured changes in the electrical potential between the stomach meridian points ST-39 and ST-37 in response to light touch after insertion of a needle at ST-36. At first, we stimulated non-insulated needle and measured electrical potentials for non ground, patient ground only, practitioner ground only, all ground, respectively. Then we used insulated needles and measured same as above.Result: Non-insulated all ground subject elicited positive mean potential 44.6ยฑ19.2ใถ and showed 181.4ยฑ59.7ใถ peak to peak potential. Practitioner ground only showed negative mean potential of -51.5ยฑ9.3ใถ and 367.4ยฑ27.8ใถ of peak to peak potential. Patient ground only revealed no mean potential of 2.9ยฑ1.3ใถ, 16.4ยฑ11.9ใถ of peak to peak potential. All ground showed no mean potential of 1.6ยฑ0.7ใถ, 3.3ยฑ1.9ใถ of peak to peak potential. In case of Insulated condition, there elicited no mean potential. Non ground and Practitioner only showed weak value of peak to peak potential as 7.8ยฑ2.6ใถ and 8.4ยฑ2.5ใถ each. But patient only and all ground showed no potential as 4.7ยฑ2.2ใถ, 3.4ยฑ1.4ใถ, respectively.Conclusion: Ground connection modulate the energy transfer course between practitioner and patient. Insulation block energy transfer but static electrical impulse between practitioner and patient.ope
๊ฒฝ์ธ๊ต์ก๋ํ๊ต ์ ํด๋ถ์ง๋ฅผ ์ค์ฌ์ผ๋ก
ํ์๋
ผ๋ฌธ (์์ฌ) -- ์์ธ๋ํ๊ต ๋ํ์ : ํ๊ฒฝ๋ํ์ ํ๊ฒฝ์กฐ๊ฒฝํ๊ณผ, 2020. 8. ์ฑ์ข
์.๊ทผ๋ํ ๊ณผ์ ์์ ๋ฐ์ํ ์ฑ์์ฅ์ ๊ตญ๊ฐ ์ฐ์
๋ฐ์ ์ ๊ธฐ์ฌํ์์ผ๋ ๊ฐ๋ฐ์ด ์
๋ฃ๋ ํ ๊ธฐ๋ฅ์ ๋คํด ์ ํดยทํ์๋์ด ๋ฐฉ์น๋ ์ํ์์ ๋ํ๋๋ ๋์ยทํ๊ฒฝยท
์ฌํ๋ฌธ์ ์ ๋ํ ํด๊ฒฐํ๊ธฐ ์ํ ํด๋ฒ์ ์ฐพ๊ณ ์ํ์๋ค.
์ฑ๊ตด์ด ์๋ฃ๋ ์ฑ์์ฅ์ ๋ฒ์ ์ผ๋ก ใ์ฐ์ง๊ด๋ฆฌ๋ฒใ์ 4์ฅ 39์กฐ1)์ ๋ฐ๋ผ ์์
ํ๋ก ๋ณต๊ตฌํด์ผ ํ๋ค. ๊ทธ๋ฌ๋ ๋ณต๊ตฌ๋ฐฉ์์ ์์ด ์ ์ ํ ๋ณต๊ตฌ๋ฅผ ํ์๋ค ํ๋๋ผ๋
์์ํ๋ก ๋ณต๊ตฌํ๊ธฐ ์ด๋ ค์ฐ๋ฉฐ ์ด๋ ๋ง๋ํ ๋ณต๊ตฌ๋น์ฉ ๊ฐ์ ธ์จ๋ค. ๋ฐ๋ผ์ ๋๋ถ๋ถ
์ ์ฑ์์ฅ์ ์ ์ ํ ๋ณต๊ตฌ๊ฐ ์ด๋ฃจ์ด์ง์ง ์๊ณ ์์ผ๋ฉฐ ๋ฐฉ์น๋๊ณ ์๋ค. ๋ฐฉ์น๋
ํ๋ฌผ์ ์ฃผ๋ณ ๊ฒฝ๊ด์ ๊ธฐ๋ฅ์ ์ ํ์ํค๋ฉฐ ์ฃผ๋ณ๋ฐ์ ์ ์ ํดํ๋ ์์๋ก ์์ฉํ
๋ค. ๊ทธ๋ฌ๋ ์ต๊ทผ ๋ฐฉ์น๋ ์ฑ์์ฅ์ ํ์ฉํ์ฌ ๊ณต์ ๋ฐ ๋ฌธํ๊ณต๊ฐ์ ์กฐ์ฑํ๊ณ ์
๋ ์ฌ๋ก๊ฐ ์๋ค. ๋ํ์ ์ธ ์๋ก๋ ํฌ์ฒ์ํธ๋ฐธ๋ฆฌ๋ฅผ ๋ค ์ ์์ผ๋ฉฐ ์ด๋ฌํ ์๋
๋ ๊ณผ๊ฑฐ ๋ถ์ ์ ์ด์๋ ์ฑ์์ฅ์ ๊ด๊ด๋ช
์๋ก ํ์ฉํจ์ผ๋ก์ ์ง์ญ๊ฒฝ์ ํ์ฑ์ ํฐ
๋์์ ์ฃผ๊ณ ์๋ ์ค์ ์ด๋ค.
์์์ ์์๋์ ์์นํ ๋ณธ ์ฐ๊ตฌ์ ๋์์ง๋ ์ํํธ๊ณต์ฌ์ ์ฐ์ผ ์๊ฐ์ ๊ณต
์ํ๊ธฐ ์ํด 1979๋
๋ถํฐ ๊ฐ๋ฐ์ ์์ํ์๊ณ 1995๋
์ฑ์์์
์ด ์๋ฃ๋จ๊ณผ ๋์
์ ๋ณต๊ตฌ๊ณต์ฌ๊ฐ ์งํ๋์๋ค. 2005๋
๊ธฐ์กด ์ฑ์์ฅ ๋ถ์ง์๋ ๊ฒฝ์ธ๊ต์ก๋ํ๊ต๊ฐ
๊ฑด๋ฆฝ๋์๊ณ , ๊ฑด๋ฆฝ๊ณผ์ ์์ ์ฌ๋ฌ ํ๊ฒฝ๋ฌธ์ ๋ค์ด ๋ฐ์ํ์๋ค. ๊ทธ๋ฌ๋ ์ด๋ฐ ๋ฌธ์ ๋ค
์ ๊ฐ์ ํ๊ธฐ ์ํด ํ๊ต์์๋ ๋์์๋ ๋
ธ๋ ฅ์ ํ์๊ณ ํ์ฌ๋ ๊ฐ์ ๋ ์ ํด๋ถ
์ง๋ก ๋จ์์๋ค. ๋ฐ๋ผ์ ๋ณธ ์ฐ๊ตฌ์์๋ ๊ณผ๊ฑฐ ์ฑ์ํ๋์ผ๋ก ํ๊ฒฝ๋ฌธ์ ์ ์ด์์
๊ณต๊ฐ์ด์์ง๋ง ํ์ฌ ์์ ์์๋ ์ฃผ์ ๊ณต๊ฐ์ผ๋ก ํ์ฉํ์ฌ ์ธ์์ ์ ํ์ ๊ณ๊ธฐ๊ฐํ์ํ๋ค๊ณ ํ๋จํ๋ค.
์ฐ๊ตฌ๋ฅผ ์งํํ๊ธฐ์ ์์ ์ฑ์์ฅ์ ๋ํ ์ ๋ฐ์ ์ธ ์ดํด
๋ฅผ ํ๊ธฐ์ํด ์ ํ์ฐ๊ตฌ๋ฅผ ์งํ ํ์๋ค. ์ ํ์ฐ๊ตฌ๋ ํฐ ๋ฒ์ฃผ์์ ์ฑ์์ฅ๊ณผ ์ ์ฌ
๊ฐ๋
์ ๊ณต๊ฐ์ ๋ํ ํ์ฉ๋ฐฉ์์ ์กฐ์ฌํ์๊ณ , ์ด์ ๋ง๋ ์ด์ฉ์ ์ฆ ์๋ฏผ์ ๋
ํ ์ธ์์กฐ์ฌ๋ฅผ ์ด์ ์ผ๋ก ๋์๋ค. ์ด๋ก ์ ๊ณ ์ฐฐ์ ํ์ฑ์์ฅ์ ํ์ฉํ์์ฑ์
๋ํ ๊ฐ๋
๊ณผ ์ด๋ฅผ ๋ณด์กดํ๋ฉฐ ํ์ฉํ๋ ๋ฒ์ฃผ์์ ์ฐ์
์ ์ฐ์์์ ์ฑ์์ฅ์ด ๊ฐ
๊ณ ์๋ ๊ฐ๋
์ ๊ณ ์ฐฐํ์๋ค.
ํ์ฑ์์ฅ์ ํ์ฉํ๋๋ฐ ์์ด ๋ฐ๋์ ์ค์ํด์ผํ๋ ๋ฒ๊ณผ ๊ด๋ จ ๊ท์ ๋ค์ ์ด
ํด๋ณด์์ผ๋ฉฐ ๊ตญ๋ด ๋ฌธํ๋ค์ ๋ฐํ์ผ๋ก ์ค๊ณ ๋ฐ ์๊ณต ๊ณผ์ ์ ๋ํด์ ๊ณ ์ฐฐํ์๋ค.
๋ณธ๊ฒฉ์ ์ผ๋ก ๋์์ง๋ฅผ ์ดํดํ๊ธฐ ์ํด ํฐ ์ค์ผ์ผ์ ๊ฐ๋
์ ์ ๋ฐ์ ์ธ ์ดํด๋ฅผ
ํ์์ผ๋ฉฐ ์ ๋์ ๋ณ์ฒ๊ณผ์ ์ ํตํด ๊ณผ๊ฑฐ ๋์์ง ์ฃผ๋ณ๋ถ์์ ์ผ์ด๋ ์ฃผ์ ์ฌ๊ฑด
๋ค์ ์ดํด๋ณด์๋ค. ์ธ๊ตฌํํฉ ๋ถ์์ ํตํด ๋ง์๊ตฌ ์์๋์ ๋ํ ์ธ๊ตฌํํฉ, ์ฐ
๋ น, ์ง์
๋ฑ์ ์กฐ์ฌํ์์ผ๋ฉฐ ์์ ์ฃผ์๋ด์ฉ์ ๋ฐํ์ผ๋ก ์ค์ง์ ์ผ๋ก ์ง์ญ ๊ด๋ จ
์ฃผ์ฒด๋ค์ด ๊ฐ๊ณ ์๋ ์ธ์๋ค์ด ์ด๋ ํ์ง์ ๋ํ ์ค๋ฌธ์กฐ์ฌ์ ์ธํฐ๋ทฐ๋ฅผ ๋ฐํ์ผ๋ก
๊ณต์์ ํ๋น์ฑ์ ์ ๋ฆฝํ์์ผ๋ฉฐ, ์ด๋ค ๋ฐฉํฅ์ผ๋ก ์ด์ฉ๋์ด์ผ ํ๋์ง์ ๋ํ
์๊ฒฌ์ ๋ค์ ์ ์์๋ค.
๋์์ง๋ถ์์ ํตํด ๋ ๊ณ ์ฐฐ ํ ๋์์ง์ ๋ฌธ์ ์ ๋ฐ ํ์ฉ๋ฐฉํฅ์ ํ์
ํ๊ธฐ
์ํด ๋์์ง์ ์ ๋์ ๊ทผ๋ ๋ณ์ฒ๊ณผ์ ์ ํตํด ๋์์ง ๊ณผ๊ฑฐ์ ์ฌํ์ ์ธ ์ด์๋ค
์ ์ดํด๋ณด์์ผ๋ฉฐ, ํ์ฌ ๋์์ง๊ฐ ์์ํด ์๋ ๋ง์๊ตฌ ์์๋์ ๋ํ ์ธ๊ตฌํํฉ
๋ถ์์ ํตํด ์ ๋ฐ์ ์ธ ์๋ฏผ๋ค์ ์ฐ๋ น, ์ง์
๋ฑ์ ์ดํด๋ณด์๋ค.
๋์์ง ๋ถ์์ ํตํด ๊ฑฐ์์ ์ธ ๋งฅ๋ฝ์์ ๋์์ง์ ์
์ง์ ์์๋ค์ ํ์
ํ
์์ผ๋ฉฐ, ์ธ๋ถ์ ์ธ ๋ถ์์ ํตํด ์ค์ง์ ์ผ๋ก ๋์์ง๊ฐ ๊ฐ๊ณ ์๋ ์ฃผ์ ํํฉ๊ณผ
๋ฌธ์ ์ ๋ค ๋์ถํ์๋ค. ์ด ์ธ ๋
๋ฆฝ์ ์ธ ์์๋ก์ ์์ฉํ๋ ๊ณต๊ฐ์ด ์๋ ๋งํผ
์กฐ์ฑ ๊ณผ์ ์ ์์ด ์ฃผ๋ณ์ผ๋์ ์งํ๋๊ณ ์๋ ๊ด๋ จ๊ณํ๋ค์ ์ดํด๋ด์ผ๋ก์จ ๋์
์ง ์กฐ์ฑ์ ์์ด ์ฐ๊ณ ๊ฐ๋ฅํ ์์๋ค์ ๋์ถํ์๋ค.
์์ ๋ถ์๋ด์ฉ์ ๊ธฐ๋ฐ์ผ๋ก ๋ณธ ์ฐ๊ตฌ์ ์ค๊ณ๋ชฉํ๋ฅผ ์ค์ ํ์๋ค. ๋จ์ ๋ ์
๊ฐ๋ฉด์ ์ฐ๊ฒฐ์ฑ์ ๊ฐํ์ํค๊ธฐ ์ํ ๋ฐฉ์์ ์ ์ํ๋ฉฐ. ๊ด๊ด์ง๋ก ๊ธฐ๋ฅ์ ํ๋ ๊ณต์์ ์กฐ์ฑํ์ฌ ์ง์ญ ๊ฒฝ์ ํ์ฑ ๋ฐ ์ปค๋ฎค๋ํฐ ๊ณต๊ฐ์ผ๋ก ํ์ฉ๋ ์ ์๋ ๊ณต๊ฐ์กฐ
์ฑ, ์ฑ์์ฅ์ด ๊ฐ๋ ์ ๊ฐ์ง์ ํน์์ ํ์ฉํ ์ ์๋ ๋ฐฉ์๋ง๋ จ๊ณผ ๊ณผ๊ฑฐ ์ฑ์ํ
๋์ผ๋ก ์ธํด ํฉํํ๋ ํ ์ง๋ฅผ ๋ณต์ํ๋ฉฐ ์ฃผ๋ณ์ฐ๋ฆผ๊ณผ ์ด์ธ๋ฆฌ๋ ๊ณต๊ฐ์กฐ์ฑ์ ๋ณธ
์ฐ๊ตฌ์ ๋ชฉํ๋ก ์ค์ ํ์๋ค.
๋ณธ ์ฐ๊ตฌ๋ ์ฑ์์ฅ์ด ๊ฐ๊ณ ์๋ ๋ถ์ ์ ์ธ์์ ์ ํํ๋ ๋ฐฉ์์ ์ผํ์ผ๋ก์
๊ณต์ ์กฐ์ฑ์ ์ ์ํ๋ฉฐ ์ด๊ธฐ ๊ณต์์ ์กฐ์ฑํ๋๋ฐ ์์ด ์ฃผ๋ณ ๊ด๋ จ์ฃผ์ฒด์ ์๊ฒฌ์
๋ฐ์ํจ์ผ๋ก์ ์ฐธ์ฌํ๊ณ , ์ฑ์ฅํ๋ ๊ณต์์ด๋ผ๋ ์ ์์ ์ฐจ๋ณ์ฑ์ด ์์ผ๋ฉฐ ์ด
ํ ํ์ฑ์์ฅ์ ํ์ฉํ๋ ๊ธฐ์ด์๋ฃ๋ก ํ์ฉ ํ ์ ์๋ค๋๋ฐ ์ ์์ ์์๊ฐ ์
๋ค.The quarry that occurred during the modernization process contributed
to the development of the national industry, but after the development
was completed, it was intended to find a solution to solve the urban,
environmental and social problems that appear in the state of decline and
closure.
The quarry where the mining is completed shall be restored to its
original state in accordance with Act 4 of the Mountainous Districts
Management Act. However, even if proper restoration is done in the
restoration method, it is difficult to restore it to its original state, which
brings huge recovery costs. Therefore, most quarry is not properly
restored and is neglected. Left unattended scars degrade the function ofthe surrounding landscape and hinder its development. However, there
are cases where parks and cultural spaces are being created using
recently neglected quarry. A typical example is Pocheon Art Valley, which
is a great help to revitalize the local economy by using quarry, which
was a negative in the past, as a tourist attraction.
The target area of this study located in Seoksu-dong, Anyang-si started
development in 1979 to airlift gravel to be used for apartment
construction. In 1995, the quarrying work was completed and the
restoration work was carried out. In 2005, Gyeongin National University of
Education was established on the existing quarry site, and various
environmental problems occurred during the construction process.
However, in order to improve these problems, the school has made
constant efforts and now remains an improved abandoned site. Therefore,
this study was a space of environmental issues as a quarrying activity in
the past, but at this point, it was judged that it is necessary to use it as
a major space and to change the awareness. Prior to the study, previous
studies were conducted to understand the quarry in general. Previous
studies have investigated the utilization plan of quarry and similar
concept space in a large category, and focused on the survey of users,
citizens, and the survey of the perception. The theoretical consideration
was to examine the concept of 'the necessity of using waste quarries'
and the concept of quarries in industrial heritage in the category of
preserving and utilizing them.
The laws and related regulations that must be observed in the
utilization of waste quarry were examined, and the design andconstruction process were considered based on domestic literature.
In order to understand the object in earnest, the overall understanding
of the concept of large scale was made, and major events that occurred
in the periphery of the object were examined through the origin and
transition process. The population status, age, occupation, etc. were
investigated through the analysis of population status. Based on the main
contents, the validity of the park was established based on the survey
and interview on the perceptions of local subjects, and opinions on 'what
direction should be used' were heard.
After the analysis of the target area, the social issues of the target
area were examined through the origin of the target area and the
process of modern change in order to grasp the problems and utilization
direction of the target area. The age and occupation of the citizens were
examined through the analysis of the population status of Seoksu-dong,
Manan-gu, where the target area belongs.
Through the analysis of the target site, the locational elements of the
target site were identified in macroscopic contexts, and the main current
status and problems of the target site were derived through detailed
analysis. In addition, as it is not a space that acts as an independent
element, it has derived the elements that can be linked to the creation
of the target area by examining the related plans that are being carried
out in the surrounding area.
Based on the above analysis, the design goal of this study was set up,
and a plan to strengthen the connectivity of the cut-out surface was
proposed. The purpose of this study was to create a park that functions์ 1์ฅ ์๋ก
1์ . ์ฐ๊ตฌ์ ๋ฐฐ๊ฒฝ ๋ฐ ๋ชฉ์ 1
1. ์ฐ๊ตฌ์ ๋ฐฐ๊ฒฝ 1
2. ์ฐ๊ตฌ์ ๋ชฉ์ 3
2์ . ์ฐ๊ตฌ์ ๋ฒ์ 4
1. ๊ณต๊ฐ์ ๋ฒ์ 4
2. ๋ด์ฉ์ ๋ฒ์ ๋ฐ ์งํ๊ณผ์ 5
3์ . ์ ํ์ฐ๊ตฌ์ ๊ณ ์ฐฐ 7
4์ . ์ฐ๊ตฌ์ ์ฐจ๋ณ์ฑ 10
์ 2์ฅ ์ด๋ก ์ ๊ณ ์ฐฐ
1์ . ํ์ฑ์์ฅ ํ์ฉ์ ์ดํด 11
1. ์ฐ์
์ ์ฐ๊ฐ๋
์ ์ฑ์์ฅ ์ดํด์ ํ์ฉ์ ํ์์ฑ 11
2. ํ์ฑ์์ฅ์ ๋ณต๊ตฌ๊ธฐ์ค ๋ฐ ๋ณต์๊ณผ์ 14
3. ํ์ฑ์์ฅ์ ๋ณต์ ์ค๊ณ ๋ฐ ์๊ณต 18
2์ . ์ฌ๋ก์ฐ๊ตฌ 23
์ 3์ฅ ๋์์ง ๋ถ์
1์ . ๋์์ง์ ์ดํด 31
1. ๋์์ง ๊ฐ์ 31
2. ๋์์ง์ ์ ๋์ ๋ณ์ฒ๊ณผ์ 32
3. ์ธ๊ตฌํํฉ 39
2์ . ๊ณต์ํ์ ํ๋น์ฑ ๋ฐ ์ฃผ๋ฏผ์๊ฒฌ 42
1. ๊ด๋ จ๋ฒ๋ฅ ๊ฒํ ๋ฐ ๊ณต์์ ํ๋น์ฑ 42
2. ์ง์ญ์ฃผ๋ฏผ ์๊ฒฌ 44
3์ . ๋์์ง ๋ถ์ 49
1. ๊ฑฐ์์ ๋งฅ๋ฝ์ ๋ถ์ 49
2. ์ธ๋ถ ๋์์ง ๋ถ์ 55
4์ . ๊ด๋ จ๊ณํ ๊ฒํ 72
5์ . ์ข
ํฉ๋ถ์ 75
์ 4์ฅ ๊ธฐ๋ณธ๋ฐฉํฅ ๋ฐ ๊ตฌ์
1์ . ๊ธฐ๋ณธ๋ฐฉํฅ 79
1. ์งํ์ ๊ณ ๋ คํ ์ค๊ณ๋ฐฉ์ ๋์
79
2. ๊ด๋ จ ์ฌ์
๋ฐ ์ฃผ๋ณ ์ธํ๋ผ์์ ์ฐ๊ณ 81
3. ์ง์ญ ์ฃผ์ฒด์ ์๊ฒฌ ์๋ ด 82
2์ . ์ค๊ณ์ ๋ชฉํ 82
3์ . ๊ธฐ๋ณธ ๊ตฌ์ 84
์ 5์ฅ ๊ธฐ๋ณธ๊ณํ ๋ฐ ์ค๊ณ
1์ . ๊ธฐ๋ณธ๊ณํ 87
1. ์ข
ํฉ๊ณํ๋ 87
2. ๋์ ๊ณํ 88
3. ํฌ์ฅ๊ณํ 89
4. ์์ฌ๊ณํ 89
5. ํ๋ก๊ทธ๋จ๊ณํ 94
2์ . ์ธ๋ถ๊ณต๊ฐ๋ณ ์ค๊ณ 96
1. ์ฐ๊ฒฐํ์ ๋ฐ ๋ ์ ์ผํฐ 95
2. ์๋ถ ์ฐ๊ฒฐ๋ก ๋ฐ ์ค์๋ณดํ๋ก 97
3. ์ ๊ฐ๋ฉด ์๋ถ ๊ณต๊ฐ ๋ฐ ์ผํฐ 99
4. ์ปค๋ฎค๋ํฐ์ ์ ๋ฐ ์๋น์ค์์ค 100
์ 6์ฅ ๊ฒฐ๋ก
[์ฐธ๊ณ ๋ฌธํ] 104
[Abstract] 106Maste
Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services
PURPOSE: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services.
METHODS: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program.
RESULTS: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling.
CONCLUSION: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.ope
The Effect of Self-Expanding Metallic Stent Insertion for the Treatment ofMalignant Colorectal Obstruction
BACKGROUND/AIMS: The aim of this study was to evaluate the clinical and cost effectiveness of the use of stent insertion for malignant colorectal obstruction as compared with performing emergency surgery. METHODS: We retrospectively reviewed the medical records of 201 patients. Malignant colorectal obstructions caused by a resectable tumor were treated with preoperative stenting followed by surgery (group A, n=55) or emergency surgery (group B, n=59). Malignant obstructions caused by an unresectable cancer were treated with palliative stenting (group C, n=58) or palliative emergency surgery (group D, n=29). RESULTS: The one-staged radical resection rate was significantly higher in group A patients than in group B patients (87.3% vs. 52.5%, p<0.05). Post-operative complications were more frequent in group A patients than in group B patients (9.1% vs. 32.2%, p<0.05). The admission period was significantly shorter for group A patients than for group B patients (25.0 days vs. 33.7 days, p<0.05). The medical cost was not different for group A and group B patients. Life-long stoma formation was necessary for 15.5% of group C patients and 69% of group D patients, respectively. The admission period was significantly shorter for group C patients than group D patients (10.5 days vs. 22.7 days, p<0.05). The medical cost was not different for group C and D patients. CONCLUSIONS: Stent insertion was an effective treatment modality for malignant colorectal obstruction.ope
Changes of Ascites Nitric Oxide According to the Treatment Course in Cirrhotic Patients with Spontaneous Bacterial Peritonitis
Background/Aims: Nitricoxide (NO) is a molecule involved in vascular dilatation and pathogen suppression. It also has immunologic and regulatory functions. Liver cirrhosis is characterized by an increased risk for bacterial infections, including spontaneous bacterial peritonitis (SBP). The role of NO in SBP which develops in cirrhosis has not been clearly established. The aim of this study was to investigate the role of NO in the pathogenesis of SBP and its clinical usefulness for prediction of disease prognosis. Methods: This study was designed to investigate the changes of ascites NO in the course of treatment. Nitricoxide metabolite (nitrites+nitrates [NO x]) was measured by chemilum inescence in 84 ascites samples obtained from 84 cirrhotic patients. Among them , the 38 patients with SBP were treated with cefotaxim e 2.0 g, q 12hr for 7 days. In 24 of SBP patients, ascites was obtained consecutively before treatment (day 0),during treatment (day 2),and after treatment (day 7). Results: Ascites NO levels in the patients w ith SBP (n=38; 82.3 14.4 ฮผM ) were not different from those in patients with sterile ascites (n=46; 54.6 13.0 ฮผM ). There was no significant change of NO levels in sequential ascites samples during antibiotic treatment. A scites NO level before treatment was significantly higher in SBP patients who responded to antibiotics (n=26; 101.86 ฮผM/L) than that in SBP patients who did not respond to antibiotics (n=12; 40.03 ฮผM/L, P =0.044). A significant direct correlation was found between ascites and serum NO levels before treatment (Pearson correlation,r2=0.86,P =0.001). Among the SBP patients, treatment response rate to antibiotics were significantly higher in those patients with pretreatment NO levelโฅ80 ฮผM/L in multivariate analysis. Conclusions: Ascites NO level was not different between ascites from SBP patients and ascites from cirrhotic patients with sterile ascites. There were no changes of ascites NO in SBP patients during treatment. Therefore ascites NO was not useful to predict the progress of SBP. Ascites NO levels reflect serum NO levels, and the patients with higher NO level may have better response to antibiotics.ope
Survival and Recurrence Pattern after Curative Resection of Pancreatic Cancer
Background/Aims: The only hope for the cure of pancreatic adenocarcinoma is curative resection. However, the rate of recurrence after curative resection is higher than 50%. The aim, of this study were to analyze survival and the factors influencing survival and to evaluate the recurrence rate and pattern after curative resection of pancreatic adenocarcinoma. Methods: The records of 250 patients who were diagnosed as pancreatic cancer were reviewed retrospectively. We classified the patients into 3 groups (curative resection, non-curative resection, and conservative treatment) and analyzed the factors influencing survival, recurrence rate, and recurrence pattern after curative resection. Results: Curative resection were performed in 31 (12.4%) of 250 cases. The patients with curative resection was significantly prolonged median survival time than those without non-curative resection or with conservative treatment. The factors influencing survival rate after curative resection were age, lymph node involvement, and disease status. Twenty-five of the 31 cases with curative resection had recurrences after 10 months. Local retroperitoneal recurrence was 69%. Liver metastasis and lymph node metastasis were occurred in 61% and 54%, respectively. Conclusions: The survival time of the patients with pancreatic adenocarcinoma was prolonged in the cases of curative resection compared with the cases of non-curative resection or conservative treatment. However, most cases after curative resection showed recurrence. Thus, early diagnosis and early treatment should be needed to prolong the survival time of the patients with pancreatic adenocarcinoma.ope
Expression of CD99 in human plasma cells and its biologic implication
ํ์๋
ผ๋ฌธ(๋ฐ์ฌ) --์์ธ๋ํ๊ต ๋ํ์ :์ํ๊ณผ (๋ณ๋ฆฌํ ์ ๊ณต),2009.2.Docto
Changes of ascites nitric oxide according to the treatment course in cirrhotic patients with spontaneous bacterial perito
์ํ๊ณผ/์์ฌ[ํ๊ธ]
Nitric Oxide๋ ํ๊ด ํ์ฅ์ ์์ฉํ๋ ์ค์ํ ๋งค๊ฐ ๋ฌผ์ง๋ก ์๋ ค์ ธ ์๋ค. ๋ํ NO๋ ํ๊ด ํ์ฅ๊ณผ ๊ฐ์ ์์ฉ์ด์ธ์๋ ์ธ์ฒด์์ ๋ค์ํ ๊ธฐ๋ฅ์ด ์๋ ๊ฒ์ผ๋ก ์๋ ค์ ธ ์์ผ๋ ์ด์ ๋ํ ์์ธํ ๊ธฐ์ ์ ์์ง ๋ช
ํํ๊ฒ ๋ฐํ์ง์ง ์์๋ค.
๊ฐ๊ฒฝ๋ณ์ฆ ํ์์์๋ ์ผ๋ฐ์ ์ผ๋ก NO๊ฐ ์ฆ๊ฐํ๋ ๊ฒ์ผ๋ก ์๋ ค์ ธ ์๊ณ ์ฆ๊ฐ๋ NO๋ ๋ด์ฅ ๋ฐ ์ ์ ์ ํ๊ด ํ์ฅ์ ์ ๋ฐํ์ฌ ์ ์ ์ํ์ ์ฅ์ ๋ฅผ ์ด๋ํ๊ณ ์ ๊ธฐ๋ฅ์ ์ ํ์ํค๋ ๊ฒ์ผ๋ก ์๋ ค์ ธ ์๋ค. ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ์ ๋ณต์๋ฅผ ๋๋ฐํ ๊ฐ๊ฒฝ๋ณ์ฆ ํ์์์ ํํ ๋ฐ์ํ๋ ์น๋ช
์ ์ธ ํฉ๋ณ์ฆ์ผ๋ก ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ์ ๋๋ฐํ ํ์์ ๋ณต์์์ NO๊ฐ ์ฆ๊ฐํด ์๋ค๊ณ ์๋ ค์ ธ ์๋ค. ๊ทธ๋ฌ๋ ๋ณต์๋ฅผ ๋๋ฐํ ๊ฐ๊ฒฝ๋ณ์ฆ ํ์์ ๋ณต์์ ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ์ ๋๋ฐํ ํ์์ ๋ณต์์์ NO์ ๊ธฐ๋ฅ๊ณผ ๋ณํ์ ๋ํ ๊ตฌ์ฒด์ ์ธ ๊ฒฐ๋ก ์ ์์ง ์๋ค.
๋ฐ๋ผ์ ๋ณธ ์ฐ๊ตฌ๋ ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ ํ์์ ๋ณต์๋ฅผ ์น๋ฃ๊ธฐ๊ฐ ๋์ ์ผ์ ํ ๊ฐ๊ฒฉ์ผ๋ก ์ฑ์ทจํ์ฌ NO์ ๋ณํ๋ฅผ ์ดํด๋ณด๊ณ ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ์ด ์๋ ๊ฐ๊ฒฝ๋ณ์ฆ ํ์์ ๋ฌด๊ท ์ฑ ๋ณต์์ ๋น๊ตํ์ฌ NO์ ์์์ ์์๋ฅผ ์ดํด๋ณด๊ณ ๋์์ ํ์ก๋ด์ NO์ ๋น๊ตํ์ฌ NO์ ์ ์ ์ ์ธ ์ญํ ๊ณผ ์์์ ์๋ฏธ๋ฅผ ์ดํด๋ณด๊ณ ์ ํ์๋ค.
2000๋
11์๋ถํฐ 2002๋
12์๊น์ง ์ฐ์ธ๋ํ๊ต ์๊ณผ๋ํ ์ ์ด ์ธ๋ธ๋์ค ๋ณ์์ ์
์ํ ๊ฐ๊ฒฝ๋ณ์ฆ ํ์ ์ค์์ ๋ณต์ ์ฒ์๊ฐ ๊ฐ๋ฅํ 84๋ช
์ ํ์๋ฅผ ๋์์ผ๋ก ํ์๋ค. ๊ฐ๊ฒฝ๋ณ์ฆ์ ์์ ์ฆ์๊ณผ ์ด์ํ ๋ฐ ๋ณต๋ถ ์ปดํจํฐ ๋จ์ธต ์ดฌ์ ๋ฑ์ ์์ ์๋ฃ๋ฅผ ์ด์ฉํ์ฌ ์ง๋จํ์๋ค. ํ์์ ๋ณต์์ ํ์ก์ ์ผ์ ํ ๊ฐ๊ฒฉ์ผ๋ก ์ฑ์ทจํ์ฌ ๋ฐฑํ๊ตฌ์์ ์ด๋จ๋ฐฑ, ์๋ถ๋ฏผ ๋ฐ NO [NOx = nitrite(NO2) + nitrate(NO3)] ๋ฅผ ์ธก์ ํ๊ณ ํ์ก์์๋ ํ์ฒญ ํํ ๊ฒ์ฌ์ ๋ง์ด ํ์ก ๊ฒ์ฌ๋ฅผ ์ํํ์๊ณ ๋ณต์์์๋ ์ธ๊ท ๋ฐฐ์์ ์ํํ์๋ค.
ํ์์ ํ๊ท ์ฐ๋ น์ 53.5ยฑ9.7 ์ธ์ด๊ณ ๊ฐ๊ฒฝ๋ณ์ฆ์ ์์ธ์ Bํ ๊ฐ์ผ์ด 68 ๋ช
, Cํ ๊ฐ์ผ์ด 4๋ช
, ์์ฝ์ฌ์ฑ ๊ฐ์ผ์ด 5 ๋ช
, ๊ธฐํ ์์ธ์ด ๋ถ๋ช
ํ์ง ์์ ๊ฒฝ์ฐ๊ฐ 7 ๋ช
์ด์๋ค. ์ด์ค Child-Pugh Class A๋ 1 ๋ช
, B๋ 28 ๋ช
, C๋ 54 ๋ช
์ด์๋ค.
๋ณต์์์ ์ธก์ ํ NO๋ ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ๊ตฐ๊ณผ ๋์กฐ๊ตฐ ์ฌ์ด์ ํต๊ณ์ ์ผ๋ก ์ ์ํ ์ฐจ์ด๋ ์์์ผ๋ ๋ณต๋ง์ผ๊ตฐ(mean, 82.6 mmole/L ยฑ 14.4)์ด ๋์กฐ๊ตฐ(mean, 54.6 mmole/L ยฑ 13.0)๋ณด๋ค ๋ค์ ๋์๋ค. ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ ํ์๊ตฐ 36๋ช
์ค ํญ์์ ์น๋ฃ 7์ผ ํ์ ๋ณต์๋ด์ ๋ฐฑํ๊ตฌ๊ฐ 250๊ฐ ์ดํ๋ก ๊ฐ์๋ ๊ตฐ(n=26)๊ณผ ํญ์์ ์ ๋ฐ์ํ์ง ์์ ์น๋ฃ ํ์๋ ๋ณต์๋ด์ ๋ฐฑํ๊ตฌ๊ฐ 250๊ฐ ์ด์์ธ ์ ๊ตฐ(n=12) ์ฌ์ด์ ์
์ ๋น์์ ๋ณต์ NO ๊ฐ์ ๋น๊ตํด ๋ณด๋ฉด ํญ์์ ์น๋ฃ์ ๋ฐ์ํ ๊ตฐ์์ ํต๊ณ์ ์ผ๋ก ์ ์ํ๊ฒ NO์ ๊ฐ์ด ๋์๋ค(p-value=0.044). ์ ์ฒด ๋์ ํ์ ์ค 10๋ช
์์ ์น๋ฃ ๊ธฐ๊ฐ ๋์ ํ์ก๊ณผ ๋ณต์๋ฅผ ๋์์ ์ฑ์ทจํ์ฌ NO๋ฅผ ์ธก์ ํ ์ ์์๋๋ฐ ํ์ก๊ณผ ๋ณต์ ๊ฐ๊ฐ์์ ์น๋ฃ ๊ธฐ๊ฐ์ ๋ฐ๋ผ ํต๊ณ์ ์ผ๋ก ์๋ฏธ ์๋ NO ๊ฐ์ ๋ณํ๋ ๊ด์ฐฐ๋์ง ์์์ง๋ง ์น๋ฃ ์ ๋ณต์์ ํ์ก์ NO ๊ฐ์ ์๊ด๊ด๊ณ๋ฅผ ๋ณด์๋ค. ์น๋ฃ ์ฑ์ ์ ์ํฅ์ ๋ฏธ์น๋ ์ธ์๋ค์ ๊ฒ์ฆํ๊ธฐ ์ํด ๊ฐ๊ธฐ๋ฅ, ๊ฐ์, ์
์ ๋น์์ ๋ณต์ NO์ ๊ฐ์ ํฌํจํ์ฌ ๋ค๋ณ๋ ๋ถ์์ ์ํํ์๋๋ฐ NO๊ฐ 80 mmole/L ์ด์์ธ ๊ตฐ์์ ํต๊ณ์ ์ผ๋ก ์ ์ํ๊ฒ ํญ์์ ์น๋ฃ์ ๋ฐ์์ ํ๋ ๊ฒ์ผ๋ก ๋ํ๋ฌ๋ค.
๊ฒฐ๋ก ์ ์ผ๋ก ์๋ฐ์ฑ ์ธ๊ท ์ฑ ๋ณต๋ง์ผ ํ์์์ ์น๋ฃ ์ ๋ณต์ NO ๊ฐ์ด ๋์ ๊ตฐ์์ ํญ์์ ์น๋ฃ์ ์ํธํ ๋ฐ์์ ๋ณด์๊ณ ํ์ก NO๊ฐ ๋ณต์ NO๋ฅผ ๋ฐ์ํ๋ค๊ณ ํ ์ ์๋ค.
[์๋ฌธ]
Nitric oxide (NO) is a molecule involved in vascular dilatation and pathogen suppression. It also has immunologic and regulatory function. Cirrhosis is characterized by an increased risk for infections, including spontaneous bacterial peritonitis (SBP). The role of NO in SBP which develops in cirrhosis has not been clearly established.
The aim of this study was to investigate the role of NO in the treatment of SBP and its clinical usefulness. This study was designed to investigate the changes of ascites NO in the course of treatment. NO is an extremely unstable molecule and is rapidly converted to in vivo to nitrite (NO2) and nitrate (NO3). Therefore nitric oxide metabolite (nitrites + nitrates [NOx]) was measured by chemoiluminescence in 84 ascites samples obtained from 84 cirrhotic patients. Among them 38 patients with SBP were treated with cefotaxime 2.0g, q12hr for 7 days. In 24 of SBP patients ascites was obtained consecutively before treatment (day 0), during treatment (day 2), and after treament (day 7). Ascites NO levels were not significantly different between patients with SBP (n=38; mean, 82.3 mM ยฑ 14.4) and patients with sterile ascites (n=46; mean, 54.6 mM ยฑ 13.0). And the change of ascites during treatment was not significant. In SBP patients ascites NOx from patients responded to antibiotics (n=26; mean 101.86 mM) was significantly higher compared with ascites from non-responded patients (n=12; mean, 40.03 mM) before treatment (p=0.044). A very significant direct correlation was found ascites and serum NOx levels before treatment (Pearson correlation, r2=0.86, P-value=0.001). Among SBP patients with SBP, treatment response rate to antibiotics was significant higher in those with NO levels ยณ 80 mM in multivariate analysis.In conclusion, ascites NO was not different between ascites from SBP patients and ascites from cirrhotic patients with sterile ascites. There was no change of ascites NOx in SBP patients during the course of treatment. Therefore ascites NO was not useful to determine the progress of SBP. However, ascites NO levels reflect serum NO levels, and patients with higher NO level before treatment may have better response to antibiotics.ope
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