138 research outputs found

    Improvement of the G-SEED to Enhance Rainwater Utilization and Reduce Greenhouse Gas Emissions

    Get PDF
    2030๋…„ ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ๋Ÿ‰ ์ „๋ง์น˜ ๋Œ€๋น„ 37% ๊ฐ์ถ•๋ชฉํ‘œ์™€ 2050 ํƒ„์†Œ ์ค‘๋ฆฝ์„ ์–ธ๊ณผ ๊ฐ™์ด ๊ตญ๊ฐ€์ ์œผ๋กœ ์˜จ์‹ค๊ฐ€์Šค ๊ฐ์ถ•์ด ์ค‘์š”ํ•œ ๊ณผ์ œ๋กœ ๋– ์˜ค๋ฅด๋Š” ๊ฐ€์šด๋ฐ ๊ตญ๋‚ด ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ๋Ÿ‰์€ ๋งค๋…„ ์ฆ๊ฐ€ํ•˜๊ณ  ์žˆ๊ณ , ํŠนํžˆ ๊ฑด๋ฌผ ๋ถ€๋ฌธ์˜ ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ๋Ÿ‰์€ ์ „์ฒด์˜ ์•ฝ 20%๋ฅผ ์ฐจ์ง€ํ•˜๊ณ  ์žˆ์–ด ์ด์— ๋Œ€ํ•œ ๊ฐ์ถ•์ด ํฌ๊ฒŒ ์š”๊ตฌ๋˜์–ด์ง„๋‹ค. ๊ฑด์ถ•๋ฌผ์—์„œ์˜ ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ๋Ÿ‰ ๊ฐ์ถ•๊ณผ ๋…น์ƒ‰๊ฑด์ถ•๋ฌผ ํ™•๋Œ€๋ฅผ ์œ„ํ•˜์—ฌ ใ€Œ๋…น์ƒ‰๊ฑด์ถ•๋ฌผ ์กฐ์„ฑ์ง€์›๋ฒ•ใ€๊ทผ๊ฑฐํ•˜์— โ€˜๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„โ€™๊ฐ€ ์‹œํ–‰๋˜๊ณ  ์žˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜, ๋น—๋ฌผ ๋ฐ ์œ ์ถœ์ง€ํ•˜์ˆ˜ ์ด์šฉ ์ธ์ฆํ•ญ๋ชฉ ๋‚ด์—์„œ ํ‰๊ฐ€ํ•˜๊ณ  ์žˆ๋Š” ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์€ ๋‹จ์ˆœํžˆ ๋น—๋ฌผ ์ €๋ฅ˜์กฐ์˜ ์šฉ๋Ÿ‰์„ ํ‰๊ฐ€์ธ์ž๋กœ ์ ์šฉํ•˜๊ณ  ์žˆ์–ด ์„ฑ๋Šฅ์„ ์ •๋Ÿ‰์ ์œผ๋กœ ํ‰๊ฐ€ํ•  ์ˆ˜ ์—†๊ณ , ์œ ์ง€๊ด€๋ฆฌ์— ๊ด€ํ•œ ๊ทœ์ •์ด ๋ฏธํกํ•˜๋‹ค๋Š” ํ•œ๊ณ„์ ์„ ์ง€๋‹ˆ๊ณ  ์žˆ๋‹ค. ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ํ˜„ ๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„์˜ ๋น—๋ฌผ์ด์šฉ์‹œ์„ค ๊ด€๋ จ ํ‰๊ฐ€ ๊ธฐ์ค€๊ณผ ์„ค๊ณ„ ๋ฐ ์œ ์ง€๊ด€๋ฆฌ ๊ธฐ์ค€์„ ๋ถ„์„ํ•˜์—ฌ ๋ฌธ์ œ์ ์„ ๋„์ถœํ•˜๊ณ , ์ด๋ฅผ ๊ฐœ์„ ํ•˜๊ธฐ ์œ„ํ•œ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๋จผ์ €, ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์˜ ์„ฑ๋Šฅ์„ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์ผ๋ณ„ ๋ฌผ์ˆ˜์ง€ ๋ชจ๋ธ์ธ RSUD ๋ชจ๋ธ๊ณผ ํ‰๊ฐ€์ธ์ž๋กœ RUR๊ณผ WSE๋ฅผ ์„ ์ •ํ•˜๊ณ , ๋‹ค๋ชฉ์  ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์„ ์œ„ํ•œ ์„ค๊ณ„์ธ์ž๋“ค์„ ๋„์ถœํ•˜์˜€์œผ๋ฉฐ ์‹ ์ถ•, ๊ธฐ์กด, ๋ฆฌ๋ชจ๋ธ๋ง ๊ฑด์ถ•๋ฌผ์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜๋Š” ํ‰๊ฐ€ ๊ธฐ์ค€์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  ๋น—๋ฌผ ์ด์šฉ์— ๋”ฐ๋ฅธ ์˜จ์‹ค๊ฐ€์Šค ๊ฐ์ถ• ํšจ๊ณผ๋ฅผ ๋ถ„์„ํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ ์›๋‹จ์œ„๋ฅผ ์—ฐ๋„๋ณ„, ์ง€์—ญ๋ณ„๋กœ ์‚ฐ์ถœํ•˜์˜€๊ณ , ์‚ฌ๋ก€๋ฅผ ์ด์šฉํ•˜์—ฌ ํ˜„ ๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„์˜ ํ‰๊ฐ€ ๊ธฐ์ค€๊ณผ ์ œ์‹œ๋œ ํ‰๊ฐ€ ๊ธฐ์ค€์„ ์ ์šฉํ•œ ๊ฒฝ์šฐ๋ฅผ ๋น„๊ต ๋ถ„์„ํ•˜์˜€๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ, ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์˜ ์„ฑ๋Šฅ ์œ ์ง€๋ฅผ ์œ„ํ•˜์—ฌ ๋น—๋ฌผ์˜ ์ˆ˜์งˆ ๊ธฐ์ค€์— ์ ํ•ฉํ•œ ์ฒ˜๋ฆฌ์‹œ์„ค์˜ ์„ค๊ณ„๊ธฐ์ค€๊ณผ ์ˆ˜์งˆ ๋ฐ ์ˆ˜๋Ÿ‰ ๋ชจ๋‹ˆํ„ฐ๋ง ๊ธฐ์ค€์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ํ˜„ ๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„์™€ ๋‹ฌ๋ฆฌ ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์˜ ์„ฑ๋Šฅ์— ๋”ฐ๋ผ ๋ณ€๋ณ„๋ ฅ์žˆ๊ฒŒ ๋ฐฐ์ ์„ ๋ถ€์—ฌํ•  ์ˆ˜ ์žˆ๊ณ , ์‹œ์„ค์„ ์•ˆ์ •์ ์œผ๋กœ ์šด์˜ํ•  ์ˆ˜ ์žˆ์Œ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋Œ€์ฒด์ˆ˜์ž์›์ธ ๋น—๋ฌผ์„ ์ด์šฉํ•จ์œผ๋กœ์จ ๊ธฐํ›„๋ณ€ํ™”์— ๋Œ€์‘ํ•˜๊ณ , ๊ตญ๊ฐ€์˜ ์˜จ์‹ค๊ฐ€์Šค ๊ฐ์ถ• ๋ชฉํ‘œ๋ฅผ ๋‹ฌ์„ฑํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ๋น—๋ฌผ์ด์šฉ์‹œ์„ค์„ ๋‹จ์ˆœํžˆ ์„ค์น˜ํ•˜๋Š” ๋ฐ์— ๊ทธ์น˜๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ผ, ์‹œ์„ค์˜ ์„ค๊ณ„ ๋ฐ ์œ ์ง€๊ด€๋ฆฌ์— ๊ด€ํ•œ ๋‹ค์–‘ํ•œ ํ•ญ๋ชฉ๋“ค์„ ์ž์„ธํ•˜๊ณ  ์ •๊ธฐ์ ์œผ๋กœ ํ‰๊ฐ€ํ•จ์œผ๋กœ์จ ์„ฑ๋Šฅ์„ ์œ ์ง€ํ•˜๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๋‹ค. ์ด์— ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๊ฐ€ ๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„ ๋‚ด ๋น—๋ฌผ์ด์šฉ์‹œ์„ค ํ‰๊ฐ€ํ•ญ๋ชฉ ๊ฐœ์„ ์„ ์œ„ํ•œ ๊ทผ๊ฑฐ์ž๋ฃŒ๋กœ ํ™œ์šฉ๋„๊ฐ€ ์žˆ์„ ๊ฒƒ์ด๋ผ ์‚ฌ๋ฃŒ๋œ๋‹ค.As the Greenhouse Gas (GHG) Emission Reduction Goal by 37% in 2030 and the 2050 Carbon Neutral Declaration, reduction of GHG emissions is emerging as an important domestic task. Meanwhile, the domestic GHG emission is increasing every year. Especially, the GHG emission in the building sector accounts for about 20% of the total emission. Therefore, the reduction from this sector is greatly required. The Green Building Certification System (G-SEED) has been implemented based on the Green Building Construction Support Act for the GHG emission reduction at the building and the green building expansion. However, the rainwater harvesting (RWH) system, which is evaluated in the certification item of rainwater and runoff groundwater utilization, has limitations that it cannot evaluate the performance quantitatively because the rainwater tank capacity is just applied as an evaluation factor and that the regulations on maintenance are insufficient. Hence, this research derived the problems by analyzing the standards for evaluation, design, and maintenance related to the RWH system of the G-SEED and proposed methods to improve them. Firstly, the RSUD model which is the daily water balance model, and RUR and WSE are selected as evaluation factors to evaluate the performance of the RWH system and proposed the design factors for multi-purposed RWH system. Also, the evaluation criteria for new, existing, and remodeled buildings is proposed. To analyze the GHG emission reduction effects according to the rainwater utilization, the GHG intensity is calculated based on the year and the region. Current G-SEED evaluation criteria and the proposed criteria are compared using the case studies. Lastly, the design criteria for the treatment facility to satisfy the rainwater quality standard and water quality and quantity monitoring standards are proposed for the performance management of the RWH system. As a result, it is confirmed that it can be assigned points differently depending on the environmental performance of the RWH system and that the facilities can be operated stably compared to the current green building certification system. To utilize the rainwater as an alternative water resource in response the climate change and to accomplish the national GHG reduction goal, not only RWH system installation but also the performance maintenance by regular and in-depth evaluation of design and management factors is important. Therefore, this research will contribute to improving the RWH system evaluation factor of the G-SEED as a solid basic study.์ œ 1 ์žฅ ์„œ ๋ก  1 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ์˜ ๋ฐฐ๊ฒฝ 1 ์ œ 2 ์ ˆ ์—ฐ๊ตฌ์˜ ๋ชฉ์  3 ์ œ 3 ์ ˆ ์—ฐ๊ตฌ์˜ ๋ฒ”์œ„ ๋ฐ ๋ฐฉ๋ฒ• 4 ์ œ 2 ์žฅ ์ด๋ก ์  ๊ณ ์ฐฐ 6 ์ œ 1 ์ ˆ ๋…น์ƒ‰๊ฑด์ถ•์˜ ๊ฐœ๋… 6 ์ œ 2 ์ ˆ ๋…น์ƒ‰๊ฑด์ถ• ์ธ์ฆ์ œ๋„ ๊ฐœ์š” 7 ์ œ 3 ์ ˆ ๋น—๋ฌผ์ด์šฉ์‹œ์„ค ํ‰๊ฐ€ํ•ญ๋ชฉ ๊ณ ์ฐฐ 12 ์ œ 3 ์žฅ ์ธ์ฆ๋Œ€์ƒ์— ๋”ฐ๋ฅธ ํ‰๊ฐ€๊ธฐ์ค€ ์ œ์‹œ 13 ์ œ 1 ์ ˆ ์„ฑ๋Šฅ ํ‰๊ฐ€๋ฐฉ๋ฒ• ๋ฐ ํ‰๊ฐ€์ธ์ž ์„ ์ • 13 1. ํ‰๊ฐ€๋ฐฉ๋ฒ• 13 2. ํ‰๊ฐ€์ธ์ž 17 ์ œ 2 ์ ˆ ์„ค๊ณ„์ธ์ž ๋„์ถœ 19 1. ๊ฐ•์šฐ 19 2. ์ง‘์ˆ˜ํšจ์œจ 21 3. ์ €์ˆ˜์œ„ ๋ฐ ๊ณ ์ˆ˜์œ„ 22 4. ์ €๋ฅ˜์กฐ ์šฉ๋Ÿ‰ ๋ฐ ์ˆ˜์š”๋Ÿ‰ 24 ์ œ 3 ์ ˆ ํ‰๊ฐ€๊ธฐ์ค€ ์ œ์‹œ 30 1. ์‹ ์ถ• ๊ฑด์ถ•๋ฌผ์„ ์œ„ํ•œ ํ‰๊ฐ€๊ธฐ์ค€ 30 2. ๊ธฐ์กด ๋ฐ ๋ฆฌ๋ชจ๋ธ๋ง ๊ฑด์ถ•๋ฌผ์„ ์œ„ํ•œ ํ‰๊ฐ€๊ธฐ์ค€ 31 ์ œ 4 ์žฅ ํ‰๊ฐ€๊ธฐ์ค€ ์ ์šฉ์— ๋”ฐ๋ฅธ ์„ฑ๋Šฅ ๋ถ„์„ 32 ์ œ 1 ์ ˆ ์˜จ์‹ค๊ฐ€์Šค ๋ฐฐ์ถœ ์›๋‹จ์œ„ ์‚ฐ์ถœ 33 ์ œ 2 ์ ˆ ํ‰๊ฐ€๊ธฐ์ค€ ์ ์šฉ์— ๋”ฐ๋ฅธ ๋น„๊ต 34 ์ œ 5 ์žฅ ์„ฑ๋Šฅ ์œ ์ง€๋ฅผ ์œ„ํ•œ ๊ฐ€์ด๋“œ๋ผ์ธ ์ œ์‹œ 39 ์ œ 1 ์ ˆ ์ฒ˜๋ฆฌ์‹œ์„ค ์„ค๊ณ„ ๊ฐ€์ด๋“œ๋ผ์ธ 39 ์ œ 2 ์ ˆ ์ˆ˜์งˆ ๋ฐ ์ˆ˜๋Ÿ‰ ๋ชจ๋‹ˆํ„ฐ๋ง ๊ฐ€์ด๋“œ๋ผ์ธ 46 ์ œ 6 ์žฅ ๊ฒฐ ๋ก  49 ์ฐธ๊ณ ๋ฌธํ—Œ 51 Abstract 58์„

    Design of Synchronize Controller for Non-Rail Mobile Rack by using Repetitive Control Method

    Get PDF
    Non-rail mobile rack which is used as a cargo storage in logistics center can improve the storage capacities. Furthermore, It has an advantage to apply in traditional logistic center without change any renovation such as installing rail. However when it is operated by a separated drive actuators which is mounted on the left and the right wheels, a precise position control for the wheels would be necessary even if unbalanced cargo weight on the non-rail mobile rack would be effected to the control. Therefore, in this study, there is necessary to internal synchronize control for position tracking between left and right wheels on the non-rail mobile rack. Also an external synchronize control for same straight movements between mobiles would be necessary. For developing the internal and the external synchronize control algorithm, we suggest a synchronize control algorithm based on the repetitive control theory. Specially, an internal synchronize control algorithm with repetitive control theory use the robust servo control method due to parameter variations. In this case, we can set up the gains for robust servo control system by considering the cargo variations on the mobile rack. Also, for constructing the external synchronize control algorithm, we use a double repetitive control system to perform synchronize control between each mobile rack. Finally, the efficiency of proposed control algorithm will be verified by simulation and experimental results. And the proposed algorithm would be applied to industrial area easily.Abstract ์ œ 1 ์žฅ ์„œ ๋ก  1 1.1 ์—ฐ๊ตฌ ๋ฐฐ๊ฒฝ๊ณผ ์—ฐ๊ตฌ๋ฐฉ๋ฒ• 1 1.2 ๋…ผ๋ฌธ์˜ ๊ตฌ์„ฑ 3 ์ œ 2 ์žฅ ์ด๋™๋ž™ ์‹œ์Šคํ…œ 4 2.1 ์ด๋™๋ž™ ์‹œ์Šคํ…œ 5 2.1.1 ์ด๋™๋ž™์˜ ํŠน์ง• 5 2.1.2 ์ด๋™๋ž™์˜ ์ข…๋ฅ˜ 6 2.2 ์ด๋™๋ž™ ๋ชจ๋ธ๋ง 8 2.3 ์ด๋™๋ž™ ํ™˜๊ฒฝ๋ณ€ํ™” ํŠน์„ฑ 11 ์ œ 3 ์žฅ ๋™๊ธฐํ™” ์ œ์–ด๊ธฐ ์„ค๊ณ„ 13 3.1 ๊ฐ•์ธ ์„œ๋ณด์ œ์–ด๊ธฐ 13 3.1.1 ๊ฐ•์ธ ์„œ๋ณด์ œ์–ด๊ธฐ์˜ ๊ตฌ์„ฑ 13 3.1.2 ์‹œ๋ฎฌ๋ ˆ์ด์…˜ 18 3.2 ๋ฐ˜๋ณต์ œ์–ด๊ณ„ 21 3.2.1 ๋ฐ˜๋ณต์ œ์–ด๊ณ„ ๊ตฌ์„ฑ 21 3.2.2 ๋ฐ˜๋ณต์ œ์–ด๊ณ„ ์„ค๊ณ„ 22 3.2.3 ๋ฐ˜๋ณต์ œ์–ด๊ณ„ ์‹œ๋ฎฌ๋ ˆ์ด์…˜ 23 3.3 ๋™๊ธฐํ™” ์ œ์–ด ์•Œ๊ณ ๋ฆฌ์ฆ˜ 25 3.3.1 ๋™๊ธฐํ™” ์ œ์–ด ์•Œ๊ณ ๋ฆฌ์ฆ˜์˜ ํ•„์š”์„ฑ 25 3.3.2 ๋™๊ธฐํ™” ์ œ์–ด ์•Œ๊ณ ๋ฆฌ์ฆ˜์˜ ๊ตฌํ˜„ ๋ฐฉ๋ฒ• 25 3.3.3 ๋™๊ธฐํ™” ์ œ์–ด ์•Œ๊ณ ๋ฆฌ์ฆ˜์˜ ๊ตฌ์„ฑ ๋ฐ ์„ค๊ณ„ 26 3.4 ์ด๋™๋ž™ ๊ตฌ๋™ํœ  ๋™๊ธฐํ™” ์ œ์–ด 28 3.4.1 ์ด๋™๋ž™ ๊ตฌ๋™ํœ  ๋™๊ธฐํ™” ์ œ์–ด๊ธฐ ๊ตฌ์„ฑ 28 3.4.2 ์‹œ๋ฎฌ๋ ˆ์ด์…˜ 29 3.5 ๋‹ค์ค‘ ์ด๋™๋ž™ ๋™๊ธฐํ™” ์ œ์–ด 37 3.5.1 ๋‹ค์ค‘ ์ด๋™๋ž™ ๋™๊ธฐํ™” ์ œ์–ด๊ธฐ ๊ตฌ์„ฑ 37 3.5.2 ์‹œ๋ฎฌ๋ ˆ์ด์…˜ 38 ์ œ 4 ์žฅ ๋™๊ธฐํ™” ์ œ์–ด๊ธฐ ์‹คํ—˜ ๋ฐ ๊ณ ์ฐฐ 46 4.1 ์ด๋™๋ž™ ๋ชจ๋ธ์˜ ๊ฐœ์š” 46 4.2 ๋‹ค์ค‘ ์ด๋™๋ž™ ์‹คํ—˜์žฅ์น˜ ๊ตฌ์„ฑ 46 4.3 ์‹คํ—˜ ๊ฒฐ๊ณผ ๋ฐ ๊ณ ์ฐฐ 53 4.3.1 ์‹คํ—˜ ์กฐ๊ฑด 53 4.3.2 ์‹คํ—˜ ๊ฒฐ๊ณผ ๋ฐ ๊ณ ์ฐฐ 53 ์ œ 5 ์žฅ ๊ฒฐ ๋ก  58 ์ฐธ๊ณ ๋ฌธ

    The Usefulness of Hip to Thigh Ratio as an Anthropometric Indicator for the Incidence of Hip Fracture

    Get PDF
    Purpose: To compare anthropometric indicators around the hip between osteoporotic fracture group and control group. Materials and Methods: Thirty patients for osteoporotic hip fracture and the same number of patients for spine fracture who admitted our institute from November 2006 to March 2007 were matched with control patients without osteoporotic fracture. The waist circumference (WC), hip circumference (HC), thigh circumference (TC), and height were measured. From these measurements, waist to hip ratio (WHR), waist to thigh ratio (WTR), hip to thigh ratio (HTR), waist to height ratio (WHtR), hip to height ratio (HHtR), and thigh to height ratio (THtR) were calculated. All these indicators were compared between hip fracture and control group, and between spine fracture and control group. Results: Comparison between spine fracture and control group showed that the WC, WHR, WHtR were statistically significant, but all indicators failed to show accuracy in the ROC analysis. Comparison between hip fracture and control group demonstrated the TC, WTR, HTR, WHtR, HHtR, THtR were statistically significant. However, only the HTR showed fair accuracy in the ROC analysis. The area under the curve (AUC) of the HTR was 0.75 (95% confidence interval, 0.62 to 0.87) (p=0.001). Conclusion: The HTR was fairly accurate in predicting the incidence of hip fracture compared with any other anthropometric indicators. Therefore, we can consider that the HTR has clinical usefulness.ope

    Fractures and Soft Tissue Injuries

    Get PDF
    Until recently, the fracture was regarded as the dominant element of high energy injuries, probably because trauma and orthopedic training was, by tradition, centered on the care of bone and joint injuries. Nowadays, however, orthopedic and trauma surgeons consider soft tissue injuries to be the most important component of high-energy trauma. High energy injuries such as polytrauma that may lead to dysfunction or failure of remote organs and vital systems, open fractures indicating a communication between the fracture and the external environment, pelvic fractures comprised of pelvic ring injuries and acetabular fractures are mostly associated with soft tissue injuries and are different from low energy injuries in their mechanism. Treatments of high energy injuries are more difficult than those of low energy injuries. Meticulous care should be taken to evaluate complications such as compartment syndrome, deep vein thrombosis, pulmonary embolism, and fat embolism, which tend to be easily neglected. Fractures with soft tissue injuries that are mostly high energy injuries need focusing on the patient as a whole and comprehensive approach. Close observations to establish early diagnosis of complications and to take timely, appropriate measures are also necessary.ope

    ์‚ฌ์šฉ์ž ๋งŒ์กฑ์„ ์œ„ํ•œ ๋กœํŒ์Šค(Ro-Pax)์—ฌ๊ฐ์„  ์‹ค๋‚ด๊ณต๊ฐ„ ๋””์ž์ธ์— ๊ด€ํ•œ ์—ฐ๊ตฌ

    Get PDF
    ์—ฌ๊ฐ์„ ์€ ์•„์ง ๊ตญ๋‚ด ์กฐ์„ ์—…๊ณ„์˜ ๊ณผ์ œ๋กœ ๋‚จ์•„์žˆ๋Š” ๊ณ ๋ถ€๊ฐ€๊ฐ€์น˜ ์„ ์ข…์œผ๋กœ์„œ ์•ž์œผ๋กœ ํ”ผํ•  ์ˆ˜ ์—†๋Š” ์‹œ์žฅ์ด๋‹ค. ๊ตญ๋‚ด ์—ฐ์•ˆ์—ฌ๊ฐ์„ ์€ ๊ทธ๊ฐ„ ํ•ด์™ธ ์ค‘๊ณ ์„  ์ˆ˜์ž…์—๋งŒ ์˜์กดํ•ด์™”๋Š”๋ฐ ์ตœ๊ทผ ์ •๋ถ€๊ฐ€ ์ถ”์ง„ํ•˜๋Š” ์—ฐ์•ˆ์—ฌ๊ฐ์„  ํ˜„๋Œ€ํ™”ํŽ€๋“œ ์ œ๋„๋ฅผ ํ†ตํ•ด ์ˆœ์ˆ˜ ๊ตญ๋‚ด ๊ธฐ์ˆ ๋กœ ๊ฑด์กฐ๋œ ์—ฌ๊ฐ์„ ์ด ์šดํ•ญํ•˜๊ฒŒ ๋˜์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ์›€์ง์ž„์€ ์—ฐ์•ˆ์—ฌ๊ฐ์„ ์ด ์„ ์‚ฌ์˜ ์‚ฌ์  ์†Œ์œ ๋ฌผ์„ ๋„˜์–ด ๊ณต๊ณต์  ์„ฑ๊ฒฉ์„ ๊ฐ€์ง„ ๊ตํ†ต์ˆ˜๋‹จ์œผ๋กœ ๋ณ€ํ™”ํ•˜๊ณ  ์žˆ๋‹ค๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค. ๋˜ํ•œ, ๊ณ ๋ น ์ธ๊ตฌ์™€ ํ›„์ฒœ์  ์žฅ์•  ์ฆ๊ฐ€๋กœ ์ธํ•œ ์‚ฌํšŒ์  ๋ฐฐ๊ฒฝ์„ ๊ณ ๋ คํ•ด ์ตœ๋Œ€ํ•œ์˜ ๋งŽ์€ ์‚ฌ๋žŒ์ด ํ•ด์ƒ๊ตํ†ต์„ ์ด์šฉํ•  ๊ถŒ๋ฆฌ์™€ ์ด์šฉ ๋งŒ์กฑ๋„๋ฅผ ์ ๊ฒ€ํ•˜๊ณ  ๊ฐœ์„ ์ด ์š”๊ตฌ๋˜๋Š” ์‹œ์ ์ด๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ตญ๋‚ด ์—ฐ์•ˆ์—ฌ๊ฐ์„  ์ค‘ ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์ด ์žˆ๋Š” ๋กœํŒ์Šค์—ฌ๊ฐ์„  7์ฒ™์„ ๋Œ€์ƒ์œผ๋กœ ํ˜„์žฅ์กฐ์‚ฌ, ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ, ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•ด ํ˜„์žฌ ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์˜ ๋ฌธ์ œ์ ์„ ํŒŒ์•…ํ•˜๊ณ  ๊ฐœ์„ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์กฐ์‚ฌ์—์„œ ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„์„ ํ†ตํ•ด ๋งŒ์กฑ๋„์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ์„ ๋ถ„์„ํ•˜๊ณ  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ ์ด๋ก ์„ ๊ธฐ์ดˆ๋กœ ํ•˜์—ฌ ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์— ์ ์šฉํ•˜๋Š” ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™ ๋„์ถœํ•˜์˜€์œผ๋ฉฐ ์ด๋ฅผ ์ ์šฉํ•ด ๊ณต๊ฐ„๋ณ„ ๋ฌธ์ œ์ ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๋‚˜์•„๊ฐ€ ๋กœํŒ์Šค์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๋””์ž์ธ ํ‰๊ฐ€ํ•ญ๋ชฉ์„ ๊ตฌ์ถ•ํ•˜๊ณ  ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๋””์ž์ธ์— ์ ์šฉ๋˜๋Š” ๊ทœ์ •๊ณผ ํ˜„์žฌ ์šดํ•ญํ•˜๋Š” ๋กœํŒ์Šค์—ฌ๊ฐ์„ ์˜ ์‹ค๋‚ด๊ณต๊ฐ„ ๊ฐœ์„ ๋ฐฉ์•ˆ ๋””์ž์ธ ๋ชจ๋ธ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ ๋ชฉ์ ์€ ์ฒซ์งธ, ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ ๊ฐœ๋…์„ ํ‰๊ฐ€๋„๊ตฌ๋กœ ํ™œ์šฉํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์—ฌ๊ฐ์„  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™์„ ๋„์ถœํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ๋‘˜์งธ, ํ˜„์žฅ์กฐ์‚ฌ, ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ, ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ๋ฅผ ํ†ตํ•ด ํ˜„์žฌ ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์˜ ์‚ฌ์šฉ์ž ๋งŒ์กฑ๋„๋ฅผ ํŒŒ์•…ํ•˜๊ณ  ๋ฌธ์ œ์ ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ์„ ์ œ์‹œํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ์…‹์งธ, ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๋””์ž์ธ์— ์ ์šฉ ๊ฐ€๋Šฅํ•œ ๋ฒ•๊ทœ๋ฅผ ํ™•์ธํ•˜๊ณ  ๋””์ž์ธ ํ‰๊ฐ€ํ•ญ๋ชฉ์„ ์ œ์‹œํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ๋„ท์งธ, ํ˜„์žฌ ์šดํ•ญ ์ค‘์ธ ์‹ ์กฐ์„  S ํ˜ธ 5 ๋ฐํฌ์˜ ์ฃผ์š”ํ•œ ์‹ค๋‚ด๊ณต๊ฐ„์„ ๋ถ„์„ํ•˜๊ณ  ํ™€, ์ขŒ์„ํ˜• ๊ฐ์‹ค, ๋งˆ๋ฃจํ˜• ๊ฐ์‹ค์˜ ๊ฐœ์„ ๋ชจ๋ธ์„ ์ œ์‹œํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ์—ฐ๊ตฌ ๋ฐฉ๋ฒ•์€ ์ฒซ์งธ, ์—ฐ๊ตฌ ๋ฐฐ๊ฒฝ๊ณผ ํ•„์š”์„ฑ์„ ๋ฐํžˆ๊ณ  ์—ฐ๊ตฌ๋ฐฉ๋ฒ•๊ณผ ๋‚ด์šฉ, ๊ธฐ์กด ์œ ์‚ฌ์—ฐ๊ตฌ์— ๋Œ€ํ•ด ์กฐ์‚ฌํ•˜์˜€๋‹ค. ๋‘˜์งธ, ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ ์ด๋ก ์„ ๋ถ„์„ํ•˜๊ณ  ์„ ๋ฐ• ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์˜ ์ ์šฉ์„ฑ ํ‰๊ฐ€๋ฅผ ํ†ตํ•ด ์—ฌ๊ฐ์„  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™์„ ๋„์ถœํ•˜์˜€๋‹ค. ์…‹์งธ, ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์ด ์žˆ๋Š” ๋กœํŒ์Šค์—ฌ๊ฐ์„  7์ฒ™์˜ ํ˜„์žฅ์กฐ์‚ฌ, ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ, ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. ๋„ท์งธ, ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ์™€ ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ๋Š” ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„(Multiple Linear Regression Analysis)์„ ํ†ตํ•ด ์‚ฌ์šฉ์ž ๋งŒ์กฑ๋„์— ์œ ์˜ํ•œ ์ •(+)์˜ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ์„ ํŒŒ์•…ํ•˜์˜€๋‹ค. ๋‹ค์„ฏ์งธ, ์กฐ์‚ฌ๋œ ๋ฌธ์ œ์ ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ์€ ์—ฌ๊ฐ์„  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™์— ์ ์šฉํ•ด ๊ณต๊ฐ„๋ณ„๋กœ ๋ถ„๋ฅ˜ํ•˜์—ฌ ์ œ์‹œํ•˜์˜€๋‹ค. ์—ฌ์„ฏ์งธ, ํ˜„์žฌ ์šดํ•ญ ์ค‘์ธ S ์„  5 ๋ฐํฌ์˜ ์‹ค๋‚ด๋””์ž์ธ์„ ๋ถ„์„ํ•˜๊ณ  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™์ด ๋ฐ˜์˜๋œ ๋””์ž์ธ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ์—ฌ๊ฐ์„  ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™์€ ์ ‘๊ทผ์„ฑ, ๊ธฐ๋Šฅ์„ฑ, ์ •๋ณด ์ธ์ง€์„ฑ, ์ ์€ ๋ฌผ๋ฆฌ์  ๋…ธ๋ ฅ, ํฌ๊ธฐ์™€ ๊ณต๊ฐ„์œผ๋กœ ๋„์ถœ๋˜์—ˆ๋‹ค. ๋‘˜์งธ, ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ์˜ ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„ ํšŒ๊ท€๊ณ„์ˆ˜์˜ ์œ ์˜์„ฑ ๊ฒ€์ฆ ๊ฒฐ๊ณผ ์ƒ‰์ฑ„ ๋งŒ์กฑ๋„์™€ ์„ ๋‚ด์ •๋ณด์ด์šฉ ๋งŒ์กฑ๋„๊ฐ€ ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ๋งŒ์กฑ๋„์— ์œ ์˜ํ•œ ์ •(+)์˜ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ํ‘œ์ค€ํ™” ๊ณ„์ˆ˜์˜ ํฌ๊ธฐ๋ฅผ ๋น„๊ตํ•˜๋ฉด ์ƒ‰์ฑ„ ๋งŒ์กฑ๋„๊ฐ€ ์„ ๋‚ด์ •๋ณด์ด์šฉ ๋งŒ์กฑ๋„๋ณด๋‹ค ๊ฑฐ์ฃผ๊ตฌ ๋งŒ์กฑ๋„์— ๋” ํฐ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๊ฒ€์ฆ๋˜์—ˆ๋‹ค. ์…‹์งธ, ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ์˜ ๋‹ค์ค‘ํšŒ๊ท€๋ถ„์„ ํšŒ๊ท€๊ณ„์ˆ˜์˜ ์œ ์˜์„ฑ ๊ฒ€์ฆ ๊ฒฐ๊ณผ ๊ณต์šฉ์‹œ์„ค ๋งŒ์กฑ๋„, ์ƒ‰์ฑ„ ๋งŒ์กฑ๋„, ์„ ๋‚ด์ •๋ณด์ด์šฉ ๋งŒ์กฑ๋„๊ฐ€ ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ๋งŒ์กฑ๋„์— ์œ ์˜ํ•œ ์ •(+)์˜ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ํ‘œ์ค€ํ™” ๊ณ„์ˆ˜์˜ ํฌ๊ธฐ๋ฅผ ๋น„๊ตํ•˜๋ฉด ๊ณต์šฉ์‹œ์„ค ๋งŒ์กฑ๋„, ์ƒ‰์ฑ„ ๋งŒ์กฑ๋„, ์„ ๋‚ด์ •๋ณด์ด์šฉ ๋งŒ์กฑ๋„ ์ˆœ์œผ๋กœ ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ๋งŒ์กฑ๋„์— ํฐ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๊ฒ€์ฆ๋˜์—ˆ๋‹ค. ๋„ท์งธ, ํ˜„์žฅ์กฐ์‚ฌ ๊ฐœ์„ ๋ฐฉ์•ˆ์€ ์ˆ˜์ง์ด๋™์‹œ์„ค ์„ค์น˜, ๋‹จ์ฐจ ์ œ๊ฑฐ, ์ง์„ ํ˜• ๊ณ„๋‹จ๋””์ž์ธ์„ ํฌํ•จํ•œ 23ํ•ญ๋ชฉ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ ๊ฐœ์„ ๋ฐฉ์•ˆ์€ ํ™€ ์ค‘์‹ฌ๋ถ€ ๋ฐํฌ์™€ ์งง์€ ๋™์„ ์„ ๊ณ ๋ คํ•œ ์‹œ์„ค ๋ถ„์‚ฐ๋ฐฐ์น˜, ์ˆ˜์ง์ด๋™์‹œ์„ค ๊ทผ์ฒ˜ ๊ณต์šฉ์‹œ์„ค ์ขŒ์šฐ ๋ถ„์‚ฐ๋ฐฐ์น˜, ํŠน์ •์‹œ๊ฐ„์— ๋ชฐ๋ฆฌ๋Š” ๊ณต์šฉ์‹œ์„ค ์ƒํ•˜(๋ฐํฌ๋ณ„) ๋ถ„์‚ฐ๋ฐฐ์น˜๋ฅผ ํฌํ•จํ•œ 10ํ•ญ๋ชฉ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ ๊ฐœ์„ ๋ฐฉ์•ˆ์€ ์•ˆ๋‚ด์ •๋ณด์‹œ์Šคํ…œ์„ ํ†ตํ•œ ๋‹ค์–‘ํ•œ ์‹œ๊ฐ์ •๋ณด ์ œ๊ณต ๋ฐ ์Œ์„ฑ์ง€์›, ํ™€ ์ค‘์‹ฌ๋ถ€ ์‚ฌ์šฉ๋„ ๋†’์€ ๊ณต์šฉ์‹œ์„ค ๋ฐฐ์น˜ ๋ฐ ๋ฏธ๋‹ซ์ด๋ฌธ ์„ค์น˜, ๋ฐ”๋‹ฅ์žฌ ๋ฏธ๋„๋Ÿผ ๋ฐฉ์ง€ ๊ณ„ํš์„ ํฌํ•จํ•œ 28ํ•ญ๋ชฉ์„ ์ œ์‹œํ•˜์˜€๋‹ค. ๋‹ค์„ฏ์งธ, ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๋””์ž์ธ ๊ฐ€์ด๋“œ๋ผ์ธ์„ ๊ตฌ์ถ•ํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์— ์ ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ๋ฒ•๊ทœ๋ฅผ ์ œ์‹œํ•˜๊ณ  ํ˜„์žฌ ์‚ฌ์šฉ์ž ๋””์ž์ธ ๋งŒ์กฑ๋„๋ฅผ ๊ทผ๊ฑฐ๋กœ ํ•˜์—ฌ ๋””์ž์ธ ํ‰๊ฐ€์ง€ํ‘œ๋ฅผ ์ œ์‹œํ•˜์˜€๋‹ค. ์—ฌ์„ฏ์งธ, ํ˜„์žฌ ์šดํ•ญ ์ค‘์ธ ์‹ ์กฐ์„  S ํ˜ธ 5 ๋ฐํฌ์˜ ํ™€, ์ขŒ์„ํ˜• ๊ฐ์‹ค, ๋งˆ๋ฃจํ˜• ๊ฐ์‹ค์˜ ํ˜„ ์ƒํƒœ๋ฅผ ๋ถ„์„ํ•œ ๋’ค ์ œ์•ˆํ•˜๋Š” ๋””์ž์ธ ๋ชจ๋ธ์„ ์ œ์‹œํ•˜์˜€๋‹ค.์ œ 1 ์žฅ ์„œ ๋ก  1 1.1 ์—ฐ๊ตฌ๋ฐฐ๊ฒฝ ๋ฐ ํ•„์š”์„ฑ 1 1.2 ์—ฐ๊ตฌ๋ฐฉ๋ฒ• ๋ฐ ๋‚ด์šฉ 8 1.3 ๊ธฐ์กด ์œ ์‚ฌ์—ฐ๊ตฌ 11 ์ œ 2 ์žฅ ์ด๋ก ์  ๊ณ ์ฐฐ 14 2.1 ์—ฌ๊ฐ์„  ๊ฐœ๋… 14 2.1.1 ๋กœํŒ์Šค์—ฌ๊ฐ์„  18 2.1.2 ๊ตญ๋‚ด ์—ฌ๊ฐ์„  ๊ฑด์กฐ์‹ค์  23 2.1.3 ์—ฐ์•ˆ์—ฌ๊ฐ์„  ํ˜„๋Œ€ํ™”ํŽ€๋“œ ๊ฐœ์š” 24 2.2 ์„ ๋ฐ• ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ 26 2.2.1 ์„ ๋ฐ• ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์˜ ํŠน์ง• 27 2.2.2 ๊ฐ•ํ™”๋œ ์•ˆ์ „์„ฑ 37 2.2.3 ํ•ด์™ธ ๋กœํŒ์Šค์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ์‚ฌ๋ก€์กฐ์‚ฌ 48 2.3 ์„ ๋ฐ• ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„์— ์ ์šฉํ•˜๋Š” ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 64 2.3.1 ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ ๊ฐœ๋… 64 2.3.2 ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ์œ ๋‹ˆ๋ฒ„์„ค๋””์ž์ธ 5์›์น™ 65 ์ œ 3 ์žฅ ๋กœํŒ์Šค์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ํ˜„์žฅ์กฐ์‚ฌ 91 3.1 ๋กœํŒ์Šค์—ฌ๊ฐ์„  ํ˜„ํ™ฉ 91 3.2 ํ˜„์žฅ์กฐ์‚ฌ 96 3.2.1 ํ˜„์žฅ์กฐ์‚ฌ ๊ฐœ์š” 96 3.2.2 ํ˜„์žฅ์กฐ์‚ฌ ๊ฒฐ๊ณผ์™€ ๋ฌธ์ œ์  103 ์ œ 4 ์žฅ ๋กœํŒ์Šค์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ์„ค๋ฌธ์กฐ์‚ฌ 117 4.1 ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ 117 4.1.1 ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ ๊ฐœ์š” 117 4.1.2 ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ ๊ฒฐ๊ณผ์™€ ๋ฌธ์ œ์  121 4.2 ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ 125 4.2.1 ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ ๊ฐœ์š” 125 4.2.2 ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ ๊ฒฐ๊ณผ์™€ ๋ฌธ์ œ์  167 ์ œ 5 ์žฅ ๋กœํŒ์Šค์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ๊ฐœ์„ ๋ฐฉ์•ˆ 172 5.1 ํ˜„์žฅ์กฐ์‚ฌ ๊ฒฐ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ 172 5.2 ์ „๋ฌธ๊ฐ€ ์„ค๋ฌธ์กฐ์‚ฌ ๊ฒฐ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ 180 5.3 ์‚ฌ์šฉ์ž ์„ค๋ฌธ์กฐ์‚ฌ ๊ฒฐ๊ณผ ๊ฐœ์„ ๋ฐฉ์•ˆ 185 ์ œ 6 ์žฅ ๊ฒฐ ๋ก  216 ์ฐธ ๊ณ  ๋ฌธ ํ—Œ 224 ๋ถ€ ๋ก 231 ์—ฐ์•ˆ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์˜ˆ๋น„์กฐ์‚ฌ ์„ค๋ฌธ์ง€ 232 ์—ฐ์•ˆ์—ฌ๊ฐ์„  ๊ฑฐ์ฃผ๊ตฌ ์‹ค๋‚ด๊ณต๊ฐ„ ์‚ฌ์šฉ์ž(์Šน๊ฐ) ์„ค๋ฌธ์ง€ 240 ๊ตญ๋‚ด์™ธ ์—ฐ๊ตฌํ™œ๋™ 248 ๊ฐ์‚ฌ์˜ ๊ธ€ 250Docto

    Sural Artery Flap

    Get PDF
    Purpose: Our clinical experiences in distally based sural artery island flap is presented to show the usefulness and the reliability as an alternative to flaps currently used for defect in lower extremity. Materials and Methods: From February 1998 to September 2001, nine cases of soft tissue defects in the lower leg, the foot, and around the ankle were treated with distally based sural artery island flap. The cause of the wound was trauma in 6cases, and osteomyelitis in 3 cases. Defects were located at the lower leg in 2 cases, at the foot in 3 cases and around the ankle in 4 cases. The results were retrospectively analyzed. Results: The defect size ranged from 3ร—3 ใŽ to 20ร—3 ใŽ. Among 9 cases, 7 cases survived and 2 cases were failed. Flap failure was due to not including the deep fascia in one case and due to extensive soft tissue damage in the other case. Both failed cases were reoperated with the split thickness skin graft. Conclusion: The advantages of distally based sural artery island flap follows : (1) reliable blood supply, (2) ease of flap elevation, (3) preservation of the major arteries, (4) less donor site morbidity. Owing to the advantages of this flap, we think it is useful for the soft tissue coverage of the lower leg, the foot and around the ankle. Also we believe it will continue to gain acceptance and use in the majority of lower leg reconstruction.ope

    Femoral Revision with the Wagner SL Revision Stem

    Get PDF
    Purpose: To evaluate the results of revision total hip arthroplasty using a Wagner SL revision stem. Materials and Methods: This study reviewed 56 revisions of the femoral component performed using a Wagner stem in 55 patients between 1992 and 2001. The mean age of the patients at the time of the revision was 50 years. The mean follow up duration was 8.4 years (range, 5 to 12.5 years). The indication for revision was aseptic loosening in fifty-two hips, septic loosening in two and peri prosthetic fractures in two. The pre-revisional femoral defects were classified according to the Paprosky classification system. A clinical evaluation and radiological assessment were performed. Results: The mean Harris hip score improved from 47 points preoperatively to 87 points at the latest follow-up. There were 5, 20, 22 and 9 hips of type โ… , โ…ก, โ…ขA and โ…ขB according to the Paprosky classification system. Fifty two hips (93%) showed stable stems at the latest follow-up radiographs. The mean vertical subsidence of the stem was 6.2 ใŽœ (range, 0 to 21 ใŽœ). Severe progressive vertical subsidence in three hips and an infection in one occurred requiring repeat revision. Conclusion: For severe proximal femoral bone loss, the conical femoral revision stem with a fully grit-blasted surface produced satisfactory results with distal press-fit fixation. We can expect a decrease in the rate of mechanical failure rate of the stem by reducing the subsidence derived from the stem design itself.ope

    ์ œ2ํšŒ ์—ฐ๊ตฌ์ง€์›์„œ๋น„์Šค ์—ญ๋Ÿ‰๊ฐ•ํ™” ์„ธ๋ฏธ๋‚˜ ๋ฐœํ‘œ์ž๋ฃŒ

    Get PDF
    ์„œ์šธ๋Œ€ํ•™๊ต ์ค‘์•™๋„์„œ๊ด€๊ณผ ๋ถ„๊ด€์ด ๋ณด์œ ํ•œ ๋…ธํ•˜์šฐ๋ฅผ ๊ณต๊ฐœํ•˜์—ฌ ์—ฐ๊ตฌ์ง€์› ์„œ๋น„์Šค์˜ ์งˆ์  ํ–ฅ์ƒ์„ ์ œ๊ณ ํ•˜๋Š” ๋“ฑ์˜ ์ •๋ณด ๊ณต์œ ์™€ ๊นŠ์ด์žˆ๋Š” ๋…ผ์˜๋ฅผ ํ†ตํ•ด ์งˆ ๋†’์€ ์—ฐ๊ตฌ์ง€์› ์„œ๋น„์Šค ๋ฐฉ์•ˆ์„ ๋ชจ์ƒ‰ํ•œ๋‹ค

    Motives for Moonlighting and Its Policy Implications

    No full text
    Moonlighting or second-jobs will increase shirking of the primary job. This paper analyzes the motives for moonlighting so that the means of reducing these motives could be explored. The traditional theory claims that a worker who cannot fully realize his work potential will look to moonlighting. In a two period model, however, the following motives are more important. The precautionary savings motive : A worker has an incentive to save for fear of losing his job and his income in the second period. The worker could save more by working more during the first period, and this additional motive for working is the precautionary savings motive. The insurance motive : When a worker is unemployed, he cannot expand his moonlighting hours according to his needs since the moonlighting hour is upward rigid. Therefore, a worker has an incentive to secure additional moonlighting hours in the first period so that quick adjustment can be made during the unemployment in the second period. Two policy measures to remove those motives for moonlighting are recommended, for these measures will enhance the productivity in the primary job. First, a firm should guarantee that there will be no layoffs in a downturn in the economy and that the employment level is adjusted to the economic states by work sharing among workers. Second, as unemployment insurance benefits compensate a portion of the income in case of unemployment, it substitutes the motives for moonlighting. A generalization of this argument can be found in Ehrlich and Becker(1972) where self-insurance(moonlighting) and market insurance( in this case, unemployment insurance) serves as substitutes. The two policy measures in the above have a spill-over effect : A decrease of labor supply in the moonlighting market will ease job search, and therefore will help those who have their primary job in the moonlighting sector.2

    ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ์กฐ์ง๊ฐœํŽธ ์„ฑ์ฐฐ

    No full text
    ์ œ5์žฅ ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ์กฐ์ง๊ฐœํŽธ ์„ฑ์ฐฐ ์ œ1์ ˆ ๋ถ„์„์„ ์œ„ํ•œ ์ ‘๊ทผ๋ฐฉ์‹ 1. ๋ฌธ์ œ์ œ๊ธฐ 2. ์กฐ์ง๊ฐœํŽธ์˜ ํ•ต์‹ฌ ์š”์†Œ ์ œ2์ ˆ ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ์กฐ์ง๊ฐœํŽธ ๋ฐฐ๊ฒฝ๊ณผ ๋ฐฉ๋ฒ• 1. ์ œ1์ฐจ ์กฐ์ง๊ฐœํŽธ(1998๋…„) 2. ์ œ2์ฐจ ์กฐ์ง๊ฐœํŽธ(1999๋…„) 3. ์ œ3์ฐจ ์กฐ์ง๊ฐœํŽธ(2001๋…„) ์ œ3์ ˆ ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ์กฐ์ง๊ฐœํŽธ ๋‚ด์šฉ๊ณผ ํŠน์„ฑ 1. ์ œ1์ฐจ ๊ฐœํŽธ์˜ ๋‚ด์šฉ๊ณผ ํŠน์„ฑ(1998๋…„) 2. ์ œ2์ฐจ ๊ฐœํŽธ์˜ ๋‚ด์šฉ๊ณผ ํŠน์„ฑ (1999๋…„) 3. ์ œ3์ฐจ ๊ฐœํŽธ์˜ ๋‚ด์šฉ๊ณผ ํŠน์„ฑ(2001๋…„) ์ œ4์ ˆ ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ๊ฐœํŽธ์— ๋Œ€ํ•œ ์„ฑ์ฐฐ 1. ๊น€๋Œ€์ค‘ ์ •๋ถ€์˜ ์กฐ์ง๊ฐœํŽธ์— ๋Œ€ํ•œ ํ‰๊ฐ€์™€ ๋ถ„์„ 2. ๊น€๋Œ€์ค‘ ์ •๋ถ€ ์กฐ์ง๊ฐœํŽธ์˜ ์‹œ์‚ฌ์  3. ํ–ฅํ›„์˜ ์ •๋ถ€์กฐ์ง ๊ฐœํŽธ์„ ์œ„ํ•œ ์ œ์–ธTRU
    • โ€ฆ
    corecore