내시경 유두부괄약근 절개술 후 통상적인 내시경결석제거술로 제거가 어려운 거대총담관결석에 대한 치료로 일차적으로는 소절개 내시경 유두부괄약근 절개술 후 내시경 유두부 큰풍선 확장술을 권고한다. 내시경 유두부괄약근 절개술과 내시경 유두부 큰풍선확장술 후에도 제거가 어려운 거대총담관결석의 경우에는 담도내시경하 전기수압쇄석술 또는 레이저쇄석술을 고려해 볼 수 있으며 일시적 담관 스텐트 삽입술을 권고한다. Billroth-II 수술, Roux-en-Y 문합술 등 해부학적 변화로 내시경역행 담췌관조영술이 어려운 총담관결석 환자에서는 소장내시경 또는 경피경간적 담도내시경을 통한 담석제거술을 선택적으로 시행할 수 있으며, 초음파내시경 유도하 중재 시술도 최근 시행되고 있다. 재발성 총담관결석에 대한 일차 치료로는 내시경역행담췌관조영술이 추천된다.

In the decommissioning process of nuclear power plants, Ni-59, Ni-63 and Fe-55 present in radioactive waste are crucial radionuclides used as fundamental indicators in determining waste treatment methods. However, due to their low-energy emissions, the chemical separation of these two radionuclides is essential compared to others. Therefore, this study aims to evaluate the suitability of various pre-treatment methods for decommissioning waste materials by conducting characteristic assessments at each chemical separation stage. The goal is to find the most optimized pre-treatment method for the analysis of Ni-59, Ni-63 and Fe-55 in decommissioning waste. The comparative evaluation results confirm that the chemical separation procedures for Fe and Ni are very stable in terms of stepwise recovery rates and the removal of interfering radionuclides. However, decommissioning waste materials, which mainly consist of concrete, metals, etc., possess unique properties, and a significant portion may be low-radioactivity waste suitable for on-site disposal. Considering that the chemical behavior and reaction characteristics may vary at each chemical separation stage depending on the matrix properties of the materials, it is considered necessary to apply cascading chemical separation or develop and apply individual chemical separation methods. This should be done by verifying and validating their effectiveness on actual decommissioning waste materials.

For the disposition of radioactive wastes generated from nuclear power plant, radioisotope inventory must be analyzed to determine an activity concentration of radionuclides. Radionuclides in low- and intermediate-low-level of radioactive wastes, however, can be easily classified to easyto- measure (ETM) and difficult-to-measure (DTM) nuclides. ETM nuclides are gamma emitting nuclides that is relatively easy to measure because they do not need to be destroyed for the preprocessing. On the other hands, DTM nuclides are alpha and beta emitting nuclides that need to be destroyed for the preprocessing and also need chemical separation. Currently, measurement methods for DTM nuclides are developed and in this paper measurement methods of Fe-55, Ni-59, Ni-63, Sr-90 and Tc-99 will be introduced.

배경/목적: 내시경 역행 췌담관 조영술(endoscopic retrograde cholangiopancrea-tography, ERCP)은 췌관에서의 협착과 폐쇄를 유발하는 질환을 치료하는 데 유용한 방법 중 하나이다. 하지만, 협착 및 폐쇄가 심하여 악세서리가 통과하지 않아 ERCP 시술에 어려움이 생기기도 한다. 이때 투열 카테터의 일종인 cystotome은 하나의 옵션이 될 수 있을 것으로 보인다. 이 논문에서는 cystotome을 사용한 시술 경험을 논해보고자 한다. 방법: 2019년 11월부터 2022년 10월까지 단일 삼차병원에서 ERCP를 시행한 환자들을 대상으로 후향적으로 분석하였다. 이 중 가이드 와이어는 통과되지만 액세서리가 통과하지 않는 7명의 환자에서 cystotome이 8번 활용되었다. 결과: 8번 전부 기술적 성공을 이루어 cystotome 시행 이후 협착부를 풍선 카테터가 원활히 통과되었다. Cystotome을 사용한 첫 번째 ERCP 이후 두 번째 ERCP에서, 추가 시술 없이 풍선 카테터가 협착부를 통과하는 기능적 성공은 8번 중 6번(75.0%)에서 달성하였다. 합병증의 경우, 시술 중 1번에서만 시술 후 2일가량 추가 입원하게 되는 경한 췌장염이 발생하였고 보존적인 치료 후 호전되었다. 결론: 이를 바탕으로 보았을 때 췌관의 심한 협착에서 대안 중 하나로 cystotome은 좋은 선택지로 보인다.

난치성 담관결석은 내시경 유두 괄약근 절개술 후 EPLBD, 기계적 쇄석술, 경구담관경 유도하 담관 내 전기수압쇄석술 혹은 레이저 쇄석술, 일시적 플라스틱 담관 스텐트 삽입, 경피경간담관경유도하 쇄석술, 체외충격파쇄석술 등 다양한 시술을 통해 해결될 수 있다. 본고에서는 가용 가능한 다양한 방법을 사용하여 난치성 총담관결석을 제거한 증례를 소개하고 각각의 과정에서의 시술의 어려움을 극복하는 대응방법을 논의하고자 하였다.

In order to indirectly evaluate the inventory of difficult-to-measure (DTM) nuclides in radioactive waste, the scaling factor method by key nuclide has been used. It has been usually applied to low-and intermediate-level dry active waste (DAW), and the tolerance of 1,000% margin of error in the US, that is the factor of 10, is applied as an allowable confidence limits considering the inhomogeneity of the waste and the limitation of sample size. This is because the scaling factor method is based on economic efficiency. Confidence limits is the uncertainty (sampling error) according to predicting the mean value of the population by the mean value of the sample at 95% confidence level, reflecting the limitations of sample size (representation) with the standard deviation. If the standard deviation is large, the sample size can be increased to satisfy the allowable confidence limits. In the new nuclear power plants, the concentration of cesium nuclide (137Cs) in radioactive waste tends to be very low due to advances in nuclear fuel and reactor core management technology, which makes it very difficult to apply cesium as a key nuclide. In addition, it is inevitable to apply the mean activity concentration method, which reasonably and empirically derives the concentration of DTM nuclides regardless of key nuclide, when the correlation between key and DTM nuclides is not significant. The mean activity method is a methodology that applies the average concentration of a sample set to the entire population, and is similar to applying the average concentration ratio between key and DTM nuclides of a sample set to the population in the scaling factor method. Therefore, in this paper, the maximum acceptable uncertainty (confidence limits) at a reasonable level was studied when applying the mean activity concentration method by arithmetic mean unlike the scaling factor method which usually uses the geometric mean method. Several measures were proposed by applying mutatis mutandis the acceptable standard deviation in radiation measurement and the factor of 10 principle, etc., and the appropriateness was reviewed through case analysis.

본고는《全唐诗补编》와《全唐文补编》속의 “ ”, “ ”, “ ”, “ ”, “ ”, “ ”, “ ”, “ ”, “ ”, “ ”등 10개의 유니코드 미등재 의난자(疑难字)를 관련 문헌, 자형의 변천, 기타 증거 자료의 세 방면에서 고찰하여 개별 글자 간의 관계를 밝혀 시문 속에서의 의난자를 고증하 여 그 해석의 어려움을 해소하고자 하였다.《全唐诗补编》,《全唐文补编》, 未编码疑难字, 考辨

The overestimation and underestimation of the radioactivity concentration of difficult-to-measure radionuclides can occur during the implementation of the scaling factor (SF) method because of the uncertainties associated with sampling, radiochemical analysis, and application of SFs. Strict regulations ensure that the SF method as an indirect method does not underestimate the radioactivity of nuclear wastes; however, there are no clear regulatory guidelines regarding the overestimation. This has been leading to the misuse of the SF methodology by stakeholders such as waste disposal licensees and regulatory bodies. Previous studies have reported instances of overestimation in statistical implementation of the SF methodology. The analysis of the two most popular linear models of the SF methodology showed that severe overestimation may occur and radioactivity concentration data must be dealt with care. Since one major source of overestimation is the use of minimum detectable activity (MDA) values as true activity values, a comparative study of instrumental techniques that could reduce the MDAs was also conducted. Thermal ionization mass spectrometry was recommended as a suitable candidate for the trace level analysis of long-lived beta-emitters such as iodine-129. Additionally, the current status of the United States and Korea was reviewed from the perspective of overestimation.

The Analects of Confucius, a scripture representing traditional culture, has concise and meaningful language that could be interpreted into literature, history, and philosophical humanities for moral discipline. However, there is a countless number of the interpretation for the Analects making it difficult for readers to guess which interpretation would be good. Interpretation of the Analects should be focused on surrounding evidence and intention and use literature and exegesis for precision. This procedure can only shine light on meaning and value of the Analects. For decode of the Analects, self-analysis based on literature must be done first. Major goals for exegetics research are to study meaning of old characters and language so as to decode old books. This study is to decode some of complicated lines in the Analects using methods of exegetics. In the Analects, people(In, 人)does not mean organization(Gwan, 官) and people(Min, 民) does not mean slave. Based on studies of Wang Inji and Yang Bongmin,it is fair to interpret Yi(Yeok, 易) of Xianxianyise(Hyeon-hyeon-yeok-saek, 贤贤易色) as “negligence” and entire meaning of the phrase will be “Respect inner virtue and neglect outer beauty.”

내시경역행담췌관조영술로 제거가 어려운 담관결석에 있어서 경피적 담석 제거 및 쇄석술은 잘 알려진 시술이다. 그러나 경피적으로 만들어진 누공을 확장하는 데 시간이 많이 걸리는 단점이 있다. 내시경 초음파하 담관십이지장문합술은 요즈음 이러한 난치성 담관결석을 제거하는 데 사용되고 있다. 저자들은 최근에 금속 스텐트를 이용한 내시경 초음파하 담관십이지장문합술을 이용한 경험을 소개하고자 한다. 세 명의 총담관 내지 간내 담관결석 환자에서 내시경역행담췌관 조영술로 제거가 실패한 후 다양한 도구를 사용해서 이 방법으로 제거하는 데 성공하였다. 심각한 출혈, 감염, 천공 등의 합병증은 없었다. 내시경 초음파하 시술로부터 퇴원까지 10-14일 정도가 소요되었다. 이 방법은 현재 아직 추가 검증이 필요하지만, 내시경역행담췌관조영술로 제거가 어려운 담관결석 환자에서 내시경 초음파하 삽입된 스텐트로 만들어진 누공을 통해서 제거하는 효과적이고 안전한 방법일 수 있다.

Magnetic abrasive finishing (MAF) process is a surface improvement method, which the magnetic field of permanent magnet or electromagnet is used to control the abrasive particles during the finishing process. The magnetic abrasive tools are filled between the N-pole and S-pole of Nd-Fe-B type permanent magnets. Tungsten carbide bar (WC) is a high hardness material and its compressive strength is much higher than the other materials. Therefore, due to its superior mechanical properties, it has been widely used in cutting or machining process. Because the smooth surface of tungsten carbide is required in cutting tools, thus the magnetic abrasive finishing process was applied for achieving its surface accuracy and dimensional accuracy. The results showed that the surface roughness of tungsten carbide bar was improved from Ra: 0.23㎛ to Ra: 0.02㎛ in 120 sec by magnetic abrasive finishing process.

배경/목적: 총담도 결석 혹은 종양으로 인한 담도 폐쇄에서 내시경적 접근이 어려운 경우, 경피경간담도배액술과 동시에 유두부 풍선확장술을 진행한 결과를 후향적으로 분석하여 시술의 안정성 및 간편화에 대해 알아보고자 하였다. 방법: 2012년부터 2015년까지 4년간 단일기관에서 종양 및 담도 결석으로 인한 담도 폐쇄를 진단받고 경피적 접근을 통해 시술한 환자 21명을 후향적으로 조사하였다. 결과: 21명 중 16명(76.2%)의 환자에서 경피경간담도배액 술과 동시에 유두부 풍선확장술을 진행하였고, 나머지 5명 (23.8%)은 담도배액술 5-8일 후에 시술을 진행하였다. 21명의 환자 중 19명(90.5%)에서 잔류 결석이나 재협착 없이 한 차례 만의 시술로 성공하였다. 나머지 두 명은 각각 2회, 3회 PBD 시행 후 결석 제거에 성공하였다. 결론: 내시경을 시행하지 못하는 환자들에 대한 경피적 접 근을 통한 시술은 안전하고 효과적이라고 할 수 있으며, 특별 한 금기가 되지 않는 한 경피경간담도배액술과 동시에 시행하 는 유두부 풍선확장술은 환자의 불편 및 시술 횟수를 감소시킬 수 있다.

Well-developed listening skills are crucial to success in the marketing profession. Poor listening skills have been rated as the most important contributing factor to salesperson failure (Ingram et al., 1992). Listening errors can result in conflicts, missed business opportunities, alienated relationships, and a waste of time and money (Bergeron & Laroche, 2009). Recognizing the importance of effective listening, organizations such as Pfizer, Ford, IBM have introduced listening training programs for all their personnel (Shepherd et al., 1997). A number of definitions exist for “listening” (e.g., Bergeron & Laroche, 2009). From the marketing perspective, this paper adopts a well-accepted listening definition as “the cognitive process of actively sensing, interpreting, evaluating and responding to the verbal and nonverbal messages of present or potential customers” (Castleberry & Shepherd, 1993, p.36). Prior research has underscored the importance of “active listening” strategies such as active empathetic listening (Drollinger et al., 2006; Bodie, 2011); adaptive selling (Spiro & Weitz, 1990); and listening across cultures (Imhof & Janusik, 2006). However, despite its importance, neither marketing students nor professionals receive coaching or instruction for situations when listening is particularly difficult – i.e., when we are required to listen carefully to another person in the presence of hindrances to communication (distractions, inattention, poor delivery). Salespeople, students, journalists, counselors … are often faced with the task of “tough listening” - when they must listen carefully to a person that is not communicating in an interesting or engaging manner, when the environment is full of distractions, or when they as listeners are fatigued. The major hindrances to effective listening have been well documented, but extant research that addresses how people might overcome those hindrances is scant. The purpose of this paper is to explore the range of strategies that people use to improve their comprehension and empathy of others when they wish to listen carefully but find it difficult to do so. The practice of effective listening is perhaps one of the most human and fundamental components of community, commerce, and culture. Several academic disciplines such as marketing, education, communication, and psychology have closely examined the listening process in an effort to understand and improve it.

Background/Aims: The ballooning time in endoscopic papillary large balloon dilation (EPLBD) remains controversial. The aim of this study was to evaluate the significance of the ballooning time comparing an immediate balloon deflation method with a conventional ballooning time of > 45 seconds. Methods: Between January 2010 and December 2010, 126 patients with bile duct stones treated with EPLBD and endoscopic sphincterotomy were divided according to the ballooning time: the immediate deflation group (n=56) and the conventional inflation group (ballooning time 45s to < 60s) (n=70). Results: The overall success rate and the success rate of the first attempt of ERCP (endoscopic retrograde cholangio-pancreatography) were 96.4% (54/56) and 80.4% (45/56) in the immediate group and 97.1% (68/70) and 77.1% (54/70) in the conventional inflation group. There were no statistically significant differences in the overall success and the first attempt of ERCP success rate (p=0.99, p=0.66). The frequency of mechanical lithotripsy was 0% in the immediate deflation group and 7.1% in the conventional inflation group (p=0.065). Complications occurred in 3.6% (2/56) patients in the immediate deflation group and 8.6% (4/70) patients in the conventional inflation group (p=0.298). Conclusions: The ballooning time in EPLBD does not affect the outcomes of the treatment for bile duct stones. And the feasibility of the immediate deflation method in EPLBD is acceptable.

내시경역행담췌관조영술을 이용한 내시경 치료는 현재 총담관결석의 주요한 치료법으로 사용되고 있으며 내시경유두괄약근절개술 시행 후 바스켓이나 풍선 카테터를 이용하는 전통적인 내시경적 방법을 이용하여 약 90%에서 결석의 제거가 가능하다. 그러나 이러한 통상적인 방법으로도 10%정도에서는 완전한 결석 제거가 불가능한 것으로 알려져 있다. 내시경역행담췌관조영술에서 담관결석이 완전히 제거되었음이 확인되어도 5년 이상 장기간 추적관찰연구들에서는 3~15% 정도의 결석의 재발을 보고하고 있다. 아직까지 국내에서는 통상적인 방법으로 제거가 어려운 총담관결석이나 재발성 총담관결석의 내시경 치료에 대한 권고안이 마련되어 있지 않아 현재까지 발표된 이에 대한 유럽, 영국과 미국에서의 가이드라인을 검토하고 이를 근간으로 대한췌담도학회의 진료 권고안을 제안하고자 한다.

L2 synonyms (and other related words) that are undifferentiated (i.e., are translated as the same word) in learners’ L1 are among the most difficult lexical items for L2learners to grasp. How to help students learn the appropriate use of these words has been a great challenge for L2 teachers. Drawing on recent research in corpus linguistics and corpus-based language teaching, this paper strives to show that corpus analysis can effectively differentiate synonyms and help L2 students successfully learn the appropriate use of the words in a synonym set. The paper begins with a brief overview of research on synonyms and their learning/use. Then using four sets of English synonyms/related words that are not differentiated in Korean, it discusses, with specific examples of learning activities and exercises, how corpus analysis and its results can be used to help learners differentiate these difficult words and grasp their usage patterns. The paper concludes with a summary of both the benefits and challenges of such a teaching approach and some strategies for dealing with the challenges.