• Journal of agricultural medicine and community health
• /
• v.25 no.1
• /
• pp.99-112
• /
• 2000

This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.2
• /
• pp.128-137
• /
• 1996

Background : We can diagnose pulmonary tuberculosis with sputum AFB smear and culture, but sputum AFB smear has low sensitivity and culture needs long period, and they are not available in the patients who can not expectorate effectively. Recently developed, PCR is a fast diagnostic tool in tuberculosis, but false positive and false negative are important problems. So, we studied the diagnostic value of bronchoalveolar lavage fluid AFB smear, culture, PCR through the bronchoscopy. Methods : The 67 pulmonary tuberculosis patients and 43 non-pulmonary tuberculosis patients were analyzed with their sputum specimen AFB smear and culture. Also, bronchoscopy and bronchoalveolar lavage were done, and bronchoalveolar lavage fluid AFB smear, culture and PCR were done. Results: 1) In the cases of pulmonary tuberculosis, the sensitivity of sputum AFB smear and culture were 32.8% and 57.4%, respectively. And the sensitivity of bronchoalveolar lavage fluid AFB smear and culture were 47.8% and 80.6%. respectively. 2) In the cases of pulmonary tuberculosis, the sensitivity and the positive predictive value(for predicting a positive culture) of PCR were 80.6% and 81.5%, respectively. 3) In the cases of sputum AFB smear-negative and culture-negative pulmonary tuberculosis, the sensitivity of bronchoalveolar lavage fluid AFB smear, culture, PCR, and the positive predictive value(for predicting a positive culture) of PCR were 23.1%, 100%, 88.5%, and 82.4%, respectively. 4) The specificity of bronchoalveolar lavage fluid PCR was 77.0%. 5) The median number of days between obtaining a specimen and starting therapy was 5 days for sputum AFB smear, 9 days for bronchoalveolar lavage fluid AFB smear, 26 days for bronchoalveolar lavage fluid PCR, 32 days for sputum culture, 56 days for bronchoalveolar lavage fluid culture. Conclusion : The sensitivity of bronchoalveolar lavage fluid AFB smear and culture are higher than sputum AFB smear and culture. So, the bronchoscopy must be considered for evaluating suspected cases of pulmonary tuberculosis in patients from whom smears of expectorated sputum do not reveal mycobacteria or from whom no sputum can be obtained. Especially, combined with PCR, it is expected that pulmonary tuberculosis can be diagnosed more rapidly and more accurately, so bronchoalveolar lavage fluid APB smear and PCR can be helpful in the early treatment of pulmonary tuberculosis.

• 선박안전기술공단연구보고서
• /
• s.4
• /
• pp.1-108
• /
• 2007

2007. 7. 23 IMO의 NAV(항해안전전문위원회)53차 회의에서는 e-Navigation을 해상에서의 안전, 보안, 해양환경보호를 목적으로 전자적인 수단에 의해 선박과 육상에서 해양정보를 수집, 교환, 표시함으로써 항구와 항구간의 항해 및 관련된 서비스를 향상시키는 것으로 정의하고 있다.2005년 11월 영국의 교통부 장관 Stephen 박사는 Royal Institute ofNavigation에서의 연설에서 해상안전과 환경보호를 위하여 선박의 항해를 감시하는 관제소 및 항행하는 선박에 유용하고 정확한 정보가 더 많이 필요함을 역설하였다. 그리고 첨단 기술에 의해 자동화된 항공 항법분야를 예로들면서, 선박의 항법 분야도 항해와 관련된 모든 시설 및 작업을 전자적 수단으로 대체하는 개념인 e-Navigation으로 전환되어야 하며 영국은 이에 필요한 작업을 주도하겠다는 의견을 피력하였다. Stephen은 e-Navigation 도입으로 얻을 수 있는 이익으로 첫째, 항해 실수로 인한 사고 확률저감, 둘째,사고 발생 시 인명 구조 및 피해 확산을 위한 효율적 대응, 셋째, 전통적인항해시설 설치 불필요로 인한 비용 저감, 넷째 선박입출항 수속의 간편화 및항로의 효율적 운용으로 인한 상업적 이익 등을 들었다. 반면에e-Navigation 체계로 전환 시 예상되는 장애로는 첫째, 체계 구축을 위한 비용(특히 개발도상국가들의 경우 어려움 예상), 둘째, e-Navigation의 성과 달성을 위하여 세계 전 해역의 모든 선박이 e-Navigation 체계에 동참하도록유도하는 문제, 셋째, 전자해도 표시 및 선교 장비들에 대한 표준화 문제, 넷째, 육상에 설치할 e-Navigation 센터의 설계 및 구축 등을 꼽았다.IMO는 2005년 81차 MSC(해사안전위원회) 회의에서 영국이 일본, 마샬아일랜드, 네덜란드, 노르웨이, 싱가포르, 미국과 공동으로 제안한 ‘e-Navigation전략 개발’ 의제를 2006년 82차 MSC 회의에서 채택하고, NAV(항해 전문위원회)를 통하여 2008년까지 e-Navigation의 구체적 개념을 정립하고 향후 개발하여야 할 전략적 비전과 정책을 수립하기로 하였다. 이어서 영국을 의장으로 e-Navigation 전략개발 통신작업반이 구성되었는데, 지난 년간 19개국, 16개 전문기관이 참여하여 아래의 작업이 수행되었다. ○ e-Navigation 개념의 정의와 목적 ○ e-Navigation에 대한 핵심 이슈 및 우선 순위 식별 ○ e-Navigation 개발에 따른 이점과 단점의 식별 ○ IMO 및 회원국 등의 역할 식별 ○ 이행계획을 포함한 추가 개발을 위한 작업계획의 작성 IMO에서 수행되고 있는 e-Navigation 전략 개발 의제 일정은 2008년까지이다. 이 전략 개발에 있어서 중요한 요소는 e-Navigation이 포함할 서비스범위, 포함하는 서비스 제공에 필요한 인프라 및 장비의 식별, 인프라 구축및 운용비용을 부담할 주체에 대한 논의, e-Navigation으로 인한 이익과 투자비용에 대한 비교 분석 등이다. 이 과정에서 정부, 선주, 항만운영자, 선원등의 입장 차이와 선진국과 개발도상국 간의 경제 수준 차이는 전략 개발에있어 큰 어려움을 줄 것이므로, 이들이 합의된 전략을 만들기 위해서는 예정된 기간보다 다소 늦어질 가능성도 있다.e-Navigation 전략 개발이 완료되면 1단계로는 해상교통 관제시스템, 선박선교 장비, 무선 통신장비 등에 대한 표준화 작업이 이루어질 것이다. 이 과정에서 각국 간에 자국 보유 기술을 표준화시키기 위한 경쟁이 치열할 것으로 예상된다. 2단계에서는 e-Navigation 체계 하에서의 다양하고 풍부한 서비스 제공을 위한 관련 소프트웨어 및 하드웨어의 개발이 이루어질 것으로전망되는데, 이는 지난 10년간 육상에서 인터넷망 설치 후 이루어진 관련 서비스 산업의 발전을 돌아보면 쉽게 짐작할 수 있을 것이다.e-Navigation 체계 하에서 선박의 항해는 현재와는 전혀 다른 패러다임으로 바뀔 것이다. 예를 들어 현재 입출항 시 요구되던 복잡한 절차는one-stop 쇼핑 형태로 단순화되고, 현재 선박 중심의 항해에서 육상e-Navigation 센터가 적극적으로 관여하는 항해 체계로 바뀔 것이며, 해상정보의 공유와 활용이 무선 인터넷을 통해 보다 광범위하게 이루어질 것이 다.e-Navigation의 잠재적 시장 규모는 선박에 새로이 탑재될 지능형 통합 항법시스템 구축과 육상 모니터링 및 지원 시스템 등 직접 시장이 약 50조원,전자해도, 통신장비, 관련 서비스 컨텐츠 등 간접 시장의 규모가 150조원으로 총 200조원으로 대략 추산하고 있다. 향후 이 거대한 시장을 차지하기 위한 전략 수립이 필요한 시점이다. 지금까지 항해 장비 관련 산업은 선진국의일부 업체들에 의해 독점되어 왔다. 우리나라는 조선과 해운에서 모두 선진국임에도 불구하고 이 분야에서는 대부분 수입에 의존해 왔다. e-Navigation체계 하에서는 전체 시장이 커지고 장비의 사양이 표준화됨에 따라 어느 소수 업체가 현재처럼 독점하기는 더 이상 어려울 것으로 예상된다. 따라서e-Navigation은 우리나라도 항해 장비 분야 시장을 차지할 수 있는 좋은 기회라고 할 수 있다. 특히 조선 1위의 장점을 적극 활용한다면 다른 나라보다우위의 경쟁력을 확보할 수도 있다. 또한, 서비스 분야의 시장은 IT 기술과밀접한 관계가 있으므로 IT 강국인 우리나라가 충분한 경쟁력을 갖고 있다고 할 수 있다.그러나, EU를 비롯한 선진국에서는 이미 e-Navigation 에 대비한 연구를10여년 전부터 수행해 왔다. 앞에서 언급한 EU의 MarNIS 사업은 현재 거의마무리 단계로 당장 실용화 할 수 있는 수준에 있는 것으로 보인다. 늦었지만 우리도 이를 따라잡기 위한 연구를 서둘러야 할 것이다. 국내에서도e-Navigation의 중요성을 깊이 인식하고, 2006년에는 관련 산학연 전문가들로 작업반을 구성하여 워크숍 등을 개최한 바 있다. 또한 해양수산부에서도e-Navigation 핵심기술 개발을 위한 연구사업을 기획 추진하고 있다.그러나 현재 항해통신장비들의 기술기준은 ITU의 전파규칙(RR)과 IMO결의 및 SOLAS 협약을 따르고 있는데 이들 규약이나 결의에 대한 국제적인 추이와 비교할 때 국내의 기술은 표준화되지 못한 부분이 많은 실정이다.본 연구에서는 e-Navigation sytem중 표준화가 필요한 요소와 전자해도,AIS 등 e-Navigation(통합전자항법시스템)관련 국내산업현황 실태조사를 통해 국내 e-Navigation기술개발 동향에 대해 조사하고자 한다.

• The Journal of the Korean bone and joint tumor society
• /
• v.15 no.1
• /
• pp.34-43
• /
• 2009

Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

• Journal of Gastric Cancer
• /
• v.8 no.4
• /
• pp.237-243
• /
• 2008

Purpose: Postoperative Infectious complications are recognized as major complications that are associated with surgery. Although many studies have focused on the risk factors of postoperative complications, little is known about the risk factors of infectious complications after gastric cancer surgery, and especially after elective gastrectomy. There is now more and more interest in the risk factors of infectious complications in relation to controlling infection and as indicators of qualitatively assessing infectious complications. The aim of this study was to evaluate the risk factors related with infectious complications after performing elective gastrectomy for treating gastric cancer. Materials and Methods: We retrospectively reviewed a total of 788 patients who had undergone elective gastrectomy for gastric cancer between Jan. 2000 and Dec. 2007. The characteristics of the patients were divided according to the patients' factors and the operations' factors. Results: The patients' mean age was 58.9 (range: 24~91) years; 545 were male and 243 were female. The mean duration of the hospital stay was 20.3 days (range: 5~135 days), the mean operation time was 181.3 minutes (range: 65~440 minutes). The total complication rate was 17.1% (n=135) and the complication rate was 38.5% (n=52) among the 135 patients with infectious complications. The infectious complications were surgical site infection (59.7%), Pneumonia (19.3%), intra-abdominal abscess (11.5%), pseudomembranous colitis (5.7%), bacteremia (1.9%) and hepatic abscess (1.9%). On the univariate analysis, the significant risk factors were male gender, blood transfusion, smoking at the time of diagnosis, alcohol drinking, diabetes mellitus and previous cardiovascular disease (P<0.05 for all). On multivariate analysis that used a logistic regression model, the significant independent risk factors were smoking at the time of diagnosis (OR: 2.877. 95% CI: 1.449~5.713), blood transfusion (OR: 3.440, 95% CI: 1.241~9.534), diabetes mellitus (OR: 3.150, 95% CI: 1.518~6.538), and previous cardiovascular disease (OR: 2.784, 95% CI: 1.4731~5.2539). Conclusion: Pre- or post-operative blood transfusion and the patient's medical history such as previous cardiovascular disease, diabetes mellitus, smoking etc. are the risk factors for infectious complications after undergoing elective gastrectomy for gastric cancer. The patients that have these risk factors need to be treated with great care to prevent infectious disease after elective gastrectomy.

• Journal of Gastric Cancer
• /
• v.8 no.4
• /
• pp.262-266
• /
• 2008

Purpose: Many patients suffer with anemia after gastrectomy. Iron deficiency due to a decreased oral intake and malabsoption is the most common cause of anemia in gastrectomized patients. This study evaluated the efficacy of administering intravenous iron sucrose for treating patients with anemia. Materials and Methods: From May 2007 to October 2007 at Yonsei University Severance Hospital, we reviewed 47 outpatients whose hemoglobin levels were below 11 g/dl after gastrectomy. Iron sucrose was used for iron supplementation. To determine the difference between before and after the treatment (at 1 week, 2 weeks, 3 weeks, 3 months and 6 months after treatment), we prospectively examined such anemia parameters as the hemoglobin level (Hgb), the hematocrit (Hct), serum iron, TIBC, ferritin and transferin. Results: Out of the 47 patients, only 36 completed their treatment. Eleven were male and 25 were female. The Hgb levels, which indicate anemia, were elevated 0.6, 0.8, 1.3, 2.1 and 2.2 g/dl after 1 week, 2 weeks, 3 weeks, 3 months and 6 months after administration, respectively (P<0.001). The changes from 1 week to 3 months were statistically significant, but those from 3 to 6 months were not. The Hgb levels of 26 patients, which accounted for 72% of all the patients, elevated up to 12 g/dl or more. No side effects or complications were found, but there was one case of temporary nausea. Conclusion: Anemia after gastrectomy is safely treated in a relatively short time with administering iron sucrose. The patients' Hgb levels are expected to increase in a week and keep increasing up to 3 months.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.40 no.1
• /
• pp.92-99
• /
• 2012

Many wildlife habitats have been destroyed and fragmented during the rapid industrialization and urbanization process in Korea. It is essential to connect these fragmented habitats to reduce road-kill of many types of endangered urban wildlife. The site selection for wildlife passages must take into account the behavior of the wildlife species for safe crossing utilizing many artificial barriers in urban areas. This study attempted to identify potential wildlife passage sites for the endangered and protected leopard cats of Gangseo Ecological Park in Seoul, Korea. A space syntax analysis, an analytical technique to objectively evaluate the spatial configurations related to passage selection, found that the integration value represents the accessibility and connectivity of spaces. In this paper, this means that the bigger the integration value, the more frequently the leopard cat passes through. The leopard cats were captured and radio-tracked for 72 hours once a month from March to June of 2009. The ArcGIS and Animal Movement of Hawth Tools were used to analyze the home range and movement paths, and Axwoman 4.0 was used to analyze space syntax. The daily average movement distance was $2.099{\pm}1.08km$. During the survey period, the leopard cats crossed over an urban expressway more than 20 times, running the risk of road-kill. The range of global integration values was 0.458~1.834, while that of the local integration was 0.210~6.061. Five sites that met across the leopard cats' movement routes and roads were selected to measure the local and global integrate values. Among these sites, the higher the integration value, the higher the road-kill possibility. Thus, two of five sites with high global and local integration values were suggested as potential wildlife passage sites for the leopard cats. Now, three tunnel passages are under construction at the suggested sites for which local integration value was highest (LI=4.369). Further studies are scheduled to verify these potential sites as suitable wildlife passages.

• Microbiology and Biotechnology Letters
• /
• v.40 no.3
• /
• pp.237-242
• /
• 2012

In this study, the skin moisturing effect and stability of cream containing L. cuneata G. Don extract (ethyl acetate fraction) were evaluated. The skin hydrating effect of the cream containing extract was 1020% higher than the placebo cream, and the TWEL of the cream containing extracts was decreased to $7.7g/m^2h$ compared to the control ($10.2g/m^2$) and placebo cream ($8.9g/m^2$). The pH, viscosity, and absorbance were measured under the 4, 25, 37, $45^{\circ}C$ and the sun light during the 12 weeks. The pH change between cream containing extract and placebo cream did not show the significant difference under the 4, 25, 37, $45^{\circ}C$ except for the sun light. Both creams showed high decrease (about 59%) of viscosity at $45^{\circ}C$. However, there was no significant change under other conditions. The absorbance of the cream containing the extract and the placebo cream was decreased similarly at all conditions. This decrease in absorbance was relatively small compared to the decrease of absorbance of the extract in ethanol solution under the sun light (Fig. 7). In addition, any change in color or smell of the cream was not observed during the 12 weeks. Also physical changes as creaming and cohesion were not shown. These results indicate that the cream containing L. cuneata extract has the skin moisturizing effect and is relatively stable. Therefore, it is suggested that the ethyl acetate fraction of L. cuneata extract could be applicable to cosmetics as a new cosmetic material with its antioxidative and antibacterial activities reported previously.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1329-1336
• /
• 1996

From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.

• Journal of Chest Surgery
• /
• v.39 no.4 s.261
• /
• pp.261-268
• /
• 2006

Background: Current vascular prostheses are still inadequate for reconstruction of small-diameter vessels. Autologous pericardium can be a good alternative for this purpose as it already possesses good blood compatibility and shows a mechanical behavior similar to that of natural arteries. However, the clinical use of autologous pericardial tissue as a small-diameter vascular graft has limitations due to mixed outcomes from uncertain biological behavior and difficulty to gain reliable patency results in animal experiments. To study this issue, we implanted fresh and glutaraldehyde-treated autologous pericardium as small-diameter arterial grafts in dogs, and compared their time-related changes histologically. Material and Method: As a form of 5mm-diameter arterial graft, one pair of autologous pericardial tissue was used for comparison between the glutaraldehyde-treated and the glutaraldehyde-untreated grafts in the bilateral carotid arteries in the same dog. The patency of the grafts were evaluated at regular intervals with Doppler ultrasonography. After the predetermined periods of 3 days, 2 weeks, 1 month, 3 months and 6 months, the grafts in each animal were explanted. The retrieved grafts were processed for light and electron microscopic analyses following gross observation. Result: Of 7 animals, 2 were excluded from the study because one died postoperatively due to bleeding and the other was documented as one side of the grafts being obstructed. All 10 grafts in the remaining 5 dogs were patent. Grossly, a variable degree of thromboses were observed in the luminal surfaces of the grafts at 3 days and 2 weeks, despite good patency. Pseudointimal smooth blood-contacting surfaces were developed in the grafts at f month and later. By light microscopy, mesothelial cell layers of the pericardial tissue were absent in all explanted grafts. Newly formed endothelial cell layers on the blood-contacting surface were observed in both the glutaraldehyde-treated and fresh grafts at 3 months and later. The collagen fibers became degraded by fragmentation in the fresh graft at 1 month and In the glutaraldehyde-treated graft at 3 months. At 6 months, the collagen layers were no longer visible in either the glutaraldehyde-treated or fresh grafts. By electron microscopy, a greater amount of coarse fibrin fibers were observed in the fresh grafts than in the glutaraldehyde-treated grafts and, more compact and well-arrayed layers were observed in the glutaraldehyde-treated grafts than in the fresh grafts. Conclusion: The glutaraldehyde-treated small-diameter pericardial arterial grafts showed a better endothelialization of the blood-contacting surface and a slower fragmentation of the collagen layers than the fresh grafts, although it has yet to be proven whether these differences are so significant as to affect the patency results between the groups.