• 한국전자통신학회논문지
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• 제17권3호
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• pp.529-536
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• 2022

지난 2년 동안 중증급성호흡기증후군 코로나바이러스-2(SARS-CoV-2)는 점점 더 많은 사람들에게 영향을 미치고 있다. 본 논문에서는 COVID-19 폐 CT 이미지를 분할하고 분류하기 위해서 서브코딩블록(SCB), 확장공간파라미드풀링(ASSP)와 어텐션게이트(AG)로 구성된 혼합 모드 특징 추출 방식의 새로운 U-Net 컨볼루션 신경망을 제안한다. 그리고 제안된 모델과 비교하기 위하여 FCN, U-Net, U-Net-SCB 모델을 설계한다. 제안된 U-Net-MMFE 는 COVID-19 CT 스캔 디지털 이미지 데이터에 대하여 atrous rate가 12이고, Adam 최적화 알고리즘을 사용할 때 다른 분할 모델에 비하여 94.79%의 우수한 주사위 분할 점수를 얻었다.

• Clinical and Experimental Vaccine Research
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• 제12권2호
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• pp.134-142
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• 2023

Purpose: The aim of this study was to determine the scope of knowledge, attitudes, and behaviors of pregnant women about the coronavirus disease 2019 (COVID-19) vaccine. Materials and Methods: A total of 886 pregnant women were recruited for the study. A cross-sectional questionnaire was conducted on these selected participants. Data about past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 infection of closely related people, and deaths due to COVID-19 among their relatives were questioned. Results: The rate of vaccination was higher (64.1%) in pregnant women with higher education levels. Informing about the vaccine, especially by health professionals, showed that the rates of vaccination (25%) increased (p<0.001). In addition, a significant increase was observed in vaccination rates with increasing age and financial income (p<0.001). Conclusion: The main limitation of our study is that the vaccine, which was approved for "emergency use", was just started to be administered to pregnant women during the study. Our findings show that our target audience, low-income, low-education, younger pregnant women should be given more attention than those who apply to the doctor for routine follow-up.

• Clinical and Experimental Vaccine Research
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• 제12권1호
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• pp.60-69
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• 2023

Purpose: Although the fast development of safe and effective messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 has been a success, waning humoral immunity has led to the recommendation of booster immunization. However, knowledge of the humoral immune response to different booster strategies and the association with adverse reactions is limited. Materials and Methods: We investigated adverse reactions and anti-spike protein immunoglobulin G (IgG) concentrations among health care workers who received primary immunization with mRNA-1273 and booster immunization with mRNA-1273 or BNT162b2. Results: Adverse reactions were reported by 85.1% after the first dose, 94.7% after the second dose, 87.5% after a third dose of BNT162b2, and 86.0% after a third dose of mRNA-1273. They lasted for a median of 1.8, 2.0, 2.5, and 1.8 days, respectively; 6.4%, 43.6%, and 21.0% of the participants were unable to work after the first, second, and third vaccination, respectively, which should be considered when scheduling vaccinations among essential workers. Booster immunization induced a 13.75-fold (interquartile range, 9.30-24.47) increase of anti-spike protein IgG concentrations with significantly higher concentrations after homologous compared to heterologous vaccination. We found an association between fever, chills, and arthralgia after the second vaccination and anti-spike protein IgG concentrations indicating a linkage between adverse reactions, inflammation, and humoral immune response. Conclusion: Further investigations should focus on the possible advantages of homologous and heterologous booster vaccinations and their capability of stimulating memory B-cells. Additionally, understanding inflammatory processes induced by mRNA vaccines might help to improve reactogenicity while maintaining immunogenicity and efficacy.

• 대한간호학회지
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• 제51권1호
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• pp.5-14
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• 2021

Purpose: This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term. Methods: From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS. Results: In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree. Conclusion: It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization.

• Pediatric Infection and Vaccine
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• 제30권2호
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• pp.73-83
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• 2023

목적: 본 연구의 목적은 혈액종양 기저질환으로 치료 중 유증상 코로나바이러스감염증-19(COVID-19)으로 확진 된 소아청소년에서 바이러스 부하(viral load)의 변화를 확인하고자 하였다. 방법: 후향적 종단 코호트연구(retrospective longitudinal cohort study)로, 19세 미만 소아청소년 중 악성 빈혈, 혈액암, 또는 고형암으로 치료 중인 상태에서 2022년 3월 1일부터 8월 30일 사이에 SARS-CoV-2 PCR 양성으로 유증상 코로나바이러스감염증-19가 확진 된 환자를 대상으로 하였다. 환자들의 의무 기록과 전화 문진으로 임상 증상과 전파경로, 그리고 증상의 경과에 대한 자료를 얻었고, 서울성모병원에서 시행했던 SARS-CoV-2 PCR titer 값을 분석하였다. 확진 이후 E gene RT-PCR Ct value ≥25을 전파가능성이 낮은 상태로 정의하였다. 결과: 6개월의 연구 기간 동안 총 43명의 환자에서 44번의 COVID-19 확진 사례가 포함되었다. 환자의 평균 연령은 8세(interquartile range, 4.9-10.5)였으며, 가장 흔한 기저 질환은 급성 림프구성 백혈병(n=30, 68.2%)이었고, 다음으로 조혈모세포이식 후(n=8, 18.2%) 상태인 환자들이었다. 대부분 경증 COVID-19 (n=32, 72.7%)에 해당이 되었고, 3명의 환자(7.0%)는 중증/위중증 COVID-19에 해당되어 산소 치료를 받았다. 2.3% (n=1)는 COVID-19 관련 급성 호흡곤란 증후군으로 사망하였다. 확진 이후 E gene RT-PCR Ct값이 ≥25을 도달한 시점이 15-21일인 환자는 총 39.4%(n=13)이었고, 22-28일에 도달한 환자는 30.3% (n=10)이었다. 15.2% (n=5)의 환자에서는 확진 후 28일이 지난 시점에서도 Ct값 <25를 유지하였다. E gene Ct값이 <25 장기간 지속되는 위험인자로 난치성 악성 종양 상태(β, 67.0; 95% CI, 7.0-17.0; P=0.030)가 유의한 관련이 있었다. 한 환자는 확진 후 Ct 값이 <25으로 유지되던 중, 확진 후 86일 째 보호자로 상주하던 어머니에게 바이러스를 전파하였다. 결론: 난치성 악성 종양 상태에서 유증상 COVID-19에 확진 되는 경우 바이러스를 장기간 배출 할 수 있기 때문에, 이런 환자군에서는 PCR 기반 바이러스 전파 예방 조치가 도움이 될 수 있다.

• 한국식품위생안전성학회지
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• 제39권3호
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• pp.260-265
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• 2024

하수기반역학을 이용한 코로나19 감시 결과, 연구기간(2022년 8월-2023년 8월)동안 울산지역 4곳 하수처리장의 전체 174건 모든 시료에서 코로나바이러스-19가 검출되었다. 확진자 수와 하수 내 코로나바이러스 농도와의 상관분석 결과, 높은 상관성이 나타났으며 특히 하수감시가 임상감시보다 2-3주 앞서 농도가 증가함으로써 조기 인지의 가능성도 볼 수 있었다. 또한 코로나19 변이 분석 결과 역시 유행 시기별 우세종화된 변이와 비교적 유사하여 변이 예측도 가능하였다. 하수감시가 전국적, 전세계적으로 적용되고 있으며 많은 연구가 국가적 사업으로 진행되고 있다. 이에 따라, 하수 분석방법 및 분석기기 발전 등의 지속적 연구 업데이트가 필요하다. 또한 코로나19를 통해 감염병의 선제적 모니터링 및 유행 예측의 가능성을 확인하였으므로 다양한 병원체 및 식품·의약품 등에 확대 적용이 진행 중이다. 따라서 본 연구는 감염병 검출분야에서 더 나아가 하수 내 식품 성분, 활성물질 및 미생물 등의 분석을 통해 지역사회의 식품안전 및 전반적인 위생환경 감시를 위해 활용될 수 있을 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.289-292
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• 2020

Yemen has been faced with the worst cholera epidemic of modern times, with more than 1 million suspected cases and 3000 deaths at the time of writing. This problem is largely due to the longstanding civil war between pro-government forces and the Houthi armed movement, which has severely damaged already vulnerable sanitation and healthcare facilities and systems in the country. It is further compounded by a dire lack of basic amenities, chronic malnutrition, and unfavourable weather conditions. Another contributory component may be aerial transfer by cholera-infected chironomid insects. To contain the spread of cholera in Yemen, a nation-wide armistice should be negotiated, and national and local committees must be convened to coordinate efforts on the ground. Community isolation facilities with proper sanitation, reliable disposal systems, and a clean water supply should be set up to isolate and treat sick patients. The continuity of vaccination programmes should be ensured. Public health campaigns to educate local communities about good hygiene practices and nutrition are also necessary. The One Health paradigm emphasizes a multi-sectoral and transdisciplinary understanding and approach to prevent and mitigate the threat of communicable diseases. This paradigm is highly applicable to the ongoing cholera crisis in Yemen, as it demands a holistic and whole-of-society approach at the local, regional, and national levels. The key stakeholders and warring parties in Yemen must work towards a lasting ceasefire during these trying times, especially given the extra burden from the mounting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak worldwide.

• 동의생리병리학회지
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• 제30권1호
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• pp.1-6
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• 2016

In recent years, there were frequent exogenous contagious diseases in Eastasia like SARS(severe acute respiratory syndrome), Avian influenza, Swine influenza, MERS etc. But there are various interpretations about their pathological differentiations and lead to controversy to diagnosis and medicinal use. So there needs universal and consistent understanding methods. Several conclusions are obtained from the research on differentiation theories of various epidemic diseases. Essential elements of differential diagnostic system are pathogen, characters and matters of disease and loci, especially three yin and three yang has close affinity with constitutional features or body shape. Binding these 3 categories, an integrated differentiation 3 dimensional coordinates are made. Out of these, each elements of 3 pathogen-axial lines are related with names of exogenous disease, and those of 3 feature-axial lines are related with 8 principal patterns. And those of 3 locus-axial lines implicating therapeutic method are related with steps and location of exterior and interior, 3 yin 3 yang, Defense, Qi, Nutrient and Blood, five viscera and six bowels and tissues. Additionally, 3 lines of each axis consist of factors which have their own affinity each other, so classification of pathogen, feature, locus of disease has layered interconnectedness. This classification system is included in constitutional features of individual patient. Afterwards, these cognitive structure can be used as a general theory guiding method of therapy, prevention and aftercure healthcare.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.239-246
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• 2021

Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.

• Pediatric Infection and Vaccine
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• 제27권3호
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• pp.180-183
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• 2020

목적: 국내 초중고 학교 등교재개 이후 소아에서의 코로나바이러스감염증-2019 (코로나19) 사례의 감염경로를 파악하고자 하였다. 방법: 2020년 5월 1일부터 7월 12일까지 국가감염병감시체계에 신고된 3-18세 소아 청소년 코로나19 확진자의 사례조사서 및 역학조사서를 분석하였다. 결과: 2020년 5월 국내 초중고 학교 등교 재개 이후 7월 12일까지 총 127명의 소아 청소년 코로나19 확진자가 신고되었다. 그 중 59명(46%)은 가족 및 친지로부터 전파된 사례였으며 18명(14%)은 학원 및 개인교습 중 전파되었다. 8명(6%)은 다중이용 시설에서 전파되었으며 3명(2%)은 학교에서 전파된 사례였다. 결론: 코로나19 감염예방을 위한 관리체계가 사전에 마련되고 준비된 경우 학교 내 코로나19 전파는 드물게 나타났다.