• Title/Summary/Keyword: fatal cases

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코로나19 환경에서 무중단 보안관제센터 구성 및 운영 강화 연구 (Enhancing on Security Monitoring & Control Redundancy Facilities Config uration & Operation in the COVDI-19 Pandemic Environment)

  • 강동윤;이재우;박원형
    • 융합보안논문지
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    • 제21권1호
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    • pp.25-31
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    • 2021
  • 본 연구의 목적은 코로나19 바이러스 유행 시기에 교대근무체계로 운영하는 보안관제센터를 무중단으로 유지하기 위한 연구 이다. 사이버 보안위협에 대응하는 보안관제 시설은 24시간 365일 실시간으로 운영해야 하는 필수 보안시설이며, 보안운영 및 관리적인 부분에서 매우 중요하다. 만약 감염병 유행, 시스템 장애, 물리적 영향 등 보안관제 시설이 폐쇄되거나 영향이 있는 경우 실시간 사이버 보안위협에 대응 할 수 없으며, 보안문제에 치명적이 될 수 있다. 최근 코로나19 바이러스 유행으로 인한 시설 폐쇄, 장마철로 인한 보안시스템 가용성 장애 등 보안관제 시설 운영을 할 수 없는 사례가 확인되고 있으며, 이 외에도 물리적 영향으로 보안관제 시설을 운영 할 수 없는 상황에 대한 대비가 필요하다. 본 논문에서는 보안관제 시설을 다중화 시설로 구성하여 폐쇄되는 상황 발생 시 무중단으로 운영 할 수 있는 방안을 제안한다.

Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch

  • Ahn, So Ra;Lee, Joo Hyun;Kim, Keun Young;Park, Chan Yong
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.288-293
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    • 2021
  • In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

정보활용교육 관련 교과서류의 내용 요소 전개에 관한 연구 - 학습 내용의 내재적 통일성을 중심으로 - (A Study on the Development of Content Components in Information Literacy Textbooks: Focusing on the internal coherence of the learning contents)

  • 소병문
    • 한국도서관정보학회지
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    • 제53권4호
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    • pp.25-44
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    • 2022
  • 이 연구의 목적은 정보활용교육 관련 교과서 3종의 내용 요소가 어떻게 전개되는가를 살펴보고, 향후 교과서 개발에 참고할 시사점을 찾는 것이다. 정보활용교육 관련 교과서 3종은 시간을 달리해 순차적으로 개발되었으며, 개별 교과서별 특징이 분명하게 구분된다. 『정보와 매체』(1996)와 『도서관과 정보생활』(2011)의 내용 요소는 선조적 구성으로 전개되는 반면, 『정보와 도서관』(2002)은 주제 중심의 단회성 프로젝트 활동으로 구성되었다. 교과서의 단원은 학습목표-학습내용-학습활동이 고르게 의미상 관계성을 맺어야 한다. 하지만 정보활용교육 관련 교과서의 경우, 일부 단원에서 학습목표와 내용, 활동 사이의 관계가 단절되는 사례가 나타난다. 이런 단절은 교과서 내용 요소의 전개에 있어 신뢰성과 직접적인 관계가 있는 만큼 향후 교과서 개발에 있어 충분 검토가 필요한 사항이 될 수 있다.

Epidemiology of PAH in Korea: An Analysis of the National Health Insurance Data, 2002-2018

  • Albert Youngwoo Jang;Hyeok-Hee Lee;Hokyou Lee;Hyeon Chang Kim;Wook-Jin Chung
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.313-327
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    • 2023
  • Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病) (Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death)

  • 이차수;박청규
    • 대한수의학회지
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    • 제27권2호
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    • pp.277-290
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    • 1987
  • This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

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가와사끼병의 역학적 연구(1987-2000년) : 관상 동맥 이상을 중심으로 (An Epidemiologic Study of Kawasaki Disease(1987-2000) : Incidence of Coronary Artery Complication in the Acute Stage)

  • 이경일;박민영;한지환;이형신;최진;황경태
    • Clinical and Experimental Pediatrics
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    • 제45권6호
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    • pp.783-789
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    • 2002
  • 목 적 : 가와사끼병은 일본에서 간헐적으로 지역적인 대유행이 나타나는 것으로 알려져 있으며 우리나라에서도 매년 계속적으로 발생하고 있다. 저자들은 지난 14년 동안 대전시와 인근 지역으로부터 입원한 모든 가와사끼병 환아에 대해 연도별, 월별, 연령별 및 남녀별 발생 수를 알아보고 그 동안의 치료방법과 이에 따른 심장 합병증에 대해 분석해 보았다. 방 법 : 1987년 1월부터 2000년 12월까지 만 14년 동안 가톨릭대학교 대전성모병원 소아과에 입원한 가와사끼병 환아 506명을 대상으로 입원기록지를 후향적으로 분석하였다. 결 과 : 연간 발생 평균 환아수는$36.1{\pm}11.1$ 명이었으며, 발생 환아 수가 많은 연도는 1993년 55명(10.9%), 1994년 50명(10.9%), 2000년 47명(9.3%) 순이었다. 월별로는 6월 59명(11.7%), 1월과 12월 각각 50명(9.9%), 7월 48명(9.5%) 순이었으며 계절별로는 여름이 147명(29.1%)으로 가장 많았으나 월별, 계절별로 큰 차이는 보이지 않았다. 연령은 2개월에서 13세 사이에 분포하였으며, 12개월 미만 135명(26.7%), 1세 153명(30.2%), 2세 108명(21.3%) 3세 54명(10.7%)로 전체의 88.9%가 3세 이하였으며 남녀비는 1.7 : 1로 남아에서 많았다. 1987-1994년간 발생한 345명을 치료 방법에 따라 아스피린 단독 치료군(54명; 15.6%), IVIG 분할 치료군(400-500 mg/일${\times}$ 4-5일, 224명; 64.9%), IVIG 일회 치료군(2.0 g/일, 67명; 19.5%)으로 나누었을 경우, 심장초음파 검사에서 grade II 이상의 관상동맥 병변의 발생빈도는 각각 8.3, 6.0, 7.5%로 통계학적인 차이를 보이지 않았다. 1996-2000년간 발생한 환아 161명중 IVIG 일회 치료만이 시행된 143명에서 관상동맥 병변은 21명(14.7%; grade I 15명, grade II 이상 6명)에서 관찰되었다. IVIG 일회의 치료에 반응하지 않아 재치료가 필요한 경우는 22례(15.4%)이었으며, 이 경우 관상 동맥 병변은 11명(50.0%, grade I 7명, grade II 이상 4명)에서 관찰되었다. 14년 동안 재발한 경우가 3례(0.3%), 형제간의 발생은 2례(0.3%)가 있었으며 사망례(0%)는 없었다. 결 론 : 대전 지역에서 가와사끼병은 96%의 환아가 5세 미만에서 발생하며 연도별로 약간의 차이를 보이고 있으나 계절적인 차이 없이 꾸준히 계속되고 있다. 현재 일반적으로 사용되는 IVIG 일회 치료에 의한 관상 동맥 이상은 14.7%이었다. 일차 IVIG 치료에 반응하지 않는 환아는 15.4%이었으며 이러한 환아에서 관상 동맥 합병증의 발생 빈도는 50.0%를 보였다.

식도 천공의 예후 인자 분석 (Analysis of Prognostic Factors in Esophageal Perforation.)

  • 정인석;송상윤;안병희;오봉석;김상형
    • Journal of Chest Surgery
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    • 제34권6호
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    • pp.477-484
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    • 2001
  • 배경: 식도 천공의 초기 증상은 명확하지 않은 반면, 조기 진단과 아울러 적절한 치료가 즉각적으로 이뤄지지 않을 때는 매우 치명적인 결과가 나온다. 이에 본 연구에서는 식도 천공의 예후에 영향을 미치는 인자들을 파악하여 치료 성적의 향상에 기여하고자 한다. 대상 및 방법: 1984년 10월부터 2000년 6월가지 식도천공으로 내원한 32명을 대상으로 하여 환자의 성별, 연령, 천공 원인, 천공 부위, 치료 시작까지의 소요시간, 천공에 의해 발생한 증상과 합병증 그리고 치료 방법 등의 임상 관찰 항목을 조사하였으며, 각 항목에 따른 식도 천공 환자 생존과의 연관성을 알아보았다. 결과: 환자는 남자가 24명, 여자가 8명이었고 평균연령은 49.7$\pm$16.4세였으며, 천공의 원인은 기구조작과 수술손상등으로 인한 의인성인 경우가 14례(43%)로 가장 많았다. 천공부위는 흉부식도에서 가장 많았으며(26례, 81.2%), 증상은 흉통이 가장 많았다. 식도천공에 의한 합병증으로는 종격동염, 농흉, 전신패혈증, 복막염의 순이었으며 치료결과 생존 23례 사망 9례로 전체 사망률은 28.1%였으며 주요 사망원으로는 전신패혈증과 호흡부전증이었다. 치료로는 8례(25.0%)에서 보존적 치료만으로 치유가 가능하였고 수술적 치료로 경부배농술이 5례(15.6%), 일차봉합술이 7례(21.8%), 식도격리-우회로 시행후 식도 재건술을 시행한 경우가 12771(37.5%) 시행되었다. 초기치료에 식도천공이 완치된 경우는 18711(56.2%)였고, 초기치료에 실패한 14례(43.8%)의 경우에서는 다음 단계 치료과정후 완치되거나 도중 사망하였다.

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Comparative Analysis of Spontaneous Infectious Spondylitis : Pyogenic versus Tuberculous

  • Lee, Yangwon;Kim, Bum-Joon;Kim, Se-Hoon;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • 제61권1호
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    • pp.81-88
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    • 2018
  • Objective : Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted. Methods : From April 2010 to March 2016, data from spondylitis patients were collected retrospectively. In total, 69 patients (51 with pyogenic spondylitis and 18 with tuberculous spondylitis) were included. Clinical data, laboratory findings including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, measurements of Cobb angles at the initial and final follow-up, and radiologic features on magnetic resonance imaging (MRI) scans were evaluated. To test differences between the pyogenic and tuberculous groups, numerical data were compared using the student's t-test and Mann-Whitney U test, and categorical data were compared using the chi-square test and Fisher's exact test. Results : The patients' mean age was 60.0 years. Male sex was slightly predominant (56.5%). There was no difference in mean age and sex between the two groups. The pyogenic group had a relatively higher proportion of immunocompromised patients. The peak CRP value was higher in the pyogenic group than in the tuberculous group (14.08 mg/dL and 8.50 mg/dL, respectively, p=0.009), whereas the ESR was not significantly different between the groups (81.5 mm/h and 75.6 mm/h, respectively, p=0.442). Radiologically, the presence of disc space sparing and vertebral body collapse differed between the groups. In the tuberculous group, the disc was more commonly preserved on contrast-enhanced MRI (50% and 23.5%, respectively, p=0.044), and vertebral body collapse was more common (66.6% and 15.7%, respectively, p<0.001). The mean length of hospitalization was longer in the pyogenic group (56.5 days and 41.2 days, respectively, p=0.001). Four mortality cases were observed only in the pyogenic group. The most commonly isolated microorganism in the pyogenic group was Staphylococcus aureus(S. aureus) (methicillin susceptible S. aureus and methicillin resistant S. aureus [MRSA] in 8 and 4 cases, respectively). Conclusion : The clinical and radiological manifestations of spontaneous spondylitis differ based on the causative organism. Pyogenic spondylitis patients tend to have a higher CRP level and a more severe clinical course, whereas tuberculous spondylitis patients present with destruction of the vertebral body with disc sparing more frequently. The presence of MRSA is increasing in community-acquired spondylitis cases.

경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査) (Epidemiology of Pesticide Poisoning in Kyungpook)

  • 정종학;조재연
    • 농촌의학ㆍ지역보건
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    • 제8권1호
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    • pp.28-34
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    • 1983
  • 농약사용량(農藥便用量)의 증가(增加)에 따라 농약중독자(農藥中毒者)가 전 세계적으로 증가(增加)하는 추세인데 우리나라에서는 아직까지 농약중독자(農藥中毒者)에 대한 역학조사(疫學調査) 보고(報告)가 없는 실정이다. 1981년(年)부터 1982년(年)까지 2년간(年間) 경상북도(慶尙北道) 전지역(全地域)을 대상으로 의원(醫院), 병원(病院) 및 보건소(保健所)의 의무기록(醫務記錄)을 조사(調査)하여 농약중독자(農藥中毒者)를 파악하여 그 실태를 분석(分析)하였다. 1981년(年)에 765명, 1982년에 853명의 중독자(中毒者)가 발생(發生)하였다. 연령별(年令別)로는 20대(代)가 제일 많았고 성별(性別)로는 남자가 70% 여자가 30%였다. 중독경위별로는 직업적인 중독이 27.8%, 우연에 의한 사고(事故)가 5.6%였고 자살목적(自殺目的)이 66.6% 였다. 월별(月別)로는 6, 7, 8, 9월(月)에 발생(發生)이 많고 7월(月)이 제일 많고, 월평균(月平均) 67명이 발생(發生)하였다. 의료기관이용(醫療機關利用)은 개인의원이 49%, 병원이 43%였다. 치명율(致命率)은 직업적인 중독이 0.9%, 사고(事故)에 의한 중독(中毒)이 5.6% 자살목적(自殺目的)의 중독(中毒)에서 20.3%로 평균(平均) 14.1%였다. 인구 100,000 당 농약중독(農藥中毒) 발생(發生)은 년간(年間) 25.4였다.

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Risk Factors for Gallbladder Cancer in Nepal - a Case Control Study

  • Tamrakar, D;Paudel, IS;Adhikary, S;Rauniyar, B;Pokharel, PK
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3447-3453
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    • 2016
  • Background: Gall bladder cancer (GBC) is highly fatal disease with poor prognosis, with a 5 year survival rate of <10%. It is relatively rare cancer worldwide; however it is the sixth cancer and second most common gastrointestinal tract cancer in Nepalese women. The study focused on associations of certain demographic, lifestyle, dietary, and reproductive factors with gall bladder cancer. Materials and Methods: We conducted a hospital-based matched case control study on newly diagnosed cases of primary GBC at BP Koirala Institute of Health Sciences and BP Koirala Memorial Cancer Hospital. Controls were healthy non-GBC relatives of cancer patients, matched for age, sex and marital status (in case of females) with cases at a ratio of 1:2. Data were collected between April 2012-April 2013 by semi structured interview from both cases and controls. Analyses were carried out with SPSS. Conditional logistic regression was used to find odds ratios and 95% confidence intervals for bivariate and multivariate analysis. Results: A total of 50 cases and 100 controls were enrolled in this study. On bivariate analysis, factors found to be significantly associated with gallbladder cancer were illiteracy (OR=3.29, CI=1.06-10.2), history of gallstone disease (OR=27.6, CI=6.57, 115.6), current smoker (OR=2.42, CI=1.005-5.86), early menarche <13 years (OR=2.64, CI=1.09-6.44), high parity more than 3 (OR=3.12, CI=1.25,7.72), and use of mustard oil (OR=3.63, CI=1.40, 9.40). A significant protective effect was seen with high consumption of fruits at least once a week (OR=0.101, CI=0.03-0.35). On multivariate analysis, history of gallstone disease, early menarche, current smoker and high consumption of fruits persisted as significant factors. Conclusions: History of gallstone disease, cigarette smoking and early menarche were associated with increased risk of gallbladder cancer while high consumption of fruits was found to have a protective effect.