• 대한임상독성학회지
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• 제8권2호
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• pp.79-87
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• 2010

Purpose: The previous studies on $H_1$ antihistamine overdose have generally been limited to cases of acute doxylamine succinate (DS) poisoning, yet there have been some studies on diphenhydramine (DPH) overdosing. But many clinicians consider the two drugs to be very similar and to have similar ingredients. The purpose of this study was to clarify the toxicologic characteristics and clinical outcomes between DS and DPH poisoning/overdose. Methods: We reviewed the medical and intensive care records of the patients with acute DS or DPH poisoning and who admitted to our emergency department from January 2008 and April 2010. We collected patient information regarding the features of the poisoning and the clinical and demographic characteristics. The patients were assessed for the clinical outcomes, the GCS, the PSS (Poisoning Severity Score) and the SOFA (Sequential Organ Failure Assessment). Results: Fifty seven patients (45 cases of DS poisoning and 12 cases of DPH poisoning) were enrolled. Compared with the DS group, the DPH group had higher incidences of intubation, serious mental change, QTc prolongation and ECG conduction abnormality (p=0.041, <0.001, 0.014 and 0.044, respectively). The DPH group had a higher PSS and a longer ICU stay. The peak CPK time and the CPK normalization time were longer for the patients with rhabdomyolysis due to DS poisoning. Conclusion: Two common $H_1$ antihistamines, doxylamine and diphenhydramine, are in the same ethanolamine-structural class, but the toxico-clinical outcomes are different according to many aspects. Therefore, clinicians could take a careful approach for the differential diagnosis and management between DS and DPH poisoning.

• Journal of Trauma and Injury
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• 제32권2호
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• pp.86-92
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• 2019

Purpose: There is increasing interest in intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) in critically ill patients. This study investigated the effects and outcomes of elevated IAP in a trauma intensive care unit (ICU) population. Methods: Eleven consecutive critically ill patients admitted to the trauma ICU at Pusan National University Hospital Regional Trauma Center were included in this study. IAP was measured every 8-12 hours (intermittently) for 72 hours. IAP was registered as mean and maximal values per day throughout the study period. IAH was defined as $IAP{\geq}12mmHg$. Abdominal compartment syndrome was defined as $IAP{\geq}20mmHg$ plus ${\geq}1$ new organ failure. The main outcome measure was in-hospital mortality. Results: According to maximal and mean IAP values, 10 (90.9%) of the patients developed IAH during the study period. The Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with $IAP{\geq}20mmHg$ than in those with IAP <20 mmHg (16 vs. 5, p=0.049). The hospital mortality rate was 27.3%. Patients with a maximum $IAP{\geq}20mmHg$ exhibited significantly higher hospital mortality rates (p=0.006). Non-survivors had higher maximum and mean IAP values. Conclusions: Our results suggest that an elevated IAP may be associated with a poor prognosis in critically ill trauma patients.

• 대한임상독성학회지
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• 제17권1호
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• pp.7-13
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• 2019

Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

• 한국콘텐츠학회논문지
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• 제19권9호
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• pp.280-292
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• 2019

본 연구는 부산의 대표적 상업 공간인 센텀 신세계백화점을 대상으로, 실내 휴게 공간과 가구 디자인 현황을 파악하고, 가구를 중심으로 한 방문객의 이용 행태 특성을 분석하고자 한다. 상업공간에서 공공의 영역이라고 할 수 있는 휴게 공간 디자인이 방문객의 특성과 행태를 지원하고 있는지를 파악하여 추후 상업 휴게 공간 디자인을 위한 기초 자료를 제공하고자 한다. 연구방법은 현장 방문 관찰을 진행해 휴게공간에서 각 층별 휴게공간의 위치, 휴게가구 디자인의 유형과 디자인 특성을 파악한 후, 주요 층별 휴게 가구 이용자의 특성과 행태를 분석하였다. 연구결과는 다음과 같다. 휴게공간과 가구를 분석한 결과 휴게공간의 위치나 크기는 적절하다고 여겨진다. 또한 휴게 가구는 베이지에서 브라운, 밝은 회색에서 블랙에 이르는 저채도의 편안한 색채에 부채형, 호형 벤치, 소파, 의자 형 등 다양한 디자인으로 제공되어 있어, 쉬기, 휴대폰 사용, 대화와 같은 가장 일반적인 이용 행태를 적절히 지원하고 있었다.

• 한국연극학
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• 제49호
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• pp.171-208
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• 2013

Site-specific performance is always the real on-site work taking place at the site. Hence, it deals with the reality, in other words, the time of creation and formation. And it creates value and meaning through the interaction and continuous direct communication process between the performers, audience and the local residents. In this performance, the audience's status as the passive observer changes. They become the co-agent who actively lead and complete the performance through their own experience. We have examined the The Working Methods of Site-specific Performance and Aesthetics of Effect through four Korean performances ; Marie, An aesthetic experiment of site as the storyteller; Heterotopia and Urban Movement Research or Play: We Will Move Your Sofa, as performances which have Revealed history, politics, institution engraved in the site ; A Song of Mandala and Miracle, as a ritualistic site-specific performance at the historic site. Some remarks on Site-specific performance ; First, In Site-specific performance, the habitus peculiar to the stage art and the mode of reception are changed. Second, a new mode of theatrical communication requires creator and audience to have a sharp aesthetic sensibility and to change one's perceptual habit. Third, Site-specific performance can act as a demonstration for the viewpoints of political activism through what could be called a dramatic close-up effect. Fourth, Site-specific performance also has the risk of merely becoming an unfocused and scattered performance or degenerating into a pseudo-sightseeing. To avoid this, an in-depth study of the site and its socio-cultural context, and the clear motivation with which one is trying to reveal and tell from the site must be indispensable. As the co-agent, the audience should also be aware and think about what the given performance signifies today.

• 실내환경 및 냄새 학회지
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• 제17권4호
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• pp.315-321
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• 2018

Phthalate is an endocrine disruptor that interferes with homeostasis and developmental regulation. It is highly toxic to the environment and is associated with various diseases of the human body. Using biological samples from 140 adult subjects, to evaluate the influencing factors which are related to contaminant concentration levels, we used correlation analysis and multiple regression analysis. Lastly, in order to analyze the health effects related to exposure to phthalates, we conducted a risk assessment by estimating acceptable daily intake exposure according to the influential factors. When we compared the concentration level according to influential factors, in general, the subjects who had engaged in home remodeling work had higher urinary phthalate metabolite concentrations levels than the subjects who had not engaged in home remodeling work. We can confirm statistically significant differences in DBP metabolites. In addition, we can confirm the concentration appeared higher in the categories such as using air freshener, sofa and foods. Through conducting a risk assessment of DEHP, BBzP, DiBP, and DnBP by using data on phthalate metabolite concentration in urine, it was found that the average concentration of all metabolites did not exceed TDI.

• 대한임상독성학회지
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• 제18권2호
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• pp.136-140
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• 2020

Purpose: The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied. Methods: This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher's exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality. Results: One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis. Conclusion: The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.

• 한국컴퓨터정보학회논문지
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• 제27권8호
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• pp.111-121
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• 2022

본 연구는 정부 차원에서 미국 정부를 상대로 방송주권의 문제를 사상 처음으로 제기했던 사례라고 평가할 수 있는, 1977년 AFKN-TV의 컬러 방송 개시를 둘러싼 한미 간의 교섭과정에 대한 역사적 사실을 규명하는 데 그 목적이 있다. 보다 구체적으로는 국가기록원과 외교사료관에 소장된 아카이브 문서에 대한 문헌연구를 통해, 한미 간의 교섭과정을 세 국면으로 나누어 각 국면별로 양국 정부의 주장과 인식, 조치 등을 살펴봄으로써 양국 간에 벌어졌던 갈등의 양상을 살펴보았다. 연구결과, 1977년 초 AFKN-TV의 일방적인 컬러 방송 실시를 둘러싸고 벌어졌던 미국 정부와의 교섭과 그 교섭과정에서 나타난 양국 간의 갈등은 AFKN방송을 새롭게 주권의 관점에서 바라보게 하는 계기였고, 이러한 1970년대 말 한국 정부의 방송주권에 대한 의지는 역사적 유산으로 이어져 1980년대에 다시 미국 정부를 겨냥하게 되었다.

• 대한예방한의학회지
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• 제26권3호
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• pp.97-108
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• 2022

Objectives : The purpose of this study is to confirm the efficacy and safety of Gongjin-dan and Ssanghwatang for chronic fatigue. Methods : A total of 90 people, between 19 and 65 years old, will be recruited to participate in a randomized, double-blind, and placebo-controlled a clinical trial. Participants in the Gongjin-dan group will take one pill of Gongjin-dan along with three packs of placebo oral liquid Ssanghwa-tang per day for 4 weeks. Participants in the Ssanghwa-tang group will take three packages of liquid Ssanghwa-tang and one placebo Gongjindan pill per day for 4 weeks. In the placebo group, participants will take one pill of placebo Gongjin-dan and three packs of placebo liquid Ssanghwa-tang per day, for 4 weeks. Outcomes will be measured at the baseline, 4^th week, and 6^th week. The primary outcome is the change in the Fatigue Severity Scale (FSS). Secondary outcomes are the change of Multidimensional Fatigue Inventory-20 (MFI-20), Chalder Fatigue Scale (CFQ), Short-Form 36 Health Survey (SF-36), Korean Version of Schedule of Fatigue and Anergy/General Physician (SOFA/GP), Glucose, Lactate, Ammonia, Free Fatty Acid (FAA), d-ROMs&BAP, Selenium, and Cortisol. Results : This trial was approved by the institutional review board of Pusan National University Korean Medicine Hospital (registry number: PNUKHIRB 2021-10-005). Recruitment opened in November 2021 and is supposed to be completed by December 2022. Conclusions : This trial will provide clinical information to determine the efficacy and safety of Gongjindan and Ssanghwa-tang for chronic fatigue.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.21-26
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• 2009

연구배경: 급성 호흡부전 환자에서 기관지경 검사 시비침습적 양압환기를 적용하면 저산소혈증의 악화 없이 안전하게 검사를 시행할 수 있으나 일부 환자에서는 저산소혈증의 악화로 기계 환기가 필요하게 된다. 본 연구는 저산소혈증으로 비침습적 양압환기 적용 하에 기관지경 검사를 시행한 환자들에서 검사 후 기관 삽관의 빈도 및 예측 인자를 알아보고자 하였다. 방 법: 2005년 1월부터 2007년 10월까지 삼성서울병원 내과계 중환자실에서 기관지경 검사를 받은 환자 210명 중 저산소혈증으로 비침습적 양압환기 적용 하에 기관지경 검사를 시행한 36명의 환자를 대상으로 후향적 조사를 시행하였다. 결 과: 36명의 환자(남:여, 18:18)들의 중앙연령은 55세(사분위 범위, 43~65세)였다. 기관지경 검사 전 SOFA 점수는 4점(3~7점), SAPSII 점수는 37점(30~42점)이었고 P/F ratio는 중앙값 155 (90~190)이었다. 기관지경 검사 후 17명(47%)에서 기관 삽관이 시행되었고, 시술 후 삽관까지 걸린 시간의 중앙값은 22시간(2~50시간) 이었다. 36명의 환자 중 15명(42%)이 사망하였고, 기관 삽관이 필요했던 경우 그렇지 않은 경우보다 병원 내 사망률이 높았다(11 [65%] vs. 4 [21%], p=0.017). 다중 로지스틱 회기분석 결과 기관지경 검사 전의 P/F ratio만이 기관지경 검사 후 기관 삽관과 독립적으로 관련이 있었다(OR, 0.961; 95% CI, 0.924~0.999; p=0.047). 결 론: 급성 호흡부전 환자에서 기관지경 검사 시 저산소혈증의 악화를 방지하기 위해 비침습적 양압환기를 적용할 때 적절한 환자 선택이 중요하며, 중증 저산소혈증환자에서는 기관 삽관을 대비하여 검사 후 집중적인 감시가 필요할 것으로 사료된다.