The author has investigated epidemiological features of human cases of epidemic encephalitis (E. E.) in the Republic of Korea and the status of antibody requisition in pre-and post-epidemic time. And virological and serological studies with regarding the relationship of E. E. infection between human and piglet, and field survey against its vector by means of virus isolation from mosquitoes were carried out. Finally, vaccine field trial against human population has also been evaluated in order to confirm its effectiveness. The results of the studies are summarized as follows : 1. The annual incidence of reported cases during the past 25 years (1949-1973) in the Republic of Korea has shown two patterns, one was typical cyclic incidence and the other one was irregular. Annual average morbidity and mortality rate per 100,000 population were 5.7 and 2.1 and fatality rate was 34.6% in typical cyclic years. 2. With regard to the geographical distribution of E. E., the province of Jeolla-Bug-Do illustrated the highest incidence regardless of the epidemic size. 3. The main epidemic period was between mid-August and mid-September (above 90% of the total number of cases). The first case was reported in middle of July and the epidemic ceased in late of October. 4. An analysis of the age distribution of cases of E. E., has shown that above 90% of the total cases occurred in the age groups under 14 years and it was noted that about its 54% were occurred in the age groups between 5-9 years group. 5. Through the Haemagglutination Inhibition (H-I) test for the laboratory diagnosis of E. E., it was found that higher H-I antibody titer was usually detected in the convalescent phase, 15 days after onset. 6. The H-I antibody survey against 563 healthy population by age groups during the pre-epidemic season showed that 422(75%) were less than H-I titer, 1:20 and 122(21.7%) were positive H-I titer, 1:20. Among the 94 American in Seoul who had not been in E. E. endemic area previously only one person had appeared sero-conversion as a H-I titer of 1:80 after post-epidemic season. 7. The E. E. virus could be isolated from the mosquitos pools-C, tritaeniorhyncus which were caught between late July and middle August. 8. E.E. Virus was also isolated from piglet blood on early August and H-I antibody conversion was occurred mostly on middle of August. 9. H-I antibody sero-conversion rate reached to high level when vaccine purified by mouse brain tissue inoculated, showing 98.9%. Higher antibody titer was acquired when booster inoculation was performed, Four fold rise of H-I add N-T antibodies was confirmed with 93.2% and 82.1% respectively.
Kim, Hyung Tae;Jang, Hyun Oh;Moon, Jin Soo;Nam, Seung Yeon;Kim, Dong Wook;Lee, Chong Guk;Cho, Chong Rae
Clinical and Experimental Pediatrics
/
v.48
no.7
/
pp.716-722
/
2005
Purpose : A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. Methods : Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. Results : Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus(11 cases, 18.6 percent), followed by Salmonella(10 cases, 16.9 percent), E. coli(7 cases, 11.9 percent), Streptococcus pneumoniae(five cases, 8.5 percent), Streptococcus viridans(5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus(61 percent), followed by meningitis(12 percent), bacteremia with enteritis(10.2 percent) and bacteremia with urinary tract infection(8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus. The case-fatality was 3.4 percent for all cases of bacteremia. Conclusion : We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.
Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.
This epidemiologic study was carried out to investigate cauuse and magnitude of food-poisoning like epidemic occurred among inhabitants of a village who have eaten dead cow's meat near Kyongju in February of 1994, around lunar new year, The investigation consisted of interview survey on all inhabitants of 77 households (111 males and 119 females) and their visitors (40 males and 35 females), skin test with anthraxinum (Russian product), study on clinical characteristics for the patients hospitalized, and microbiologic examination on microbes isolated from cow's meat, patient and soils of dead cow's barn. The results obtained are as followings; 1. The proportion of the inhabitants who ingested the dead cow's meat was 36.4%. The incidence rate of the disease was 65.1% for males, 41.7% for females and the cases were distributed evenly for all age groups. The group ingested raw meat showed higher incidence than the group ingested cooked meat. There was no case among people who did not eat the meat. 2. The most clinical symptoms were significantly more frequent among cases than non-cases : sore throat (57%), nausea (51%), fever (47%), indigestion (43%), cough (41%), anorexia (41%), abdominal distention (41%), and abdominal pain (39%) were the major symptoms among cases. 3. Among 29 cases hospitalized out of total 61 cases, three patients, all old and feeble persons, deceased from the disease resulting in 4.9% fatality rate among total patient and 10.3% among hospitalized. Septicemia and meningitis were the causes of the deaths. 4. Three strains isolated from patients, and three strains from dead cow's meat and soil revealed typical microbiologic characteristics of Bacillus Anthracis, which also proved to be fatal to experimentally infected mice.
This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rater case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer, esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.
Objective: In the winter of 2002, severe acute respiratory syndrome(SARS) began to spread throughout the world. More than 5,000 cases were reported in China, including over 1,700 cases in Hong Kong Special Administrative Region(Hong Kong SAR). The total number of cases reported from Canada and Singapore was more than 200. The total number of SARS cases world-wide reached 8,437 with incidences in 29 counties. Mortality from SARS is estimated at $10{\sim}12%$. When the SARS outbreak occurred in China, the State Administration of Traditional Chinese Medicine of China immediately initiated clinical research projects on the use of integrated herbal medicine and Western medicine for treating SARS. and, in Hong Kong SAR, research on the use of herbal medicine for the prevention and treatment of SARS. Reports were released during convalescence. The objective of this study is to overview twelve clinical SARS reports of WHO on the treatment of SARS with herbal medicine and evaluate the efficacy and safety of treatment of SARS with herbal medicine, and further to share experiences and knowledge of the treatment of SARS. Methods: Twelve clinical reports about SARS from the WHO were selected, overviewed and evaluated for efficacy and safety of treatments of SARS. Results and Conclusion: Twelve clinical reports about SARS showed that the integrated treatment may have advantages, and the advantages are reflected in the following findings: Firstly, herbal medicine is not targeted only at a specific etiology or a certain pathological link, but also at the pathological status of the patients at that particular time. Therefore, comprehensive readjustment was made through various angles, targets and channels to restore the balance of the body. Secondly, there are advantages in the differentiation of the disease and the treatment. Based on the various symptoms, herbal medicine enables the physician to adopt the most suitable principle, provide individual treatment, and to administer medicine in accordance with the actual process and nature of the illness. Thirdly, there are advantages in the results of the treatment; herbal medicine can relieve symptoms, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other Western medicines, and reduce case fatality rate, in addition to lowering the cost of treatment.
A cluster of severe pneumonia of unknown etiology in Wuhan City, Hubei province in China emerged in December 2019. A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was isolated from lower respiratory tract sample as the causative agent. The current outbreak of infections with SARS-CoV-2 is termed coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). COVID-19 rapidly spread into at least 114 countries and killed more than 4,000 people by March 11, 2020. WHO officially declared COVID-19 a pandemic on March 11, 2020. There have been 2 novel coronavirus outbreaks in the past 2 decades. The outbreak of severe acute respiratory syndrome (SARS) in 2002-2003 caused by SARS-CoV had a case fatality rate of around 10% (8,098 confirmed cases and 774 deaths), while Middle East respiratory syndrome (MERS) caused by MERS-CoV killed 858 people out of a total 2,499 confirmed cases between 2012 and 2019. The purpose of this review is to summarize known-to-date information about SARS-CoV-2, transmission of SARS-CoV-2, and clinical features of COVID-19.
Kim, Ji-Hoe;Gong, Qing-Li;Mok, Jong-Soo;Min, Jin-Gi;Lee, Tae-Seek;Park, Jeong-Heum
Journal of Food Hygiene and Safety
/
v.18
no.3
/
pp.133-138
/
2003
The data on outbreaks of puffer fish poisoning during 1991 to 2002 in Korea were gathered from press reports, and characterized information collected. During the period, a total of 32 outbreaks of puffer fish poisoning was reported. These outbreaks caused 111 persons to become poisoning, among the cases 30 persons were fatal. The mean case fatality rate was 27.0%, and most of deaths (93.3%) were the male of above 29 years old. Patient number of below 4 persons per a poisoning accident occupied 75.0% of total outbreaks; 65.8% of total cases; and 66.7% of total deaths) was occurred in the months, November through January. Most of puffer fish poisoning (75.0% of total outbreaks; 68.5% of total cases; and 73.3% of total deaths) were found along the south coastal area of Korea, including Busan, Gyeongsangnam-do, Jeollanam-do and Jeju-do. Over than 80% of puffer fish poisoning outbreaks occurred at fishing boat and home where privately made food was cause, and outbreaks in restaurants accounted for 15.6%. Most commonly implicated foods were Guk, boiled soup with puffer fish meat and spices.
Korean Journal of Construction Engineering and Management
/
v.20
no.6
/
pp.66-73
/
2019
Thanks to various efforts to reduce disasters by the government and the Health and Safety Authority, disasters across industries and the construction industry show their reduction trend. However, the falling disasters in the construction industry have not decreased and increased on the contrary. Especially falling disaster caused by Hanging Scaffolding is the most critical disaster which shows low occurrence frequency but is directly connected to death of worker. The working environment for Hanging Scaffolding is poor in domestic construction site. In particular, the Hanging Scaffolding workers in small construction sites are not on the safety control and management by anyone for their works. They are driven to unsafe working condition with mostly uncertified facilities which are made by themselves. Therefore, this study is focused on searching falling disaster factors from the 242 disaster cases caused by Hanging Scaffolding Work in 15 years presented by KOSHA, and trying to provide suggestions for improvement. The improvement of the method of work requires facility improvement and work due to high accident rate caused by unsafe behavior. Analysis of the case of a disaster occurring over the past 15 years shows that no disaster occurred due to problems in the order of operations presented by KOSHA. However, it was found that many accidents resulted from death caused by safety belts not being installed or attached to ropes using safety belts without following the order of work. The most important aspect of improving the work method was the installation and wearing of lifeboats and safety belts.
Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.