• 제목/요약/키워드: Dama

검색결과 43건 처리시간 0.024초

일산화탄소 중독의 역학적 특징: 전국 20개 병원 응급실 손상환자 표본 심층조사 (Epidemiologic Characteristics of Carbon Monoxide Poisoning: Emergency Department Based Injury In-depth Surveillance of Twenty Hospitals)

  • 배소현;이지숙;김경환;박준석;신동운;김현종;박준민;김훈;전우찬
    • 대한임상독성학회지
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    • 제14권2호
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    • pp.122-128
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    • 2016
  • Purpose: This study was conducted to describe the characteristics of patients with carbon monoxide (CO) poisoning. Methods: We retrospectively surveyed data from the Emergency Department based Injury In-depth Surveillance of 20 hospitals (2011-2014). We included patients whose mechanism of injury was acute CO poisoning caused by inhalation of gases from charcoal or briquettes. We surveyed the annual frequency, gender, age, result of emergency treatment, rate of intensive care unit (ICU) admission, result of admission, association with alcohol, and place of accident. We also surveyed the cause and experience of past suicide attempts by intentional poisoning. Results: A total of 3,405 patients were included (2,015 (59.2%) and 1,390 (40.8%) males and females, respectively) with a mean age of $39.83{\pm}18.51$ year old. The results revealed that the annual frequency of CO poisoning had increased and the frequency of unintentional CO poisoning was higher than that of intentional CO poisoning in January, February and December. The mean age of intentional CO poisoning was younger than that of unintentional CO poisoning ($38.41{\pm}13.03$ vs $40.95{\pm}21.83$) (p<0.001). The rates of discharge against medical advice (DAMA), ICU care and alcohol association for intentional CO poisoning were higher than for unintentional CO poisoning (36.4% vs 14.0%, 17.8% vs 4.7%, 45.2% vs 5.6%) (p<0.001). The most common place of CO poisoning was in one's residence. Conclusion: The annual frequency of total CO poisoning has increased, and unintentional CO poisoning showed seasonal variation. DAMA, ICU care, and alcohol association of intentional CO poisoning were higher than those of unintentional CO poisoning.

치료중단행위에 대한 의료형법적 고찰 -의학적 충고에 반한 퇴원 사례를 중심으로- (A Study on Medical-criminal Problem of Withdrawing Life-Sustaining Treatment)

  • 조인호
    • 의료법학
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    • 제9권1호
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    • pp.319-382
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    • 2008
  • As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

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국부변형률방법을 이용한 노치를 지닌 축의 피로수명평가 (Fatigue Life Evaluation of Notched Shaft Using Local Strain Approach)

  • 고승기;김영일;이학주;김완두;이상록
    • 한국자동차공학회논문집
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    • 제4권2호
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    • pp.80-89
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    • 1996
  • Fatigue life of a notched shaft was evaluated in order to estimate the durability and integrity of the notched shaft in design stage. Cumulative fatigue dama- ge analysis was performed using local strain approach based on the assumption that the fatigue life of a notched component is approximately same as that of a smooth specimen is subjected to the same strain at the notched component. In this paper, shafts with different notch root radius of 1, 2㎜ resulting in different values of stress concentration factors were tested under||rotating bending fatigue loading condition. Theoretical stress concentration factor for each notch type was calculated using finite element method. Fatigue life prediction program, FALIPS, written in C language was developed using the strain-life curve, and the local strain approach integrating Neuber's rule, cyclic stress-strain, and hysteresis loop equations. The fatigue life evaluated using the fatigue notch factor obtained from the experimentally determined fatigue strength showed very large scattering with nonconservatism, but the fatigue notch factors derived from the stress concentration factors and Peterson's equation reduced the considerablely accurate fatigue life evaluation within a factor of three.

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아세트화 아크릴 공중합체-올레인산 혼합 에멀젼계 방수제 제조연구 (The Study on Prepare Water Proof Agent by Acryl Copolymer and Oleic Acid Mixed Emulison)

  • 김영근;황용현
    • 한국응용과학기술학회지
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    • 제13권3호
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    • pp.83-94
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    • 1996
  • EMA-co-DAMA were synthesized from 2-diethylaminoethyl metacrylate and ethylhexyl metacrylate in acrylmonomer. To facilitate water emulsification, acrylic copolymer was cationized by acetic acid to produce acetated acrylic copolymer. The structures of the synthesized copolymer and acetated copolymers were confirmed by IR, NMR, and molecular weight was measure by GPC, and C.H.N elemental analysis. Acetated acrylic copolymers were perfectly emulsified in water and showed increased emulsion stability. Polymer dispersion for cement modifier[(PDCM-PED) water proof agent of cement for concrete in building construction] was prepared by blending of the guaternized acrylic copolymer syndisized above, sodium silicate, sodium gluconate and oleic acid emulsion. The result with prepared polymer dispersion of cement modifier was examined, and it was found that excellent waterprooffing effect ; Water permeability ratio is 0.50 under the water pressure of $100g/cm^2$ and 0.60 under $3kg/cm^2$, and water absorption ratio is $0.42{\sim}0.50$ and $1.0{\sim}1.02$ compressive strength ratio at mixed of water/PDCM-PED is 50 times.

소장 무공증 환아에서 GIA stapler를 이용한 Tapering Enteroplasty 임상경험 (Clinical Experience of Tapering Enteroplasty Using GIA Stapler in Jejunoileal Atresias)

  • 송영택
    • Advances in pediatric surgery
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    • 제1권1호
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    • pp.27-32
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    • 1995
  • Jejunal and ileal atresias are the most common cause of congenital intestinal obstruction and accounts for about 1/3 of all cases of intestinal obstruction in newborns. Despite the relative frequency of this anomaly, its survival rate was less than 10% up to 1950, more recently the survival rate has risen rapidly to 90% with the introduction of modern surgical techniques and the use of total parenteral nutrition. In 1969 Thomas described a tapering jejunoplasty to manage the discrepancy in the size of the proximal dilated lumen & contracted distal lumen, and to preserve absorptive surface when the dilated jejunum involved a long length, and Grosfeld et al.(1979) facilitated this method by using GIA staplers. Author have also used GIA stapler to resect the antimesenteric portion of the dilated proximal bowel in 8 cases of jejunoileal atresias with good results. The following results were obtained ; 1. There we 3 jejunal atresias & 5 ileal atresias, and male to female sex ratio was 5 : 3. 2. The type of atresia was as follows ; type IIIa was 3 cases, type IIIb was 4 cases, type IIIb+IV was 1 case. 3. In non-complication cases(5 cases), the mean hospital day was 16 days, and oral feeding was feasible from 6.2 days after operation. 4. The complications(anastomotic leakage, pneumonia) were frequently occurred in type IIIb cases and in low birth weight cases(75%). 5. Mortality rate was 25% including DAMA(discharge against medical advice) discharge case.

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이진영상을 이용한 효율적인 에지 기반의 디인터레이싱 보간 알고리즘 (Overload Measurement and Control of Access Control Channel Based on Hysteresis at Satellite Communication of DAMA)

  • 이청언;김성관;이동호
    • 한국통신학회논문지
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    • 제30권8C호
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    • pp.801-809
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    • 2005
  • 본 논문에서는 디인터레이싱 방법 중에서 가장 중요한 요소인 공간 필터의 성능 개선을 위한 새로운 알고리즘을 제안한다. 기존의 에지 기반 알고리즘들은 보간의 성능을 좌우하는 정확한 에지 방향을 판단함에 있어서 만족스럽지 못하다. 제안하는 알고리즘은 에지 대신에 원 영상의 이진화 된 영상을 근간으로 에지의 방향과 기울기를 판단함으로써 효율성과 정확도를 증가시켰으며 보다 완만한 각에서의 방향판단을 위하여 탐색 윈도우 수평 크기를 IS로 증가시켰다. 기존의 에지를 이용한 방항 판단보다 이진화 된 이미지를 근간으로 에지의 방항과 기울기를 판단하여 보간 했을 때 판단의 오류를 최소화하여 차질을 향상시킬 수 있었다. 다양한 종류의 영상에 대한 컴퓨터 모의 실험 결과를 통하여 기존의 에지 기반의 보간 방법들에 비해 성능이 매우 우수함을 보였다.

압입축의 파손 저감을 위한 설계 방법에 대한 연구 (Design Method to Reduce the Press-Fitted Assembly Dama)

  • 변성광;최하영;이동형
    • 한국기계가공학회지
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    • 제20권5호
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    • pp.128-134
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    • 2021
  • A press-fitted shaft is an essential part used in industrial machines, and it is generally used to transmit large quantities of power. Very high contact pressure occurs at the end parts of the contact between the shaft and boss, which are press-fitted shaft components. Such contact pressure not only damages the contact surface of a press-fitted shaft but also reduces its fatigue strength. To improve a press-fitted shaft's fatigue strength, the contact pressure on the contact surface, which directly affects the fatigue strength, should be minimized. Thus, in this study, the design configuration optimization of the end part of the boss was based on the approximate optimization method and was aimed at minimizing the contact pressure at the end of a press-fitted shaft. Comparison of the contact pressure and the contact stress of a conventional press-fitted shaft with those of the optimized press-fitted shaft showed that the boss design of the optimized press-fitted shaft effectively improved the fatigue life.

Molecular epidemiological survey of pathogenic trypanosomes in naturally infected cattle in northern Côte d'ivoire

  • Jean-Yves Ekra;Edouard K. N'Goran;Leonard E.G. Mboera;Biego Guillaume Gragnon;Koco Rita Nadege Assovie;Eliakunda Michael Mafie
    • Parasites, Hosts and Diseases
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    • 제61권2호
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    • pp.127-137
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    • 2023
  • Bovine trypanosomiasis is a significant health concern for livestock intensification in Côte d'Ivoire. This study aimed to determine the prevalence and distribution of pathogenic trypanosomes and identify the most infected cattle breed in northern Côte d'Ivoire. We examined 700 cattle and found that polymerase chain reaction (PCR) was more sensitive (12.3%) than microscopic observation (5.6%). Among the trypanosome species detected in naturally infected cattle, Trypanosoma vivax was 7.3%, Trypanosoma simiae tsavo was 6.7%, and Trypanosoma congolense was 0.4%. The overall prevalence of trypanosome infection in all cattle breeds was 12.3%, while the prevalence in individual breeds was 14.8%, 7.3%, 10.6%, and 12.3% for N'Dama, Baoule, Zebu, and Mere breed, respectively. The infected animals had low packed cell volume, influencing the prevalence. Our findings indicate that bovine trypanosomes are prevalent in Côte d'Ivoire, and their prevalence varies by region and breed. These pathogens include T. vivax, T. simiae tsavo, and T. congolense.

사양 방식이 엘크 암사슴의 건물섭취량, 증체량 및 자록의 번식성적에 미치는 영향 (Effects of Feeding Systems on Feed Intake, Weight Gain and Fawn Performance in Elk Doe(Cervus canadensis))

  • 이진욱;이성수;이상훈;최봉환;전다연;김찬란;김동교;이은도;김관우
    • 한국초지조사료학회지
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    • 제41권4호
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    • pp.250-258
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    • 2021
  • 본 연구는 엘크 암사슴(Cervus canadensis)의 사육방식에 따른 사료섭취량, 체중변화 및 자록의 성장에 미치는 영향을 확인하고 적정 방목강도를 구명하기 위하여 수행되었다. 본 실험에 사용된 공시가축은 3~4년생 엘크 암사슴 16두(평균체중 : 236.2 ± 15.7 kg)를 이용하였으며, 방목초지는 3년 이상된 톨 페스큐 위주의 기성 혼파초지로서 초종구성은 톨 페스큐(약 50%), 오차드그라스(약 10%), 켄터기 블루그라스(약 5%)와 피, 바랭이 등으로 구성되었다. 방목초지의 수분함량은 19.51~22.61%로 방목기간 동안 유사하였으며, 조단백질 함량은 6~7월에 유의적으로 높게 나타났다. 조지방과 조회분 함량은 가을로 갈수록 점차 증가하였으며, NDF와 ADF함량은 각각 53.65~60.18%과 26.08~29.10%로 조사되었다. 실험기간동안 보충사료 섭취량은 월별로 처리구 사이에 유의적인 차이가 나타나지 않았으나, 조사료와 총 건물섭취량은 5월을 제외하고 처리구 사이에 유의적인 차이가 나타났다 (p<0.05). 특히 8월에는 GR처리구의 조사료 섭취량이 급격히 감소하였는데, 여름철 환경변화에 따른 것으로 사료된다. 반면, 9월 포유를 위해 부족한 영양소를 섭취하기 위해 사초섭취량이 급격히 증가하였다. 우리 연구에서 암사슴의 채식패턴은 수사슴과 차이를 보였으며, 이는 실험기간 자록의 이유 및 포유기간에 따른 영향을 받은 것으로 사료된다. 본 실험에서 사양방식에 따른 엘크 암사슴의 체중은 유의적 차이가 나타나지 않았으나, GR처리구에서 자록의 성장률이 빠른 것으로 나타났다. 그러나, GR처리구에서 BF처리구에 비해 낮은 이유율이 나타나 분만 전후 사사사육을 통해 이유율을 높여주는 것이 필요할 것으로 판단되며, 목지 내에서 분만 시 포유경험이 있는 산차가 높은 암사슴을 이용하고 방목강도를 높여주는 것이 이유율을 향상시키는 데 도움을 줄 수 있을 것으로 사료된다. 엘크 암사슴의 방목강도는 연평균 15두/ha로 나타났는데, 이는 다마 암사슴(Dama dama)에 비해서는 체중대비 높게 나타났으나, 엘크 수사슴에 비해서는 낮은 수치를 보여주었다. 이러한 결과는 기성초지 이용으로 인해 사초의 생산성이 감소한 결과로 사료되며, 앞으로 방목초지의 혼파방법과 기성초지의 비배관리 등을 통해 초지 활용성을 높일 수 있는 연구가 추가적으로 필요할 것으로 사료된다.

Microsatellite loci 분석에 의한 한우와 타 품종간의 유전적 유연관계 (Assessment of Genetic Diversity and Relationships Between Korean Cattle and Other Cattle Breeds by Microsatellite loci)

  • 윤두학;박응우;이승환;이학교;오성종;정일정;홍기창
    • Journal of Animal Science and Technology
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    • 제47권3호
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    • pp.341-354
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    • 2005
  • For the genetic assessment of the cattle breeds including Hanwoo, eleven microsatellite markers on ten bovine autosomes were genetically characterized for 618 individuals of nineteen cattle breeds; North Eastern Asian breeds (Korean cattle, Korean Black cattle, Japanese Black cattle, Japanese Brown cattle, Yanbian cattle), Chinese yellow cattle (Luxi cattle, Nanyang cattle), European Bas taurus (Angus, Hereford, Charolais, Holstein, Limousin), African Bas taurus (N'Dama, Baoule), African Bas indicus (Kavirondo Zebu, White Fulani), Asian Bas indicus (Sahiwal, Nelore) and one Bali cattle, Bas banteng as an outbreed-reference population. Allele frequencies derived from the genotyping data were used in estimating heterozygosities, gene diversities and genetic distances. The microsatellite loci were highly polymorphic, with a total of 162 different alleles observed across all loci. Variability in allele numbers and frequencies was observed among the breeds. The average expected heterozygosity of North Eastern Asian breeds was higher than those of European and African taurines, but lower than those of Asian and African indicines. Genetic distances were estimated using Nei's DA genetic distance and the resultant DA matrix was used in the construction of the phylogenetic trees. The genetic distances between North Eastern Asian cattle breeds and Bas indicus were similar with those between European Bas taurus and Bas indicus, and African Bas taurus and Bas indicus, respectively. The clusters were clearly classified into North Eastern Asian, European and African taurines groups as well as different cluster with Chinese mainland breeds, firstly out-grouping with Bas indicus. These results suggest that Korean cattle, Hanwoo, had not been originated from a crossbred between Bas primigenius in Europe and Bas indicus in India and North Eastern Asian Bas taurus may be have separate domestication from European and African Bas taurus.