• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.112-120
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• 2004

Purpose : Methicillin Resistant-Coagulase Negative Staphylococcus(MR-CNS) infection has become an increasingly important cause of morbidity in NICU infants. We investigated the c linical characteristics of MR-CNS sepsis. Methods : This study included 40 neonates with MR-CNS sepsis who were admitted to the neonatal intensive care unit of Kangnam Sacred Heart Hospital, Hallym University from January 1998 to July 2002. MR-CNS sepsis was defined as MR-CNS recovery from blood with clinical symptoms and signs of infection. Retrospective analyses of the medical records of patients with MR-CNS sepsis were performed. The analyses included demographic findings, clinical features, hospital courses, risk factors for infection including invasive procedures and mortality. Results : From 1998 to 2002, there were 40 cases of MR-CNS sepsis, comprising 17.7% of late onset infections in NICU of Kangnam Sacred Heart Hospital. The male/female ratio was 1.5 : 1. The mean gestational age of infected babies was $32.4{\pm}4.3$ weeks at birth. And the first positive MR-CNS culture was done in the day $10.6{\pm}9.3$ after birth. Clinical symptoms such as fever, dyspnea, cyanosis, grunting, bradycardia, vomiting and diarrhea were frequent in MR-CNS. Mechanical ventilation was applied in 12 cases and catheter was inserted in 11 cases. The mortality(12.5%) directly attributable to MR-CNS sepsis was similar to other late onset infections. Conclusion : MR-CNS is a pathogen responsible for most late onset and nosocomial infections. And it will be life-threatening in high-risk neonate. Awareness of increasing infections due to MR-CNS in NICU is important not only for infection control but also placing a great limit in use of antibiotics and invasive procedures, especially in premature infants.

• Journal of the Korean Association of Geographic Information Studies
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• v.26 no.1
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• pp.21-40
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• 2023

This study analyzed the cold air characteristics of the Nakdong Jeongmaek, which is advantageous for the formation of cold air that can flow into the city, in order to suggest the wind ventilation corridor plans, which have recently been increasing interest as a way to improve the urban thermal environment. In addition, based on the watershed analysis, specific cold-air watershed areas were established and management plans were suggested to expand the cold air function of the Nakdong Jeongmaek. As a result of the analysis of cold air in the Nakdong Jeongaek, cold air was strongly generated in the northern forest of the Jeongamek, and flowed into nearby cities along the valley topography. On average, the speed of cold air was high in cities located to the east of the Jeongmaek, while the height of cold air layer was high in cities located to the west. By synthesizing these cold air characteristics and watershed analysis results, the cold-air watershed area was classified into 8 zones, And the plans were proposed to preserve and strengthen the temperature reduction of the Jeongmaek by designating the zones as 'Conservation area of Cold-air', 'Management area of Cold-air', and 'Intensive management area of Cold-air'. In addition, in order to verify the temperature reduction of cold air, the effect of night temperature reduction effect was compared with the cold air analysis using weather observation data. As a result, the temperature reduction of cold air was confirmed because the night temperature reduction was large at the observation station with strong cold air characteristics. This study is expected to be used as basic data in establishing a systematic preservation and management plan to expand the cold air function of the Nakdong Jeongmaek.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.558-570
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• 1996

Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1200-1206
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• 2003

Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in $PaCO_2$. However, the control group showed a slight $CO_2$ retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.35 no.1
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• pp.173-185
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• 2015

This study aims to investigate the characteristics and types of car accidents and establish a prediction model by analyzing 456 car accidents having occurred in the 11 tunnels in Busan, through statistical analysis techniques. The results of this study can be summarized as below. As a result of analyzing the characteristics of car accidents, it was found that 64.9% of all the car accidents took place in the tunnels between 08:00 and 18:00, which was higher than 45.8 to 46.1% of the car accidents in common roads. As a result of analyzing the types of car accidents, the car-to-car accident type was the majority, and the sole-car accident type in the tunnels was relatively high, compared to that in common roads. Besides, people at the age between 21 and 40 were most involved in car accidents, and in the vehicle type of the first party to car accidents, trucks showed a high proportion, and in the cloud cover, rainy days or cloudy days showed a high proportion unlike clear days. As a result of analyzing the principal components of car accident influence factors, it was found that the first principal components were road, tunnel structure and traffic flow-related factors, the second principal components lighting facility and road structure-related factors, the third principal factors stand-by and lighting facility-related factors, the fourth principal components human and time series-related factors, the fifth principal components human-related factors, the sixth principal components vehicle and traffic flow-related factors, and the seventh principal components meteorological factors. As a result of classifying car accident spots, there were 5 optimized groups classified, and as a result of analyzing each group based on Quantification Theory Type I, it was found that the first group showed low explanation power for the prediction model, while the fourth group showed a middle explanation power and the second, third and fifth groups showed high explanation power for the prediction model. Out of all the items(principal components) over 0.2(a weak correlation) in the partial correlation coefficient absolute value of the prediction model, this study analyzed variables including road environment variables. As a result, main examination items were summarized as proper traffic flow processing, cross-section composition(the width of a road), tunnel structure(the length of a tunnel), the lineal of a road, ventilation facilities and lighting facilities.

• Journal of Korean Public Health Nursing
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• v.4 no.2
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• pp.59-77
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• 1990

The purpose of this study was to provide the basic data for the effective health management of the industrial workers, by classifying factors influencing their perceived symptoms to examine their health status and identifying the inter' relationship of their perceived symptom with their working department. the environment of working area and their general characteristics. The study was undertaken from October 1 to November 30. 1989. The subjects were 999 workers who had worked in Industrial Corps located in Chungbuk Province. The results of this study were as follows: I . Worker's perceived symptoms were classified according to the following eight factors; 1) musculo - skeletal symptoms of shoulder, neck, back and arm 2) optical symptoms 3) symptoms in head(such as headache and dull) 4) musculo - skeletal symptoms of leg and lower back 5) gastro - intestinal symptoms 6) mental symptoms. 7) neural symptoms 8) lung and heart symptoms II . The degrees of workers' perception of perceived symptoms; Mean score of perceived symptoms:7.0 The rank of degrees of perceived symptoms: The highest:musculo - skeletal symptoms of shoulder, neck, back, and arm The second:optical symptoms The third:musculo - skeletal symptoms of leg and lower back The fourth:mental symptoms the fifth:gastro-intestinal symptoms m . Analysis of the inter-relationship of perceived symptoms with working department, environment of working area and general characteristics; 1) sexuality The difference of degrees of perceived symptoms was significant;femanle was higher than male(P<0.000). 2) level of education The difference of degrees of perceived symptoms according to the level of education was significant; The higher the level of education, the higher the degree. 3) working department The working department played a significant part in the degrees of perceived symptoms of workers; Workers of assembling department:musculo-skeletal symptoms both of shoulder. neck, back and arm and of leg and lower back(P<0.000). Workers of inspection department:optical symptoms(P<0.05). Office workers:mental symptoms(P<0.05). 4) kinds of job The difference of the degrees of perceived symptoms according to kinds of job was significant; Workers dealing with chemical materials and workers dealing with job with high tension:gastro-intestinal symptoms and symptoms in head. Workers dealing with weighty things or working a long time with the same posture:musculo-skeletal symptoms both of shoulder, neck, back and arm and of lower back(P<0.000). 5) working posture The difference of the degrees of perceived symptoms related with working posture was significant; Sitting:optical symptoms(P<0.0000) and symptoms in head(P<0.005) Standing:musculo-skeletal symptoms of leg and lower back(P<0.0000). 6) satisfaction with their own duty The more dissatisfien they were. the higher became the degrees of their perceived symptoms(P<0.0001). 7) satisfaction with their working condition The more dissatisfied with their working condition they were, the higher became the degrees of their perceived symptoms(P<0.001). 8) environment of working area The environment of working area played a significant part in the degrees of perceived symptoms of workers; Workers exposed to most of the factors of the environment of working area were higher than those not exposed in the degrees of musculoskeletal symptoms. Workers in the noisy environment:optican symptoms(P<0.000), symptoms in head(P<0.005). Workers in the damp environment:optical symptoms(P<0.005) and lung and heart symptoms(P <0.01). Workers with illumination problem:optical symptoms(P<0.000), mental symptoms(P<0.005) and neural symptoms(P<0.01). Workers with ventilation problem:optical symptoms and lung and heart symptoms(P<0.001)

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.383-390
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• 2008

Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

• The Korean Journal of Emergency Medical Services
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• v.15 no.1
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• pp.47-63
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• 2011

Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.228-234
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• 2006

Background : Acinetobacter baumannii is an important pathogen associated with nosocomial infections in intensive care units, and is responsible for nosocomial pneumonia, UTI, bacteremia, etc. The main concern is that this pathogen is often resistant to many antimicrobial agents, particularly to carbapenem. This study compared the clinical those of ICU admitted patients with the carbapenem resistant A. baumannii isolated from the sputum with characteristics of patients with carbapenem sensitive A. baumannii. Methods : A total of 49 patients with A. baumannii from a sputum culture who were admitted to the ICU from January to December 2003 were enrolled in this study. This study evaluated the demographic variables, mortality, APACHE II score, comorbidity, antibiotics used, hospital and ICU stay, Clinical Pulmonary Infection Score, and mechanical ventilation. A retrospective analysis was made by a review of the patients' medical records. Results : Carbapenem sensitive and resistant A. baumannii was isolated from 23 patients and 26 patients respectively. Univariate analysis revealed renal disease, the use of carbapenem and aminoglycoside to be statistically significant factors for carbapenem resistance. Multivariate analysis revealed carbapenem use(p=0.024; OR, 8.17; CI 1.32 to 50.68) to be positively associated with carbapenem resistance, and aminoglycoside use(p=0.026; OR, 0.18; CI, 0.04 to 0.82) to be negatively associated with carbapenem resistance. There was no significant difference in mortality between the carbapenem sensitive and resistant group(30 vs 42%. P=0.39). Conclusion : The occurrence of carbapenem resistant A. baumannii is positively associated with carbapenem use and negatively associated with aminoglycoside use. Carbapenem resistance in the sputum culture did not affect the mortality rate.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.239-254
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• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.