• 한국환경보건학회지
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• 제39권5호
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• pp.456-464
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• 2013

Objectives: The aim of this study was to investigate the microbial contamination levels in elevators in apartment buildings and to provide information on such microbial contamination. Methods: A total of 144 samples, including from the exterior buttons, interior buttons, elevator handrails, walls, ventilators and airborne bacteria were collected in the morning and afternoon from July to August 2013 for six different elevators. The samples were used to detect sanitary indicator bacteria (total bacteria, coliform, and Escherichia coli), pathogenic bacteria (E. coli O157, L. monocytogenes, Salmonella spp., B. cereus, S. aureus) and fungi. Results: Contamination levels of total bacteria were 0.3-3.8 and 0.0-2.4 log CFU/100 $cm^2$ in the morning and afternoon, respectively. In the case of coliform bacteria, the levels were 0.0-3.7 log CFU/100 $cm^2$ in the morning and 0.0-0.3 log CFU/100 $cm^2$ in the afternoon. However, E. coli was not detected among all samples. Bacillus cereus, pathogenic bacteria, was only detected in 13 (11%) among 144 samples. E. coli O157, L. monocytogenes, Salmonella spp. and S. aureus were not detected among all samples. Comparing the samples collected in the morning and afternoon, we could confirm that the samples in the afternoon were cleaner. Conclusions: This study indicates that the samples in the afternoon were cleaner because these samples were collected following routine cleaning. Also, the levels of contamination in the elevators were low and the sanitary conditions were comparatively well-managed. Therefore it is deemed necessary for elevators be cleaned regularly to provide good conditions for people using elevators.

• 생물환경조절학회지
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• 제27권1호
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• pp.46-53
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• 2018

본 연구는 공기주입 이중피복온실과 관행 이중피복온실의 생육환경과 단열성능을 비교하기 위하여 수행하였다. 두 온실의 온도, 상대습도, 포차, 이산화탄소농도, 일사량, 딸기 생산량 및 난방연료소비량을 비교하였다. 공기주입온실이 관행온실보다 야간에 상대습도가 더 높고 포차는 더 낮게 나타나 딸기의 생육에 좋지 않은 환경을 보여주었다. 이산화탄소농도는 공기주입온실이 관행온실보다 더 높게 나타났으며, 이는 공기주입온실이 더 밀폐되어 있어 환기량이 적기 때문인 것으로 판단된다. 관행온실의 광투과율이 77%로 공기주입온실의 72%보다 더 높아 관행온실의 광환경이 더 우수한 것으로 나타났다. 관행온실의 딸기 생산량이 더 높게 나타났으며, 이는 관행온실의 생육환경이 공기주입온실보다 더 우수한 결과로 판단된다. 난방연료는 공기주입온실에서 더 적게 소모되어 공기주입온실의 단열성능이 더 우수한 것으로 나타났다.

• 한국산학기술학회논문지
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• 제10권1호
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• pp.52-57
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• 2009

본 논문은 실내 외의 온 습도변화에 따른 효율변동을 고려하여 폐열회수 환기장치의 성능을 예측할 수 있는 프로그램을 개발하였다. 국내의 외기조건에서 폐열회수 환기장치의 성능에 대한 기초자료를 얻기 위하여 고효율기자재 인증조건을 만족하는 풍량 $250m^3/h$의 일본 M사의 제품을 선정하였다. 폐열회수 환기장치를 설치할 경우 서울은 난방부하 69.1%, 냉방부하 59.4%의 절감효과가 나타났고, 부산은 난방부하 66.4%, 냉방부하 59.6%의 절감효과가 나타났다. 동절기의 가습부하는 강릉이 3월에 $0.737{\ell}/h$의 최대 가습부하가 발생하고, 하절기의 제습부하는 목포가 8월에 $1.008{\ell}/h$의 최대 제습부하가 발생한다. 동절기에 남부지방과 동해안지역은 배기측에 응축 또는 응결이 발생하지 않으나 그 외의 지역은 발생한다. 따라서 남부지방과 동해안지역을 제외한 지역에서는 동절기에 배기측에 응축 또는 응결이 발생하지 않도록 방지책을 강구하여야 한다.

• Tuberculosis and Respiratory Diseases
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• 제73권3호
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• pp.151-161
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• 2012

Background: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation. Methods: A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG. Results: In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, $1.3{\pm}0.5{\mu}g/kg/min$; day 2, $0.9{\pm}0.4{\mu}g/kg/min$; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; $r_s$=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; $r_s$=0.77), and RASS and BIS ($r_s$=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS. Conclusion: Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.

• 산업융합연구
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• 제17권4호
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• pp.77-86
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• 2019

본 연구는 가정간호기반 호흡관리프로그램이 근위축성 측상경화증으로 가정에서 인공호흡기를 적용하고 있는 환자에게 미충족의료와 의료자원이용에 효과가 있는지를 확인하는 연구이다. 연구대상자는 실험군 19명, 대조군 21명으로 40명이다. Cox의 상호작용모델에 기반을 둔 가정간호기반 호흡관리프로그램은 인지적 동기로 교육, 전문간호, 사례관리, 내적 동기로 기도청결, 흉곽운동, 공기누적운동, 심리적 반응으로 명상과 적극적 경청이다. 이를 실험군은 12주 동안 제공하였고, 대조군은 통상적인 가정간호를 제공하였다. 중재관련변수는 사전, 사후 12주, 24주에 측정하였고, 의료자원이용은 24주에 측정하였다. 연구결과 호흡관리프로그램은 미충족의료정도에는 차이가 없었으나, 의료자원이용정도 중 입원횟수 감소에는 효과가 있었다. 이에 근위축성 측상경화증 환자 호흡관리프로그램은 호흡문제로 인한 의료기관 이용횟수를 감소시켜 환자의 호흡기능 향상에 기여할 수 있을 것이다.

• Neonatal Medicine
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• 제17권1호
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• pp.109-115
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• 2010

신생아의 지속성 폐동맥 고혈압증(PPHN)은 출생 후 폐동맥의 저항이 낮아지고 전신 혈관 저항이 올라가면서 폐로 가는 혈류가 증가하고 난원공과 동맥관을 통한 폐와 전신의 평행 순환에서 연속 순환인 신생아 순환으로 바뀌게 되는 과정에 문제가 있는 것이다. 저자들은 태변흡인이 있었던 두 명의 만삭아에서 고빈도 환기 요법과 흡인성 일산화질소 가스를 이용하여 PPHN을 치료하였으나 치료에 반응하지 않고 전신 장기에 산소화가 문제가되어 정맥-정맥도관체외막형산소섭취(V-V ECMO)를 시행하였고 두 증례 모두 체외막형 산소 섭취를 이탈하여 생존할 수 있었다. 현재까지 태변 흡인 증후군에 의해 생긴 PPHN 환아들에서 ECMO를 적용하여 치료한 국내 보고가 없고, 특히 V-V ECMO 적용으로 신생아를 치료한 보고 또한 없다. 이에 저자들은 태변 흡입 증후군에 의해 생긴 PPHN 환아들에서 V-V ECMO로 생존한 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국건설순환자원학회논문집
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• 제6권1호
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• pp.103-110
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• 2011

본 연구는 폐콘크리트로부터 발생한 성토 복토용 순환잔골재의 pH 저감을 목적으로 자연적 처리 방법 및 인위적 처리 방법을 이용하여 순환잔골재의 pH 저감특성을 비교 분석 하고자 하였는데, 그 결과를 요약하면 다음과 같다. 실내방치된 순환잔골재의 경우는 사람의 호흡 등 대기중 높은 $CO_2$농도로 인해 실외방치된 순환잔골재보다, 또한 쌓기 두께가 얇을수록 pH를 저감시킨 것으로 분석된다. 공기투과의 경우 비교적 순환잔골재의 pH저감이 효과적이었는데 이는 고압의 환풍기로 인해 순환잔골재에 원활한 $CO_2$ 공급으로 pH를 저감시킨 것으로 판단된다. 살수처리의 경우 미수화 시멘트의 수화반응을 촉진시켜 수산화칼슘을 용해시키고, 건조과정중 대기중 $CO_2$에 의한 중성화로 pH를 크게 저감시키는 것으로 나타났으며 침수처리에서는 pH 저감 효과가 미흡하였다. $CO_2$촉진의 경우 순환잔골재의 pH저감 효과가 가장 우수한 것으로 나타났는데, 이는 원활한 $CO_2$공급이 가능하기 때문인 것으로 분석된다. 이상의 실험 결과를 종합하면, pH 저감성능, 경제성 및 작업성 측면을 고려할 경우 순환잔골재 질량비 1: 0.5 비율로 살수한 다음, 강제적인 $CO_2$가스의 처리로 건습을 반복한다면 순환잔골재의 pH저감에 가장 효과적인 방법이 될 것으로 분석된다.

• 임상간호연구
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• 제26권2호
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• pp.207-216
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• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• Tuberculosis and Respiratory Diseases
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• 제70권1호
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• pp.36-42
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• 2011

Background: Adaptive support ventilation (ASV), an automated closed-loop ventilation mode, adapts to the mechanical characteristics of the respiratory system by continuous measurement and adjustment of the respiratory parameters. The adequacy of ASV was evaluated in the patients with acute lung injury (ALI). Methods: A total of 36 patients (19 normal lungs and 17 ALIs) were enrolled. The patients' breathing patterns and respiratory mechanics parameters were recorded under the passive ventilation using the ASV mode. Results: The ALI patients showed lower tidal volumes and higher respiratory rates (RR) compared to patients with normal lungs ($7.1{\pm}0.9$ mL/kg vs. $8.6{\pm}1.3$ mL/kg IBW; $19.7{\pm}4.8$ b/min vs. $14.6{\pm}4.6$ b/min; p<0.05, respectively). The expiratory time constant (RCe) was lower in ALI patients than in those with normal lungs, and the expiratory time/RCe was maintained above 3 in both groups. In all patients, RR was correlated with RCe and peak inspiratory flow ($r_s$=-0.40; $r_s$=0.43; p<0.05, respectively). In ALI patients, significant correlations were found between RR and RCe ($r_s$=-0.76, p<0.01), peak inspiratory flow and RR ($r_s$=-0.53, p<0.05), and RCe and peak inspiratory flow ($r_s$=-0.53, p<0.05). Conclusion: ASV was found to operate adequately according to the respiratory mechanical characteristics in the ALI patients. Discrepancies with the ARDS Network recommendations, such as a somewhat higher tidal volume, have yet to be addressed in further studies.

• 대한임상독성학회지
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• 제16권2호
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• pp.75-85
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• 2018

Purpose: This study examined the Poisoning Severity Score (PSS) from acute poisoning patients, to determine the relationships among the PSS, PSSsum, the primary outcome (prolonged stay at the ER over 24 hours, general ward and ICU admission and the application of intubation and mechanical ventilator, and the administration of inotropes). Methods: A retrospective study was conducted through the EMR for 15 months. The PSS grade was classified according to the evidence of symptoms and signs. The differences in the primary outcomes between the PSS of when a single organ was damaged, and the PSS, PSSsum combined with the grade of when multiple organs were damaged, were studied. The cutoff value was calculated using the receiving operating characteristics (ROC) curve. Results: Of the 284 patients; 85 (29.9%) were men with a mean age of 48.8 years, and their average arrival time to the ER was $4.4{\pm}6.7\;hours$. The most frequently used drug was hypnotics. The number of patients with PSS grade 0, 1, 2, 3, and 4 was 17, 129, 122, 24, and one, respectively. No ICU admissions, application of intubation and mechanical ventilators, administration of inotropes were observed among the patients with PSS grades 0 and 1 but only on patients with PSS grades 2 to 4. At PSS, when separating the patients according to the number of damaged organs, 17 had no symptoms, 133 had one organ damaged, 75 had two organs damaged, 36 had three organs damaged, and 23 had four organs damaged. Significant differences were observed between increasing number of damaged organs and the primary outcome. Conclusion: Among the acute poisoning patients, the PSS was higher in severity when the grade was higher. The number of damaged organs and the primary outcome showed meaningful statistical differences. This study confirmed that when the patients' PSS>2 and PSSsum>5, the frequency of ICU admission was higher, and they were considered to be severe with an increased prescription risk of application of intubation and mechanical ventilator, and the administration of inotropes.