• Pediatric Infection and Vaccine
• /
• 제11권1호
• /
• pp.112-120
• /
• 2004

목 적 : Methicillin 저항 coagulase negative staphylococcus의 감염은 계속 보고되어 왔음에도 불구하고 실제적으로 임상적 중요성이 부각되지 못하였으며 실제 신생아에서 유병률의 큰 원인 중 하나이다. 저자들은 병원감염의 가장 큰 원인 중의 하나인 MR-CNS에 대하여 임상 양상을 알아내고 그 중요성을 재검토 하고자 하였다. 방 법 : 1998년 1월부터 2002년 7월까지 4년 6개월간 한림대학교 강남성심병원 신생아 중환자실에 패혈증으로 입원한 총환아 253명을 대상으로 하여 환아의 병력 및 임상 기록 등을 후향적으로 조사하였다. 주산기 위험요인, 발열, 빈호흡, 빈맥, 호흡곤란 및 그렁거림, 무호흡, 구토 및 설사, 청색증, 황달 등의 임상증상과 제대 동맥이나 제대 정맥 도관과 같은 카데터 삽입유무, 흉관 삽관 유무, 인공호흡기 사용 등의 위험인자를 조사하였으며 항생제 치료 기간, 입원기간 등에 관한 의무기록을 후향적으로 조사하였다. 결 과 : 총 253명 중 MR-CNS 패혈증은 40명(전체 패혈증 환아의 15.8%, 후기 패혈증의 17.7% 포함)이었으며 MR-CNS 패혈증 환아 중 남아가 여아에 비해 1.5배 많았고 감염된 환아들의 출생 시 제태 연령은 평균 $32.4{\pm}4.3$주였다(Table 1). 처음 패혈증 증상을 보여 혈액 배양(MR-CNS 양성)을 실시한 시기는 평균 $10.6{\pm}9.3$일이었다. 임상 증상을 조사했을 때 발열, 호흡 곤란, 청색증, 무호흡, 그렁거림, 황달, 서맥, 구토, 설사, 빈맥의 순으로 많이 나타났으며(Table 2) 병원 감염에의 위험인자로서는 기계호흡 및 유지기간, 카데터 삽입, 항생제 사용기간, 입원기간 등이 있었다. 결 론 : 장기간 입원하는 미숙아의 경우 후기 패혈증이나 병원 감염의 원인 중 MR-CNS는 중요한 원인 균이며 증상과 징후를 보이는 환아에서 혈액 배양 시 MR-CNS 양성일 경우 오염된 결과로 단정해서는 안 된다. 불필요한 항생제 사용의 감소와 카데터 삽입 기간의 감소 및 입원 기간의 단축을 통한 의료의 질적 향상이 중요하다고 생각된다.

• 대한한방내과학회지
• /
• 제30권1호
• /
• pp.24-35
• /
• 2009

Object : In conditions of brain infarction, irreversible axon damage occurs in the central nerve system (CNS), because gliosis makes physical and mechanical barriers. If gliosis formation could be suppressed, irreversible axon damage would be reduced. This could mean that an injured CNS could be regenerated. CD81 and GFAP have close relationships to gliosis. The increase in glial cells at CNS injury gives rise to the expression of CD81 and GFAP. CD81 was postulated to play a central role in the process of CNS scar formation. Method : In this study, the author investigated the effect of the water extract of the Moutan Radicis Cortex on regulation of CD81 and GFAP expression in injured CNS cells. MTT assay was used to examine cell viability, while RT-PCR and ELISA methods were carried out to measure the expression of CD81 and GFAP in the astrocyte. Results : We observed that water extract of the Moutan Radicis Cortex increased cell viability under hypoxia induced by $CoCl_2$ and suppressed the expression of CD81 and GFAP up-regulated by hypoxia. Conclusion : These results suggest that the Moutan Redicis Cortex could promote neural regeneration as a consequence of protecting CNS cells from hypoxia and suppressing the reactive gliosis following CNS injury.

• Geomechanics and Engineering
• /
• 제29권1호
• /
• pp.91-97
• /
• 2022

The cohesive non-swelling soil (CNS) cushion technology has been widely applied in the subgrade and slope improvement at expansive soil regions. However, the mechanism of the inhibition effect of the CNS layer on expansive soil (ES) has not been fully understood. We performed four outdoor model tests to further understand the inhibition effect, including different kinds of upper layer and thickness, under the unidirectional seepage condition. The swelling deformation, soil pressure, and electrical resistivity were constantly monitored during the saturation process. It is found that when a CNS layer covered the ES layer, the swelling deformation and electrical resistivity of the ES layer decreased significantly, especially the upper part. The inhibition effect of the CNS layer increases with the increase of CNS thickness. The distribution of vertical and lateral soil pressure also changed with the covering of a CNS layer. The electrical resistivity can be an effective index to describe the swelling deformation of ES layer and analyze the inhibition effect of the CNS layer. Overall, the CNS deadweight and the ion migration are the major factors that inhibit the swelling deformation of expansive soil.

• 지역사회간호학회지
• /
• 제5권2호
• /
• pp.130-146
• /
• 1994

Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

• 간호행정학회지
• /
• 제3권1호
• /
• pp.65-82
• /
• 1997

The purpose of this study was to investigate the role expectation of Clinical Nurse Specialist(CNS) in A tertiary-affiliated hospital in Seoul. Data were surveyed from Jul. 8, to Jul. 20, 1996. 74 medical doctors and 119 nurses participated in this survey. For data analysis, SPSS/PC+ program was used: ${\chi}2-test$, t-test, ANOVA. The difference was analyzed by the subjects' position and department. The results of this study were summarized as follows: 1. The perception about the CNS system : Most of the subjects of study perceived that the introduction of CNS system was needed. And the introduction time of CNS system was demanded as fast as possible, or after special preparation. 2. The comparison of the need for the subroles of the CNS in A tertiary-affiliated hospital : The need for the subroles(0=not known, 1=not needed to 4=absolutely essential) was significantly different between medical doctors and nurses. The total mean scores for degree of need for each subole were as follows: Education 3.37, Consultant 3.34, Researcher 3.29, Direct care provider 2.86. 3. The comparison of the percent of time spent in A tertiary-affiliated hospital : The percent of time spent was significantly different between medical doctors and nurses. The total mean percent of time spent in the five subroles was as follows: Direct care provider 34.9%, Educator 23.9%, Researcher 18.9%, Consultant 12.8%, and Management/Change agent 9.5% According to the study results, suggestions were made: 1. Further study for the need of the CNS role as direct care provider is needed, after correcting the items within the narrow scope in some clinical department. 2. Development of the detail roles for the extent of autonomy is needed, and validity should be tested. And then they will be used for the basic data of the role development of the CNS.

• 간호행정학회지
• /
• 제5권3호
• /
• pp.535-545
• /
• 1999

The purpose of this study is to investigate the nurses' needs in the general hospitals as a basic study to develop ICU clinical nurse from Aug. 3 to Sept. 26 1998 at 13 general or university hospitals that have ICU nurse training course and are accredited at KNA. The subjects of study were ICU nurses and nurse managers at the department of nursing. The questionnaire items were developed from literature review, interviews with 30 ICU nurses at an university hospital in Pusan. The results were as follows : The subjects of study educated in ICU nurse training course were 44.3% of total. The 93.1% responded the necessity of ICU CNS and 89.1% wanted to have ICU CNS certification. The 43.8% answered that ICU should be a center of CNS education and 32.0% answered the department of nursing. Most of subjects responded that the clinical experience of ICU should be needed prior to CNS education. Regarding the treatment of ICU CNS, the 34.2% of total subjects responded it would be suitable to pay additional allowance and the 28.3% answered to grade-up salary step, and then the 13.7% to promote level position. Concerning the assignment department, the 63.5% answered that the charge nurse would be proper than general nurse or head nurse. As to the working time of ICU CNS, the 93.2% responded that D-duty is needed, the 79.5% to E-duty and the 64.4% to N-duty. It is suggested that the consensus of ICU nurses for the concept, the role and the system of ICU CNS is needed.

• Brain Tumor Research and Treatment
• /
• 제6권2호
• /
• pp.73-77
• /
• 2018

Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.

• ETRI Journal
• /
• 제42권6호
• /
• pp.899-911
• /
• 2020

The data in tables are accurate and rich in information, which facilitates the performance of information extraction and question answering (QA) tasks. TableQA, which is based on tables, solves problems by understanding the table structure and searching for answers to questions. In this paper, we introduce both novice and intermediate Korean TableQA tasks that involve deducing the answer to a question from structured tabular data and using it to build a question answering pair. To solve Korean TableQA tasks, we use S3-NET, which has shown a good performance in machine reading comprehension (MRC), and propose a method of converting structured tabular data into a record format suitable for MRC. Our experimental results show that the proposed method outperforms a baseline in both the novice task (exact match (EM) 96.48% and F1 97.06%) and intermediate task (EM 99.30% and F1 99.55%).

• BMB Reports
• /
• 제41권8호
• /
• pp.560-567
• /
• 2008

The importance of lipids in cell signaling and tissue physiology is demonstrated by the many CNS pathologies involving deregulated lipid metabolism. One such critical metabolic event is the activation of phospholipase $A_2$ ($PLA_2$), which results in the hydrolysis of membrane phospholipids and the release of free fatty acids, including arachidonic acid, a precursor for essential cell-signaling eicosanoids. Reactive oxygen species (ROS, a product of arachidonic acid metabolism) react with cellular lipids to generate lipid peroxides, which are degraded to reactive aldehydes (oxidized phospholipid, 4-hydroxynonenal, and acrolein) that bind covalently to proteins, thereby altering their function and inducing cellular damage. Dissecting the contribution of $PLA_2$ to lipid peroxidation in CNS injury and disorders is a challenging proposition due to the multiple forms of $PLA_2$, the diverse sources of ROS, and the lack of specific $PLA_2$ inhibitors. In this review, we summarize the role of $PLA_2$ in CNS pathologies, including stroke, spinal cord injury, Alzheimer's, Parkinson's, Multiple sclerosis-Experimental autoimmune encephalomyelitis and Wallerian degeneration.

• 한국항행학회논문지
• /
• 제20권4호
• /
• pp.285-291
• /
• 2016

CNS/ATM 분야에서 안전 평가는 시스템을 개발하는데 반드시 필요한 개발 활동이다. 현재까지, 안전 평가와 관련된 많은 참고할 만한 자료들이 있으나 CNS/ATM분야에서 무엇을 어떻게 적용해야 할지 명확하게 명시된 자료는 없다. 또 다른 문제는 DO-278A기반으로 소프트웨어를 개발하기 위해서는 개발하고자 하는 소프트웨어에 대한 소프트웨어 보증 수준이 결정되어 있어야 한다. 하지만 개발 보증 수준을 결정하는 체계도 또한 정의되어 있지 않다. 이와 같은 문제를 해결하기 위해 본 논문에서는 ICAO Doc 9689에 정의된 안전 목표 수준을 기반으로 한 위험 평가를 수행하기 위한 방법을 제시한다. 항행 안전 시스템에서 일반적으로 적용 가능하도록 하기 위해 위험 평가 수행 절차를 수학적으로 표현하였으며 위험 평가를 위해 필요한 위험원의 심각도 분류, 발생 확률, 시스템 안전 목표 수준 등을 정의하고 위험 평가를 수행하기 위해 이벤트 트리 분석 절차를 적용하는 방법을 설명하였다.