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뇌실외 배액술 시행과 관련된 뇌실염 : 원인균주와 경험적 치료약제의 적절성
도병훈,김신우,오종택,손종원,하상우,이응갑,장현하,이종명,김능수 대한감염학회 2005 감염과 화학요법 Vol.37 No.2
목적 : 본 연구는 뇌실외 배액술을 시행한 신경외과 환자들에서 뇌실염 발생 빈도, 원인균주와 감수성 추이 및 경험적 치료로 사용되는 항생제인 ceftazidime과 vancomycin의 적절성 여부에 대하여 조사하였다. 재료 및 방법 : 2000년 12월부터 2003년 10월까지 EVD를 시행한 경북대학교병원 신경외과 입원환자 340명 중 뇌실염이 발생한 39명을 대상으로 후향적으로 조사하였다. 결과 : 340명 중 39예 (11.5%)에서 뇌실염이 발생하였고 이들 가운데 4명이 뇌실염과 연관하여 사망하였다(10.3%). EVD 시행일로부터 뇌실염 발생까지는 평균 8.4일이었다. 원인균은 33예(87.1%)에서 확인되었으며 Aci-netobacter (19예, 45%), methicillin-resistant coagulase negative Staphylococcus (9예, 22%), methicillin-resistant Staphylococcus aureus (9예, 22%) 등의 순이었다. 가장 많이 동정된 Acinetobacter 19예 중에서 8예(42.1%)가 ceftriaxone에 내성을 보였으며 현재 경험적으로 널리 사용되는 ceftazidime에 대해서는 11예중 3예(27%)가 내성을 보였다. 결론 : 최근 EVD 시행과 관련된 뇌실염 뇌실염 최근 그람음성 non-fermenter 특히 Acinetobacter에 의한 경우가 증가하고 있으며, 이들 그람음성 non-fermenter는 현재까지 경험적으로 사용되는 ceftazidime에 점차 내성을 보이고 있다. 경험적 치료제에 대한 성공률을 높이기 위해서는 각 병원별 내실염의 원인균주의 감수성에 대한 검사가 필요하겠다. Purpose : To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. Materials and Methods : Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. Results : Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows : Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. Conclusion : These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.
응급실에서 급성 췌장염 환자의 선별을 위한 actim pancreatitisR검사의 유용성
송석훈,도병수,이삼범 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4
Background: Acute pancreatitis is a fairly common abdominal disorder that can be easily confronted in the emergency department(ED) and is one of the most complex and clinically challenging of all abdominal disorders. Currently, there is no gold standard for the diagnosis of acute pancreatitis. We evaluated the usefulness of the actim Pancreatitis□ rapid test, which has been recently developed in Europe, as a screening test of acute pancreatitis in our emergency department. Methods: We prospectively studied the urinary trypsinogen-2 dipstick tests(actim Pancreatitis□, Medix Biochemica, Kauniainen, Finland) of 200 patients with acute abdominal pain who were treated at our ED. All urine samples were collected from the patients within 12 hours of arrival at ED. We also measured serum amylase assay in the laboratory and compared the sensitivities and the specificities of the two test. Acute pancreatitis was diagnosed by authors according to standardized criteria. Abdominal USG or CT was performed when a patient with a normal serum amylase level had a typical clinical presentation. Results: The actim Pancreatitis□ rapid test was positive in 22 of the 25 patients with acute pancreatitis(sensitivity, 88.0 percent). The test was also positive in 6 of 175 patients without pancreatitis(specificity, 96.6 percent). The serum amylase assay had a sensitivity of 68.0 percent(with a cutoff value of 300 U per liter for the upper reference limit) and a specificity of 90.9 percent. But there were no statistical differences between the correlation coefficients of the two tests as diagnostic tool Conclusion: In patients with acute abdominal pain who are seen in the emergency department, the actim Pancreatitis□ urinary dipstick test has a high degree of probability as a screening test for acute pancreatitis. Also it can easily and rapidly be use at the bedside.
측정오차와 외란을 고려한 유도전동기의 강인한 속도제어에 관한 연구
蔡英茂,尹炳道,金燦起,鄭憲主 충주대 산업과학기술연구소 1995 産業科學論文集 Vol.3 No.-
It is difficult to control industrial drive systems because of load disturbance, parameter variation and measurement noise. So a theorem is required to have robustness for the measurement noise and disturbance. This paper is among the researches of solving these problems. Sliding mode state observer is robust for measurement noise, modeling-error and load disturbance. The pole of sliding mode state observer can be placed at (0,0) in Z-plane for fast response. This method is, namely, deadbeat control. One side, sliding mode state observer output is discontinuous on a switching hyperplance, that causes harmful effects such as current harmonics and speed oscillation. In this paper, also the reducing method of the chattering of sliding mode state observer output is proposed. In this paper, the method of designing a robust sliding mode state observer taking account of the ability of disturbance and noise attenuation is proposed. Also, the proposed control system is digitally implemented with TMS320C31.
김윤수,박수우,임병훈,김태균,최병재,박철영,이문락,도용태 대구대학교 정보통신연구소 2008 情報通信硏究 Vol.5 No.1
Metal balls are commonly used in mechanical elements and systems including bearings. If there is a defect in a metal ball, it can cause a serious machine failure. By this reason every balls produced are required to be inspected, and the inspection is usually done by human eyes. However, the inspection by human eyes is always with the risk of mistakes, and a need to automate the inspection process is arisen. This paper describes a design of an automatic inspection system for detecting defects on ball surface. A machine vision system is used, and design process and techniques are described in detail. 강구는 베어링을 비롯한 기계 요소 및 장치에서 널리 사용되는 부품이다. 만약 강구에 결함이 있을 시, 이를 사용하는 기계에서 치명적인 결함이 초래될 수 있다. 따라서 제조된 강구에 대해서는 전량검사가 요구되고 있고, 검사과정은 사람의 육안에 의한 검사가 주를 이루고 있다. 그런데 사람에 의한 검사에는 항상 실수의 가능성이 있으므로, 이를 자동화하는 것이 필요하다. 본 논문에서는 강구의 표면 결함을 자동적으로 검사할 수 있는 장치를 설계한다. 기계시각 장치가 사용되었고, 설계에 따른 구체적 절차와 기술들이 서술된다.
석탄회 인공경량골재를 사용한 고강도 철근콘크리트 보의 휨거동
송병훈 ( Song Byung-hun ),한병찬 ( Han Byung-chan ),성수용 ( Sung Soo-yong ),윤현도 ( Yun Hyun-do ),최창식 ( Choi Chang-sik ),정수영 ( Chung Soo-young ) 한국구조물진단유지관리공학회 2000 한국구조물진단유지관리공학회 학술발표대회 논문집 Vol.4 No.2
This investigation provides experimental data regarding the flexural behavior and ductilities of reinforced high-strength lightweight concrete beams. The objectives of this study are (1)to study the flexural behavior of reinforced high-strength lightweight concrete beams and (2)to examine current ACI recommendations for flexural design in terms of strength and ductility. Test results show that the ratio of flexural strength between experimental results and those by ACI 318-95 is 1.01 in case of lightweight concrete. Also, When concrete compressive strength is 400kgf/cm<sup>2</sup> in reinforced high-strength lightweight concrete beams, the ratio of longitudinal reinforcement to balanced reinforcement needs to be limited to 0.5 in order to obtain 3 in ductility factor.