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On-peak 기간 부하 변동성을 위한 ESS 충방전 전략
황진솔(Jin Sol Hwang),김정수(Jung-Su Kim) 대한전기학회 2021 대한전기학회 학술대회 논문집 Vol.2021 No.10
하루 중 피크 부하 시간대에 빌딩이 사용하는 전력량을 줄이기 위하여 에너지 저장 장치를 이용하는 방안을 제시한다. 특히, 피크 부하 시간 동안에 예상하지 못한 급격한 부하의 변동성에 대응하기 위하여 두 종류의 에너지 저장 장치를 충방전하는 전략을 제시한다.
임상 ; 선택적 제왕절개술로 출생한 재태연령 35주 이상신생아의 재태연령에 따른 호흡기 이환율
황진솔 ( Jin Sol Hwang ),김세연 ( Sae Yun Kim ),신승한 ( Seung Han Shin ),이주영 ( Ju Young Lee ),김이경 ( Ee Kyung Kim ),김한석 ( Han Suk Kim ),최중환 ( Jung Hwan Choi ) 대한주산의학회 2013 Perinatology Vol.24 No.4
목적: 선택적 제왕절개술로 태어난 재태연령 35주 이상의 신생아에서 재태연령에 따라 호흡기 이환율의 차이가 있는지 알아보고자 하였다. 방법: 2011년 1월부터 2012년 12월까지 서울대학교병원에서 선택적 제왕절개술로 태어난 재태연령 35주 이상의 신생아 443명을 대상으로 후향적 고찰을 통해 조사하였다. 대상 신생아들을 재태연령에 따라 네 군(35+0-36+6주, 37+0-37+6주, 38+0-38+6주, 39+0-40+6주)으로 나누어 호흡기 이환율을 비교하였다. 결과: 1분, 5분 아프가 점수는 후기 조산아(35-36주)군이 만삭아군에 비하여 낮았고, 전자간증 산모의 비율은 재태연령이 증가함에 따라 감소하는 경향을 보였다. 재태연령에 따라 네 군으로 나누어 비교하였을 때, 산소 투여 여부, 24시간 이상 산소 투여, 흉부방사선 촬영, 신생아 일과성 빈호흡, 신생아 중환자실 전동, 기관내 삽관, 기계적 환기요법 적용등 모든 항목에서 유의한 차이가 있었다(P<0.05). 재태연령간 호흡기 이환율을 비교하였을 때, 재태연령 35-36주인 군은 38주인 군보다 신생아 일과성 빈호흡(122.5배), 신생아 중환자실 전동(54.0배), 기계적 환기요법 적용(99.5배) 의 위험도가 높았으며, 재태연령 37주인 군도 38주인 군보다 신생아 일과성 빈호흡(8.8배), 신생아 중환자실 전동(5.3배), 기계적 환기요법 적용(8.4배) 의 위험도가 높았다(P<0.05). 재태연령 38주인 군과 39-40주인 군 사이에는 호흡기 이환율의 유의한 차이가 없었다. 결론: 선택적 제왕절개술의 시기를 재태연령 38주 이후로 늦추는 것이 신생아 호흡기 이환율을 줄이는데 도움이 될 수 있을 것으로 생각된다. Purpose: We evaluate respiratory morbidities in infants beyond 35 weeks of gestation born via elective cesarean section by gestational age. Methods: This is a retrospective study of 443 infants who were born at Seoul National University Hospital by elective cesarean section beyond 35 weeks of gestation from January 2011 to December 2012. We compared respiratory morbidities in four groups classified by gestational age (35+0-36+6 weeks, 37+0-37+6 weeks, 38+0-38+6weeks, 39+0-40+6 weeks). Results : There were significantly lower Apgar scores in the late-preterm infant group (35-36 weeks) compared to other term infant groups and the proportion of infants born from mothers with preeclampsia gradually decreased as gestational age increased. There were significant differences in O2 supplement, duration of O2 (>24hours), checked chest radiography, transient tachypnea of newborn (TTN), transfer to neonatal intensive careunit (NICU), end otracheal intubation, and ventilator uses including nasal continuous positive airway pressurein four groups (P <0.05). By logistic regression analysis, compared to births at 38 weeks, births at 35-36 weeks and at 37 weeks were associated with an increased risk of respiratory morbidities [odds ratios (OR) and 95%confidence intervals (CI) for births at 35-36 weeks, 122.5 (17.4-863.4) for TTN; 54.0 (10.1-289.4) for transfer to NICU; 99.5 (14.9-666.2) for ventilator apply; OR and 95% CI for births at 37 weeks, 8.8 (1.6-50.1) for TTN;5.3 (1.1-24.7) for transfer to NICU; 8.4 (1.5-47.7) for ventilator apply; P <0.05]. There were no significant differences in respiratory morbidities between births at 38 weeks and births at 39-40 weeks. Conclusion: Postponing the timing of elective cesarean section to beyond 38 weeks of gestation would be helpful in reducing the neonatal respiratory morbidities.
이봉진,황진솔,최유현,한영주,최영훈,박준동 대한중환자의학회 2013 Acute and Critical Care Vol.28 No.4
Disseminated neonatal herpes simplex virus (HSV) infection is one of the most severe neonatal infections, and can have devastating consequences without early proper treatment. However, the administration of acyclovir can often be delayed because the symptoms and signs of HSV infection are non-specific and because HSV polymerase chain reaction (PCR) results may be negative early in the course of HSV infection. We report a case of disseminated neonatal HSV infection that was diagnosed by type 1 HSV PCR on day 8 of admission. Despite delayed administration of acyclovir, the patient was cured and subsequently discharged after 30 days of admission. Fortunately, this patient was treated successfully, but delayed administration of acyclovir has the potential to lead to significant problems. Considering the seriousness of neonatal HSV infection, empirical acyclovir therapy should be considered if HSV infection is suspected.
만성육아종질환 환자에서 합병된 식도 폐쇄 사례 -만성육아종질환의 육아종성 식도 폐쇄
김지수,황진솔,최영훈,김우선,김중곤,Kim, Ji Soo,Hwang, Jinsol,Choi, Young Hun,Kim, Woo Sun,Kim, Joong Gon 대한소아감염학회 2014 Pediatric Infection and Vaccine Vol.21 No.1
CGD 환자에서는 면역 체계의 결함으로 인한 반복적인 감염과 육아종 형성이 특징적이다. CGD 환자에서 육아종의 형성에 의한 식도 폐쇄는 매우 드문 합병증 중 하나로 CGD 환자의 육아종 형성에 의한 식도 폐쇄의 치료에 대해서는 불현성 감염이 동반될 가능성이 있어 스테로이드 치료와 항생제 치료에 대한 논란이 있어왔다. 저자들은 항생제 치료에 반응하지 않는 육아종 형성에 의한 식도 폐쇄 증상을 보인 8세 만성육아종질환 환자를 보고하는 바이다. 환자는 스테로이드 치료 이후에 임상적 증상과 영상 검사 상의 급격한 호전을 보였으나 스테로이드 치료를 중단한 지 한 달 뒤 환자의 식도 폐쇄 증상은 재발하였고, 이는 스테로이드를 재 투약 후 호전되었다. 스테로이드 중단 이후 한 차례 다시 재발하였으나, 항생제 치료 후 호전되었고 이후 추가적 재발 없이 경과 관찰 중이다. Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
급성 세기관지염 영아에서 관찰된 임상 지표들과 질환의 중증도의 연관성
김경훈 ( Kyung Hoon Kim ),황진솔 ( Jin Sol Hwang ),송준혁 ( Jun Hyuk Song ),이윤식 ( Yun Sik Lee ),권지원 ( Ji Won Kwon ),서동인 ( Dong In Suh ),박준동 ( June Dong Park ),고영률 ( Young Yull Koh ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4
Purpose: We aimed to verify whether the formal clinical index derived from infants and toddlers have a good association with the disease severity when we confine subjects to only infants, who undergo profound changes physically and immunologically. Methods: We retrospectively reviewed the medical records of hospitalized infants with acute bronchiolitis caused by respiratory syncytial virus between January 1, 2010 and December 31, 2011 in three hospitals. The age, respiratory rate, presentation of chest retraction, and percutaneous oxygen saturation upon admission; presentation of fever, use of oxygen therapy and inhaled corticosteroid within 24 hours after admission were investigated. We then examined the effect of clinical index on severity of acute bronchiolitis; the mean length of stay, mean duration of fever and oxygen therapy. Results: A total of 172 infants were studied. The mean length of stay was longer in patients younger than 3 months (P=0.015), in those with fever (P=0.028) and chest retraction (P=0.014), and in those who needed oxygen supplement (P=0.000). In the patients with fever, the mean duration of fever was longer in those who needed the oxygen supplement than those who did not (P=0.046). Conclusion: Younger than 3 months of age, chest retraction upon admission; fever, need of oxygen supplement within 24 hours after admission may predict the severe course of infants with acute bronchiolitis.
급성 세기관지염 영아에서 관찰된 임상 지표들과 질환의 중증도의 연관성
김경훈 ( Kyung Hoon Kim ),황진솔 ( Jin Sol Hwang ),송준혁 ( Jun Hyuk Song ),이윤식 ( Yun Sik Lee ),권지원 ( Ji Won Kwon ),서동인 ( Dong In Suh ),박준동 ( June Dong Park ),고영률 ( Young Yull Koh ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4
Purpose: We aimed to verify whether the formal clinical index derived from infants and toddlers have a good association with the disease severity when we confine subjects to only infants, who undergo profound changes physically and immunologically. Methods: We retrospectively reviewed the medical records of hospitalized infants with acute bronchiolitis caused by respiratory syncytial virus between January 1, 2010 and December 31, 2011 in three hospitals. The age, respiratory rate, presentation of chest retraction, and percutaneous oxygen saturation upon admission; presentation of fever, use of oxygen therapy and inhaled corticosteroid within 24 hours after admission were investigated. We then examined the effect of clinical index on severity of acute bronchiolitis; the mean length of stay, mean duration of fever and oxygen therapy. Results: A total of 172 infants were studied. The mean length of stay was longer in patients younger than 3 months (P=0.015), in those with fever (P=0.028) and chest retraction (P=0.014), and in those who needed oxygen supplement (P=0.000). In the patients with fever, the mean duration of fever was longer in those who needed the oxygen supplement than those who did not (P=0.046). Conclusion: Younger than 3 months of age, chest retraction upon admission; fever, need of oxygen supplement within 24 hours after admission may predict the severe course of infants with acute bronchiolitis. (Allergy Asthma Respir Dis 2013;1:377-382)