「논어」의 ‘서(恕)’의 관점으로 본 2015 개정 초등 도덕과 교육과정 분석

조광원 ( Cho Kwang-won ) 한국초등도덕교육학회 2020 초등도덕교육 Vol.0 No.70

도덕적 타락은 현대 사회에서 우리가 극복해야 할 과제이다. 공자가 「논어」에서 강조했던 ‘서(恕)’는 초등 도덕 교육 속에서 배려의 실천원리로서 학습자가 내면의 진정성을 바탕으로 타인과의 관계를 올바르게 맺는 도덕적 행동을 가능하게 할 것이다. 이에 본 연구에서는 서(恕)를 파악하고, 이를 바탕으로 2015 개정 초등 도덕과 교육과정을 분석하고 보완하고자 하였다. 서(恕)의 관점에서 ‘배려’를 핵심가치로 설정한 ‘타인과의 관계’ 영역의 내용 요소, 도덕과 기능, 교과서 활동을 분석한 결과, 7개의 내용 요소, 7개의 도덕과 기능, 13개의 교과서 활동은 서(恕)가 담겨 있었으나, 행동적 측면이 인지적 측면보다 상대적으로 부족하여 이에 대한 보완은 필요할 것으로 보인다. 그리고 교육현장에서 도덕을 가르치는 교사들은 초등 도덕과 교육과정에서 서(恕)에 대한 충분한 이해를 바탕으로 접근하기를 기대해본다. Moral corruption is a task that we must overcome in modern society. The ‘Shu(恕)’ that Confucius emphasized in the Analects of Confucius is a practical principle of consideration in elementary moral education, and it will enable learners to engage in moral behaviors in which the learners establish relationships with others correctly based on their inner authenticity. Therefore, this study attempted to identify ‘Shu(恕)’ and analyze and supplement the 2015 revised elementary school moral subject curriculum. From the point of view of ‘Shu(恕)’, the analysis of content elements, moral skills, and textbook activities in the area of ‘Relationships with others’, which set ‘caring’ as the core value, showed that 7 content elements, 7 moral skills, and 13 textbook activities contained ‘Shu(恕)’, but the behavioral aspect is relatively lacking than the cognitive aspect, and it seems necessary to supplement it. And teachers who teach morality in the field of education look forward to a sufficient understanding of ‘Shu(恕)’ in elementary moral subject curriculum.

시스톨릭 어레이 구조를 갖는 효율적인 n-비트 Radix-4 모듈러 곱셈기 구조

박태근,조광원,Park, Tae-geun,Cho, Kwang-won 한국정보처리학회 2003 정보처리학회논문지 A Vol.10 No.4

본 논문에서는 Montgomery 알고리즘을 기반으로 시스톨릭 어레이 구조를 이용한 효율적인 Radix-4 모듈러 곱셈기 구조를 제안한다. 제안된 알고리즘을 이용하여 모듈러 곱셈을 위한 반복의 수가 감소되었으며, 따라서 n-비트의 모듈러 곱셈을 수행하기 위하여 (3/2)n+2 클럭이 소요된다. 그러나 하드웨어의 이용도를 감안할 때 두 개의 곱셈에 대한 중첩(interleaving) 연산이 가능하며, 가장 빠른 시기에 새로운 곱셈을 시작한다면 하나의 모듈러 곱셈을 수행하기 위하여 평균 n/2 클럭이 필요하다. 제안된 구조는 시스톨릭 어레이 구조의 잇점으로 규칙성과 확장성을 갖기 때문에 효율적인 VLSI 구조로 설계하기가 용이하다. 기존의 다른 구조들과 비교하여 볼 때 제안된 구조는 상대적으로 적은 하드웨어들을 사용하여 높은 수행 속도를 보여주었다. In this paper, we propose an efficient architecture for radix-4 modular multiplication in systolic array structure based on the Montgomery's algorithm. We propose a radix-4 modular multiplication algorithm to reduce the number of iterations, so that it takes (3/2)n+2 clock cycles to complete an n-bit modular multiplication. Since we can interleave two consecutive modular multiplications for 100% hardware utilization and can start the next multiplication at the earliest possible moment, it takes about only n/2 clock cycles to complete one modular multiplication in the average. The proposed architecture is quite regular and scalable due to the systolic array structure so that it fits in a VLSI implementation. Compared to conventional approaches, the proposed architecture shows shorter period to complete a modular multiplication while requiring relatively less hardware resources.

외상 중환자에서 Systemic Inflammatory Response Syndrome(SIRS) 점수와 다른 예후예측 지표들과의 비교

이준호 ( Jun Ho Lee ),이순정 ( Sun Jung Lee ),조광원 ( Kwang Won Cho ),황성연 ( Seong Youn Hwang ),표창해 ( Chang Hae Pyo ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.1

Background: Since the systemic inflammatory response syndrome (SIRS) was first introduced in 1992, it has been well-known as an significant indicator to predict the level of severity and outcomes in medical, surgical and trauma patients for the last ten years. There are several other indicators such as triage Revised Trauma Score (t-RTS), Triage Score (TS), Trauma and Injury Severity Score (TRISS), Acute Physiology and Chronic Health Evaluation (APACHE), and Simplified Acute Physiology Score (SAPS) to predict trauma patients` severity and outcomes, and the authors focused on comparing the SIRS with those five other indicators to predict severity and outcome of traumatic intensive care unit (ICU) patients. Material and Method: The retrospective medical records of four hundred forty one consecutive ICU trauma patients from the emergency center, Masan Samsung Hospital from March 2002 and February 2003 have been carefully examined, and among them, three hundred fifty six were included as the target of this research. The t-RTS, TS and TRISS were calculated based on the record from the emergency center and operating rooms while SIRS, APACHE Ⅱ and SAPS Ⅱ were measured by the data for the first twenty four hours after their ICU hospitalization. The predictability of SIRS and other indicators was evaluated by using two by two decision matrices and receiver operating characteristic (ROC) curve analysis. Result: Using injury severity score 15 as the gold standard, the accuracy of SIRS was higher than t-RTS, yet it was not higher than the one of TS (p<0.01). And the areas under the ROC curves of the SIRS, TS and t-RTS were 0.645±0.073, 0.803±0.054 and 0.766±0.054, respectively (p<0.01 vs. SIRS). Using survival as the gold standard, the accuracy of SIRS was remarkably lower than the ones of TRISS, APACHE Ⅱ and SAPS Ⅱ(p<0.01 vs. SIRS). And the areas under the ROC curves of the SIRS, TRISS, APACHE Ⅱ and SAPS Ⅱ were 0.665±0.052, 0.925±0.023, 0.946±0.025, and 0.965±0.017, respectively(p<0.001 vs. SIRS). Conclusion: The authors concluded that even though SIRS was closely related to death rate and injury severity score, yet its predictability was lower than the ones of other indicators mentioned above.

응급실내 급성 중독 환자들의 예후 예측에 대한 혈액 젖산 수치의 유용성

김혜란 ( Hye Ran Kim ),강문주 ( Mun Ju Kang ),김용환 ( Yong Hwan Kim ),이준호 ( Jun Ho Lee ),조광원 ( Kwang Won Cho ),황성연 ( Seong Youn Hwang ),이동우 ( Dong Woo Lee ) 대한임상독성학회 2016 대한임상독성학회지 Vol.14 No.1

Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients`` condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89- 8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

성인둔상환자에서 평균동맥압과 위해사건발생의 관련성: 단면 조사 연구

차승용 ( Seung Yong Cha ),김용환 ( Yong Hwan Kim ),홍종근 ( Chong Kun Hong ),이준호 ( Jun Ho Lee ),조광원 ( Kwang Won Cho ),황성연 ( Seong Youn Hwang ),이경렬 ( Kyoung Yul Lee ),이영환 ( Young Hwan Lee ),최성희 ( Seong Hee Choi 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.2

Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.

글라이포세이트 중독 환자에서 포함된 염의 종류에 따른 예후의 차이

정민규 ( Jeong Min Gyu ),금경탁 ( Kyoung Tak Keum ),안성준 ( Seongjun Ahn ),김용환 ( Yong Hwan Kim ),이준호 ( Jun Ho Lee ),조광원 ( Kwang Won Cho ),황성연 ( Seong Youn Hwang ),이동우 ( Dong Woo Lee ) 대한임상독성학회 2021 대한임상독성학회지 Vol.19 No.2

Purpose: Glyphosate herbicide (GH) is a widely used herbicide and has been associated with significant mortality as poisoned cases increases. One of the reasons for high toxicity is thought to be toxic effect of its ingredient with glyphosate. This study was designed to determine differences in the clinical course with the salt-type contained in GH. Methods: This was a retrospective study conducted at a single hospital between January 2013 and December 2017. We enrolled GH-poisoned patients visited the emergency department. According to salt-type, patients were divided into 4 groups: isopropylamine (IPA), ammonium (Am), potassium (Po), and mixed salts (Mi) groups. The demographics, laboratory variables, complications, and their mortality were analyzed to determine clinical differences associated with each salt-type. Addtionally, we subdivided patients into survivor and non-survivor groups for investigating predictive factors for the mortality. Results: Total of 348 GH-poisoned patients were divided as follows: IPA 248, Am 41, Po 10, and Mi 49 patients. There was no difference in demographic or underlying disease history, but systolic blood pressure (SBP) was low in Po group. The ratio of intentional ingestion was higher in Po and Mi groups. Metabolic acidosis and relatively high lactate level were presented in Po group. As the primary outcome, the mortality rates were as follows: IPA, 26 (10.5%); Am, 2 (4.9%); Po, 1 (10%); and Mi, 1 (2%). There was no statistically significant difference in the mortality and the incidence of complications. Additionally, age, low SBP, low pH, corrected QT (QTc) prolongation, and respiratory failure requiring mechanical ventilation were analyzed as independent predictors for mortality in a regression analysis. Conclusion: There was no statistical difference in their complications and the mortality across the GH-salt groups in this study.

외상환자의 중증도분류를 위한 Triage Score와 Triage-Revised Trauma Score의 비교

조광원,황성연,배성만 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: The triage-revised trauma score(t-RTS) is used for triage in trauma patients in many countries. Recently, the triage score was developed as a new triage method for trauma patients in Korea. The objective of this study was to assess the accuracy of triage for the t-RTS and the triage score. Methods: The medical records of 1575 consecutive trauma patients visiting the Emergency Center, Masan Samsung Hospital, from March to August 1999 were retrospectively analyzed. The triage score and the t-RTS were taken from the charts completed by the emrgency room doctors and nurses. The accuracies of the two triage methods were compared by using the undertriage and the overtriage rates, receiver operating characteristic(ROC) curve analysis, and a correlation analysis with many physiologic, anatomical, biochemical, and mixed scores(Glasgow coma scale, injury severity score, TRISS, APACHE II and III scores, operation, survival, etc.). Results: The undertriage rates for the triage score and the t-RTS were 22.8% and 38.2%, respectively(p≤0.001), the overtriage rates were 6.3% and 3.1%, respectively,(p≤0.001), and the accurate triage rates were 91.3% and 91.7%, respectively. The areas under ROC curves for the triage score and the t-RTS were 0.871±0.033 and 0.800±0.039, respectively(95% confidence interval, p<0.001). In general, the correlations of the two triage methods with many physiologic, anatomical, biochemical, and mixed scores were moderately high, but there were no statistical differences between the correlation coefficients of the two triage methods for those scores. Conclusion: The triage score was equal or superior to the t-RTS for triage in trauma patients. The former was simpler and could be used easily by emergency medical personnel. Therefore, the authors conclude that the triage score can be used instead of the t-RTS for triage in trauma patients.

외상 중환자의 예후 예측을 위한 TRISS, APACHE Ⅱ, SAPS Ⅱ의 비교

조광원,황성연,홍은석 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: Several statistical models, such as the TRISS, the APACHE Ⅱ and the SAPS Ⅱ scoring systems, have been utilized over the recent decades to accurately predict outcomes in Intensive Care Unit (ICU) trauma patients. This study was performed to evaluate the ability of these three statistical models to predict hospital mortality and to compare the performance of these three statistical models in ICU trauma patients. Methods: Seven hundred forty-seven trauma patients were admitted to the ICU via the emergency center, Masan Samsung Hospital, from March 1999 to February 2001. Of them, 684 patients were included in this study, and their medical records were retrospectively analyzed. The probability of death was calculated for each patient based on the TRISS, the APACHE Ⅱ, and the SAPS Ⅱ equations. Results: The values of the Hosmer and Lemeshow X2 for TRISS, APACHE Ⅱ, and SAPS Ⅱ were 41.32, 43.03, and 17.64, respectively, and all of them underestimated mortality (p<0.05). For two-by-two decision matrices with a decision criterion of 0.5, the specificities and percentages correctly classified of APACHE Ⅱ and SAPS Ⅱ were higher than those of TRISS (p<0.001). For the ROC curve analysis, the areas under the curves (±SEM) of TRISS, APACHE Ⅱ, and SAPS Ⅱ were 0.922±0.011, 0.951±0.011, and 0.957±0.009, respectively (95% confidence interval). The areas under the curves of APACHE Ⅱ and SAPS Ⅱ were larger than that of TRISS (p<0.05 and p<0.01, respectively). Conclusion: All of these three statistical models had good discriminative power, with APACHE Ⅱ and SAPS Ⅱ performing better than TRISS. However, all of them showed poor calibration and underestimated mortality. The authors conclude that a new statistical model is needed to accurately predict hospital mortality in severely injured patients.