2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

한방 이화주의 미백 및 피부 주름 개선 효과

이상진(Sang-Jin Lee),권이영(Yi-Young Kwon),조성원(Sung-Won Cho),권희숙(Hee-Suk Kwon),신우창(Woo-Chang Shin) 한국식품영양과학회 2013 한국식품영양과학회지 Vol.42 No.4

본 연구에서는 한방이화주의 피부 생리기능 활성을 알아보기 위해 70% EtOH 추출물의 피부 미백, 주름 개선 및 항염증 효과를 조사하였다. HEE은 tyrosinase 활성 억제 및 tyrosine을 기질로 melanin이 형성되는 pathway에 관여하는 주요한 인자인 TRP-1과 TRP-2를 저해하는 작용 기전을 통해 피부 색소침착의 주요 원인 물질인 melanin 생합성을 농도 의존적으로 저해하는 것을 확인하였다. HEE은 피부진피 내 피부 탄력을 유지하는 elastin을 분해하는 효소인 elastase의 활성을 저해하였고, 피부의 keratinocyte가 생성분비하는 MMP-2와 MMP-9의 단백질 발현과 proteolytic 활성을 억제하여 노화에 따른 피부 주름 생성 억제할 수 있는 가능성을 확인하였다. 또한 세포 독성 없이 LPS에 의해 유도된 염증 반응을 50% 저해하는 HEE의 농도(IC50)는 24.9 μg/mL이며, 50 μg/mL 농도로 처리하였을 때 염증 반응 저해 효과가 70%로 높은 효과를 가지는 것을 확인하였다. 이상의 결과를 종합하면 HEE의 피부 미백, 주름 개선 및 항염증에 우수한 효과를 나타내고 있으므로 기능성 화장품의 주요한 소재로 이용 가치가 높을 것으로 사료된다. Extrinsic skin aging is characterized by the loss of skin tone and resilience, irregular pigmentation, and deep wrinkles. The aim of this study was to investigate the effects of Ehwa Makgeolli containing oriental herbs (Glycyrrhiza uralensis Fisch., Lycium chinense MILL., Morus alba L., and Saururus chinensis Baill) on skin whitening and wrinkling in human skin cells. We prepared Makgeolli extracts (HEE) with 70% ethanol. HEE significantly inhibited in vitro mushroom tyrosinase activity and reduced the cellular and secreted melanin content of mouse melanoma melanocytes (B16F1 cells). HEE down-regulated the protein expression of tyrosinase related protein (TRP)-1/-2, a key player in melanogenesis. Treatment with HEE in human keratinoctyes (HaCaT cells) inhibited the proteolytic activities of matrix metalloproteinase (MMP)-2/-9 in a dose-dependent manner and dramatically reduced the expression of MMP-2/-9. In addition, HEE attenuated lipopolysaccharide (LPS)- induced nitric oxide production in murine macrophages (RAW264.7 cells). These results indicate that HEE may be a great cosmeceutical ingredient for its whitening, anti-wrinkle, and anti-inflammatory effects.

Performance of electrochemical double layer capacitors using highly porous activated carbons prepared from beer lees

Sang Guk Lee,Hee Moon,Kwang Hyun Park,심왕근,M.S. balathanigaimani 한국공업화학회 2011 Journal of Industrial and Engineering Chemistry Vol.17 No.3

Beer lees precursor is chosen to prepare activated carbons having different physical and chemical properties. The beer lees-based activated carbons (BL-ACs) are characterized by N2 adsorption/desorption isotherms, adsorption energy distributions (AEDs), and X-ray photoelectric spectroscopy (XPS). Furthermore the electrochemical properties of the BL-ACs are assessed using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and constant current charge/discharge method. The maximum specific capacitance (about 188 F/g at discharge current of l mA/cm2) is obtained in 0.1 M H2SO4 electrolyte solution, which is a relatively low electrolyte concentration. The overall results suggest that the BL-ACs are good candidates for EDLC electrode materials.

평면형 Bi-Sb 다중접합 열전변환기의 특성

이현철,유호종,김진섭,함성호,신장규,이종현,이정희,권성원,박세일 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

A planar Bi-Sb multijunction thermal converter for the precise measurements of ac voltage and current has been fabricated and its characteristics was discussed. In order to convert ac power into heat, a bifilar thin film Pt-heater, which could cancel its Thomson and Peltier effects, was prepared on the Si_(3)N_(4)/SiO_(2)/Si_(3)N_(4) diaphragm for the thermal isolation between heater and silicon substrate. To convert the temperature or the heat generated by the heater into dc voltage and current, hot and cold junctions of the Bi-Sb thermopile, which has a large difference in Seebeck coefficients, were formed on the dielectric diaphragm and the silicon substrate, respectively. The respective thermal sensitivity of the thermal converter with a bifilar heater was about 10.1 mV/mW and 14.8 mV/mW in the air and vacuum, which is about eight times higher than that of commercial 3-dimensional thermal converter. In the case of ac 2 V-input voltage, the ac-dc voltage transfer difference was about ±2.0 ppm, and in the case of ac 10 mA-input current, the ac-dc current transfer difference was about ± 0.6 ppm, in the frequency range from 10 Hz to 10 kHz.

정수처리공정상 염소소독부산물형성에 미치는 오존의 영향

성낙창,박현석,이성식,이용희,이종팔,윤태경 한국환경과학회 2004 한국환경과학회지 Vol.13 No.1

The effect of ozone on the formation and the removal of disinfection byproducts(DBPs) of chlorination process was studied to elucidate the performance of water treatment process. The samples of raw water, prechlorination process, and preozonation process were analyzed quantitatively according to the Standard Methods for the Examination of drinking water. As a result, most of total trihalomethanes(THMs) which were formed in prechlorine treatment process was not removed in the preozonation process. Most of haloacetic acids(HAAs), haloacetonitriles(HANs), and chloral hydrate(CH) was removed in sedimentation and biological activated carbon(BAC) filtration processes. However, DBPs were increased more or less by postchlorine step. In particular, the formation of THMs and HAAs depends on ozone more than chlorine, but, the formation of HANs and CH depends on chlorine more than ozone. The seasonal variation of DBPs concentration for the year needs to be investigated to study the temperature effect because DBPs strongly depend on temperature among various efficient factors.

백혈병환자에서 Liposomal Amphotericin B로 치료된 파종성 Fusarium 감염 1예

이지연,김성범,박대원,신성희,김용현,윤소영,엄중식,최철원,정희진,김우주,김준석,김장수,이갑노 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

Fusarium spp.는 사람에서 드물게 각막염, 조갑진균증, 상처나 화상부위감염 등을 유발하는 것으로 알려져 있으나 최근에는 면역저하자에서 기회감염의 원인균으로 증가하고 있는 추세이다. 면역저하자에서 파종성 감염이 있는 경우에 예후는 치명적이나, 증례가 많지 않고 진단방법이 제한되어 있어 조기 진단과 신속한 치료가 쉽지 않다. 그러나 특징적으로 피부병변의 동반이 흔하여 면역저하자에서는 피부 병변의 면밀한 관찰과 함께 Fusarium 감염을 조기에 의심하여 피부생검이나 배양을 하는 것이 진단에 도움이 되리라 생각된다. 파종성 Fusarium 감염의 치료로는 감염 부위의 국소적 외과적 절제와 전신적 항진균제의 사용이 필요하고 현재까지는 amphotericin B가 비교적 효율적인 항진균제로 알려져 있으나 면역저하자에서 이에 반응을 하지 않는 경우가 많다. 저자들은 급성골수성백혈병 환자에서 관해유도화학요법 시행 후 호중구감소상태에서 피부병변과 폐침윤이 발견되었고 피부의 중심부 궤양을 동반한 구진성 병변에서 배양검사를 통해 파종성 Fusarium 감염을 진단하였으며 liposomal amphotericin B (AmBisome )를 사용하여 성공적으로 치료한 예를 경험하여 보고하는 바이다. Fusarium spp., basically a superficial pathogen, is a newly emerging fungal pathogen of opportunistic infections in immunocompromised patients. At present, although Fusarium spp. are relatively resistant to amphotericin B, the combination of amphotericin B and surgical debridement appear to be optimal treatment for disseminated infection. Recently we experienced a 32-year-old neutropenic patient after induction chemotherapy for acute myelocytic leukemia presented with skin lesions and infiltrations in both lungs. We diagnosed with disseminated fusariosis by skin culture and successfully treated the patient with liposomal amphotericin B. We emphasize a high index of suspicion for skin lesions especially in immunocopromised patients.

한국에서의 간질의 사회적 낙인

이상암,유희정,허경,박형국,신동진,송홍기,정원영,권오영,이성수,김요식,김성은,이병인 대한간질학회 2002 대한간질학회지 Vol.6 No.2

Antigastritis effects of <i>Armillariella tabescens</i> (Scop.) Sing. and the identification of its anti-inflammatory metabolites

Lee, Seulah,Lee, Dahae,Park, Jun Yeon,Seok, Soonja,Jang, Tae Su,Park, Hyun Bong,Shim, Sang Hee,Kang, Ki Sung,Kim, Ki Hyun Pharmaceutical Society of Great Britain 2018 Journal of pharmacy and pharmacology Vol.70 No.3

임상 검체에서 분리된 nontyphoid Salmonella에서의 integron의 빈도와 특징

이정은,박수진,김성한,김미나,이남용,이복권,이상오,김양수,우준희,최상호 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

Background : Nontyphoid Salmonella (NTS) is a leading cause of human food-borne enteritis, It has been known that integron, a naturally occurring gene capture and expression element, Plays an important role in the development and dissemination of multidrug-resistance. In this study, we investigated the prevalences and molecular characteristics of integrons in NTS clinical strains. Materials and Methods : Between 1995-96 and 2000-03, a total 261 NTS clinical strains comprising 39 serotypes were collected from clinical specimens. All strains were serotyped, and the MICs of ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim were determined by agar dilution method. Integrons were detected by PCR amplification of integrase genes, and gene cassettes were determined by PCR and sequencing, Conjugation experiments were performed using E. coli J53 as a recipient. The clonal relationship was analyzed by pulsed-field gel electrophoresls (PFGE). Results : Of the 261 strains tested, class 1 integrons were present in 21 strains (8.0%). Class 2 and class 3 integrons were not found. The integron-positive rate was higher in S. Typhimurium (24.2% [8/33]) than in S. Enteritidis (2.0% [3/153]). Overall rates of antimicrobial resistance were higher in integron-positive strains. dhfr12-orfF-aadA2gene cassette was detected in 5 strains, aadA2in 4 strains, dhfr17-orfF-aadA5 in 2 strains, and addA1 in 1 strain. Ten integron-positive transconjugants were successfully selected. Among 8 integron-positive strains of S. Typhimurium, 7 had similar PFGE patterns. Conclusion: This study suggests that integrons are already playing a significant role in antimicrobial resistance in NTS. Continuous monitoring is needed to detect the emergence and spread of integron-mediated antimicrobial resistance.