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.

상염색체우성 다낭신의 임상경과 및 합병증

이상주,이영모,이한규,최대은,박기현,이강욱,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Autosomal dominant polycystic kidney disease(ADPKD) is one of most common hereditary disorder. It is potentially fatal and the major mobilities are hypertension and renal failure. To elucidate clinical characteristics and outcomes of ADPKD, 67 ADPKD patients were analyzed retrospectively. The male to female ratio was 48 years for males and 42 years for females. The factors leading to the dignosis of ADPKD were flank or abdominal pain (46%), palpable abdominal mass (24%), incidental findings (18%), gross hematuria and headache. Urinalysis result showed hematuria (31%), proteinuria (19%), pyuria (18%). Among renal complications hypertension (67%) was the most common. Other complications were urolithiasis (16%) upper urinary tract infection (9%), cyst infection (7%). Azotemia was observed in 24% of cases. Echocardiography showed left ventricular hypertrophy in 24% and valvular regurgitation in 18% of cases, but there was no mital valve prolapse. Cerebrovascular events occurred in 6 cases (2 cases of intervertebral hemorrhage and 4 cases of cerebral infarction). Hipatic cyst were observed in 64% of cases. Eighteen cases culminated in end stage renal failure (ESRF) at an of 47. According to this study, the most common complications of ADPKD was hypertension (67%), ESRF (27%), and cerebrovascular event (9%). Hypertension was more frequently observed in increased creatinine group than normal.

Dongasia-ui Geundaeseong-gwa Seong-ui Jeongchihak : The Modernity and Gender Politics in the East Aisa

Lee, Sung-Eun Ewha Womans University Press 2003 Asian Journal of Women's Studies(AJWS) Vol.9 No.1

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.

정수처리공정에서 소독부산물인 트리할로메탄의 생성모델

이성식,성낙창,이종팔,박현석,정미은,이상준,윤태경 한국환경과학회 2004 한국환경과학회지 Vol.13 No.3

We have been proposed model equation which is able to predict the trihalomethane producing concentration formation, that is one of byproduct, in the water treatment processes. In proposed model, the effects of trihalomethane factors like chlorine contact time, pH, temperature, TOC and UV-254 are considered. The concentration of the trihalomethane produced is proportion to the contact with chlorine, pH of water, temperature of water TOC and UV-254, respectively. This proposed model could be predicted the formed concentration of trihalomethanes by trihalomethane factors.

Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation

Eun-Do Kim,Jin-Kwon Lee,Jin-Kyu Cho,Jae-Myung Kim,Ji-Ho Park,Ju-Yeon Kim,Sang-Ho Jeong,Young-Tae Ju,Chi-Young Jeong,Eun-Jung Jung,Young-Joon Lee1,Soon-Chan Hong,곽승진 대한종양외과학회 2019 Korean Journal of Clinical Oncology Vol.15 No.2

Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H

The Role of Multiple Mediating Effects of SNS Channel between Perceived Quality and Revisit Intention in Coffee Concept Shops

Lee,Jee Eun,Lee,Sang Suk 한국상품학회 2021 商品學硏究 Vol.39 No.5

The purpose of this study is to examine the relationship between the perceived quality and revisit intention of the use of SNS, and then verifies the mediating role of the SNS channel between them. To achieve the purpose of this study, a total of 350 questionnaires were distributed at various coffee concept shops in the Korean metropolitan area (Seoul / Gyeonggi), including global / domestic brands. After removing the response with the missing information, the sample was 320 (91.4%). A structural equation model using AMOS 20.0 tested the hypotheses. Hypotheses are tested and confirmed by analyzing Korean coffee concept shops and the results have shown that information sharing and interaction of SNS play an important role in understanding perceived quality and revisit intention. Moreover, this study empirically verifies that when customers recognize the quality of products, including service and experience quality, they use SNS channels to visit the coffee shop again. The result of the study supported that information sharing and interactivity of SNS played critical roles in understanding perceived qualities and revisit intention. We empirically provide evidence that product quality of perceived qualities has direct positive in fluence on SNS channel and revisit intention. In addition, information sharing and interactivity of SNS channel has indirect significant impacts on intent to revisit. The result of research has shown that product quality had crucial impact on SNSs channel than service or experience quality. The study also shows that increasing the quality level of a product has a positive relationship with social media channels, which in turn can have a positive effect on information sharing and interactions. This study empirically examines that when customers perceive a product quality including service and experience quality, it induces them to use SNS channel, which eventually make them to revisit the store.

내측 측두엽 간질에서 간질발작 중 언어증상

이장준,이승환,이형,김지언,임정근,손은익,이상도,박영춘 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

Background and Objectives : Several speech manifestation are observed in temporal lobe epilepsy(TLE). We studied the frequency of ictal speech manifestations and their localizing and lateralizing value in TLE. Methods : We reviewed 379 seizures recorded on videotape in 135 patients who underwent temporal lobectomy for intractable TLE. We divided patients into group A(n=75) who became seizures free after surgery, and group B(n=60) who were only slightly benefited or unchanged after surgery. Speech manifestations were classified as normal speech, vocalization, or abnormal speech. Abnormal speech was subdivided into speech arrest, dysarthria, dysphasia, or nonidentifiable speech. Results : Speech manifestations occurred in 70(18.5%) seizures of 28 patients. Forty eight seizures of 20 patients were observed in group A, and 22 seizures of 8 patients were observed in group B. In group A, 25 seizures of 11 patients were originating from dominant hemisphere, 23 seizures of 9 patients from nondominant hemisphere. In group B, 13 seizures of 5 patients were originating from dominant hemisphere, and 9 seizures in Lt. side and 6 seizures in Rt. side, respectively) of group A(P>0.05), and eleven seizures of 4 patients(8 seizures from Lt. side and 3 seizure from Rt. side) in group B(P>0.05). Normal speech was observed only seizures from Rt. side in both groups(3 seizures in 1 patient, each group). Dysphasia occurred only in seizures originating from Lt. side. Nonidentifiable speech occurred in 22 seizures of 9 patients(11 seizures from each side) in group A(P<0.01), and 3 seizures of 1 patient occurred only from Lt. side in group B. Conclusion : Ictal speech manifestations were not uncommon(18.5%). All kinds of ictal speech manifestations except normal speech have no reliable lateralizing and localizing value in TLE. Normal speech could be a good indicator of seizure originating from nondominant hemisphere.

한국에서의 간질의 사회적 낙인

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

위신경내분비암 1례

김상일,이정은,윤상미,송홍석,이상숙 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.4

저자들은 67세 남자 환자에서 위부분절제술 시행 후 cisplatin와 etoposide의 복합항암화학요법을 실시한 위신경내분비암 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The existence of gastric neuroendocrine carcinomas had been scarcely recognized. When present, the correct diagnosis is seldom made before surgery. The recognition of these tumors can be problematic for the pathologist. Some of these tumors have "small cell" appearance by light microscopic examination, but others only be called "poorly differentiated carcinoma". But tremendous advances in immunohistochemistry in the last 15 years have yielded powerful tools to the pathologist in diagnosing these tumors. We experienced a case of neuroendocrine carcinoma of the stomach. The patient was a 67-year-old male and visited our hospital with epigastric pain. Subtotally resected stomach showed 3.5×4×5cm sized ulcerated tumor that was located at lesser curvature. Final diagnosis was neuroendocrine carcinoma, which stained positively for synaptophysin immunohistochemically. Herein, we report a case of neuroendocrine carcinoma of stomach and review the literature.