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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.
김민지,신수영,송월섭,조수진,최동락,황미진,황진규,박진현,김경,Dennis W. Fell 대구대학교 특수교육재활과학연구소 2011 再活科學硏究 Vol.29 No.1
이 연구는 트레드밀 운동과 키네시오 테이핑의 효과에 따른 폐활량의 변화를 알아보기 위해 26명의 비흡연자가 참가하였으며 키네시오 테이핑을 적용하지 않은 그룹과 키네시오 테이핑을 적용한 두 그룹으로 무작위로 배정하고 각 군들을 주 3회 6주간의 트레드밀 훈련을 실시하였다. 실험 전과 후, 스파이로미터를 사용하여 키네시오 테이핑의 적용 따른 폐활량 변화 효과를 측정하였다. 이 연구의 결과를 종합해보면 키네시오 테이핑을 적용 그룹에서 적용하지 않은 그룹에 비해 FVC, FEV1에서 유의한 증가를 보였다. 이러한 결과는 건강한 성인에서 키네시오 테이핑을 적용한 경우 키네시오 테이핑을 적용하지 않고 트레드밀 운동을 한 경우보다 폐활량의 향상에 효과적이라고 생각되어진다. The purpose of this study was to investigate the variation of vital capacity(VC) according to the effects of kinesio taping with treadmill exercise. Twenty-six non-smokers were participated in this research and these subjects were randomly assigned into two groups. To measure the VC variation effects of kinesio taping, spirometer was used. The collected data were analyzed statistically by using a paired Mauchly test and repeated measure ANOVA. The results of this study were as follows; A group: treadmill with kinesio taping B group: treadmill without kinesio taping. Between A and B, there were significant differences. In the case of A group, there was 11.66% increase of VC, during 3 weeks experiment(p<.01). In the case of B group, there were significant differences, 3.35% increase of VC, during 3 weeks taping intervention(p<.01). After 6 weeks experiment, the improvement of VC shown a significant difference with intergroup (p<.05). From this result, it was revealed that treadmill exercise with kinesio taping was effective to improve VC to healthy adult than treadmill exercise without kinesio taping.
렙토스피라증의 진단에 있어 수동혈구응집반응법과 육안응집반응법의 정확도에 관한 연구
최보율,김영규,이수진,송재철,박항배 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.2
Before 1984, Leptospirosis had been reported sporadically in middle inland of Korea as hemorrhagic pneumonia like disease, epidemic pulmonary hemorrhagic fever or epidemic pneumonitis since 1975. The epidemiologic characteristics of this disease were found out and the agent was isolated microbiologically after a large epidemic in 1984. Thereafter many consecutive studies for leptospirosis had been performed in the realm of epidemiology, microbiology and clinical field. But in order to appropriate control of Leptospirosis there are many problems such as organizing surveillance system for early diagnosis and treatment, identifying sero-group and serovar in each epidemic area and assessing vaccine efficacy. The objectives of this study was to find out easily applicable diagnostic methods to be used in a rural community surveillance system. Two diagnostic methods, passive hemagglutination(PHA) test and macroscopic agglutination test(maAT) were measured against their accuracies, sensitivity, specificity and predictive value of positive and negative. 301 sample sera from 270 human cases was collected through Leptospirossis surveillance system in a rural community during 1989-1992. Microscopic agglutination test(MAT) were used for confirmed diagnosis according to WHO guideline with 4 strains; Icterohemorrhagiae lai and Canicola canicola Hond Utrecht IV as standard strians and 6P-014-1 and YP-35-1 as strains isolated in Korea in 1986. The results are as follows. 1. 75(24.9%) among 301 sample sera and 49(18.1%) among 270 persons was serologically positive with MAT. 2. Agreement between PHA and MaAT was very low(k-coefficient≤0.252). 3. In PHA, specificity was very high(≥0.96) but sensitivity was very low(≤0.28). 4. In MaAT, specificity(≥0.73) was relatively lower than PHA but sensitivity (≥0.79) was significantly higher than PHA, especially false-positive rate case was absent in MAT's high antibody titer(above 1:640). It was concluded that MaAT method was a very useful diagnostic tool for early diagnosis of Leptospirosis in a rural community surveillance system, provided that confirmed diagnosis with MAT method be carried out in laboratory of medical school or research institute such as National Institute of Health or Provicial government Institute of Health and Environment.
Starter 및 멸치액젓 첨가가 김치양념 및 겉절이 김치의 품질에 미치는 영향
최택권,박소희,유진현,임호수,조재선,황성연 한국식생활문화학회 2003 韓國食生活文化學會誌 Vol.18 No.2
양념에 Leu. mesenteroides, Lac plantarum의 젖산균과 멸치액젓 첨가가 김치 양념의 대장균군 제어, 속성촉진여부 및 관능적 특성에 미치는 영향을 조사하였다. Leu. mesenteroides과 젓갈을 첨가한 경우 초기 숙성이 촉진되나 후기 산패는 완만하였으며 Lac. plantarum의 첨가시에는 초기 숙성에는 큰 차이가 없고 후기 산패가 현저하게 진행되었다. 대장균군은 산도 0.80% 이상에서 사멸되었는데 leu. mesenteroides의 경우가 숙성이 촉진되어 보다 신속히 사멸시켰다. 총균수와 젖산균수는 초기에 starter 첨가구는 10^6CFU/mL 정도인데 반해서 starter를 첨가하지 않은 않은 처리구에서 총균수는 10^6CFU/mL , 젖산균수가 10^4CFU/mL 이었고 숙성 후에는 첨가균이 높은 수준을 유지하였다. 하지만 대체적으로 스타터의 첨가가 숙성 및 대장균에 크게 영향을 주지 못하는 경향으로 동일하게 나왔다. 관능적 특성에서는 Leu. mesenteroides 첨가구가 Lac. plantarum의 경우보다 우수하였다. 한편, 시판 겉절이 김치는 산도가 0.09~0.18%, ph 5.46~5.89, 총균수 2.2×10^6~3.1×10^7CFU/mL, 젖산균수는 2.1×10^4~6.6×10^5CFU/mL, 대장균수는 1.8×10^4~7.1×10^5CFU/mL, 염분 1.89%~2.51%으로 스타터 첨가 겉절이에 비해 ph와 염도를 제외한 품질 특성에서 전반적으로 낮은 값을 나타냈다. This study was performed in order to investigate the effect of Leuconostoc mesenteroides, Lactobacillus plantarum and salt fermented anchovy extracts on Kimchi sauce. The sauce was fermented more rapidly by addition of Leu. mesenteroids or salt fermented anchovy extracts on the early fermentation stage than the control, but it was fermented slowly on the late fermentation stage. When L. plantarum was added to the Kimchi on the early fermentation stage, the acidity of Kimchi didn't show a significant difference from the control, but acidity was remarkably increased on the late stage. Coliform group was disappeared when acidity of sauce was higher than 0.8% during fermentation. It was controlled by Leu. mesenteroides but not by L. plantarum. Total count and lactic acid bacterial count of the sauces with starter were 6.30×10^6~1.0×10^7 CFU/mL and 1.04~2.04×10^6 CFU/mL, respectively, but those of the control sauce were 10^6 CFU/mL and 10^4 CFU/mL, respectively. Those count of the sauce with starter were higher than those of the control sauce on the later stage of fermentation. Organoleptic quality of the sauce with Leu. mesenteroides was superior to that with L. plantarum.
횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예
최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2
Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.
일개 대학병원 직원에서 인플루엔자 백신접종 후 이상반응
최새로운,김수미,이진수,김은실,정문현 대한감염학회 2004 감염과 화학요법 Vol.36 No.5
Influenza vaccination on health care workers in a university hospital was conducted using inactivated split vaccines from two pharmaceutical companies (A, B), December 2003. Among 1,880 health care workers, 1,404 (74.7%) were vaccinated and 714 (50.8%) responded to the questionnaires about adverse reactions. Pain and redness at the injection site, febrile sensation, and restricted occupational activities were reported by 316 (44.3%), 141 (19.7%), 169 (23.6%), and 62 (8.7%) participants, respectively. There was no serious adverse events. The incidence of adverse reactions was similar to the previous reports. No statistical difference was detected according to the vaccines company.
魚油함유 飼料에 첨가한 α- 토코페롤의 含量이 흰쥐 血液의 肢質過酸化反應에 미치는 影響
崔鎭浩,金一星,金在一,金東右,朴泉洙,尹泰憲 부경대학교 기초과학연구소 1993 기초과학연구논문집 Vol.4 No.-
어유와 돈지의 혼합지질(3 : 1, wt/wt: P/S : 1.6)에 α-토코페롤을 용량별(0, 50, 100, 200, 400, 800mg/kg diet)로 첨가하여 조제한 어유 함유 사료로써 7주간 사육하여 이 사료에 혼합한 α-토코페롤의 첨가량이 혈청 중의 지질대사에 미치는 영향을 검토하였다. 중성지질(TG)과 인지질의 함량은 α-토코페롤 200mg 이상의 첨가군은 대조군에 비하여 유의적으로 감소하였고, 또한 총콜레스테롤의 함량은 α-토코페롤의 첨가에 따라 감소하는 경향이었지만 낮은 첨가농도에서만 유의성이 인정되었다. HDL-콜레스테롤의 함량은 100mg 이상의 α-토코페롤 첨가군에서 총콜레스테롤에 대한 HDL-콜레스테롤의 비(HDL-chol/T. chol)도 α-토코페롤의 모든 첨가군에서 유의적으로 증가효과가 인정되었다. 따라서 동맥경화 지표가 α-토코페롤 첨가군에서 유의적으로 감소하였다. 중성지질에 대한 과산화지질(TBA value/TG)의 비는 10mg 이상의 α-토코페롤의 첨가군에서 유의적으로 억제되???고, 중성지질에 대한 α-토코페롤(α-tocopherol/TG)의 비는 100mg 이상의 α-토코페롤 첨가군에서 유의적으로 증가되었다(p<0.001). 어유 함유 사료에 α-토코페롤을 첨가함으로써 C20 : 5/C20 : 4의 비를 효과적으로 억제할수 있었다. 따라서 혈액 중의 적절한 지질대사를 위해서는 이들 어유 함유 사료에 100mg 이상의 α-토코페롤이 첨가되어야 할것으로 생각된다. To evaluate the vitamin E requirement, Fischer 344 male rats were fed diets containing the fish oil-lard (3 : I, wt/wt: P/S ratio : 1.6) supplemented with 0, 50, 100, 200. 400 and 800 mg/kg diet of a-tocopherol for 7 weeks. The effects of a-tocopherol levels supplemented to fish oil rich diets on the lipid metabolism in serum were investigated. Triglyceride (TG) and total cholesterol significantly decreased by supplementation of a-tocopherol. The a-tocopherol supplementation of abme 100 mg diet caused an incressis in HDL-cholesterol. and HDL-cholesterol : T. chol ratio, and a decrease in the atherogenic index. The lipid peroxide : TG ratio significantly inhibited by a-tocopherol supplementation of above 100 mg. The ratios of α-tocopherol/TG or n-3 fatty acid (EPA+ DHA) significantly increased in all α-tocopherol supplemented groups. The ratio of eicosapentaenoic acid : arachidonic acid effectively inhibited by a-tocopherol supplementation of above 100 mg. The results suggest that a-tocopherol supplementation of above 100 mg to fish oil-rich diets map be requisite for adequate lipid metabolism.
독거미 Psalmopoeus cambridgei에서 추출한 거미독 펩타이드 독소의 항말라리아 특성
최수진 서울여자대학교 자연과학연구소 2011 자연과학연구논문집 Vol.23 No.-
Two antimalarial peptide toxins, PcFK1 and PcFK 2, isolated from the venom of the tarantula Psalmopoeus cambridgei were reported to inhibit the intra-erythrocyte stage of Plasmodium falciparum, the causative agent of malaria in vitro. In the present study, their selectivity and specificity to the intra-erythrocytic parasite was further investigated. Two peptide toxins were determined to have no significant effect on microorganisms, intracellular parasitic bacterial pathogen Chlamydia trachomatis, and human cervical epithelial cells. Both PcFK1 and PcFK2 did not induce hemolytic effect on red blood cells (RBCs), while they rapidly inhibited the growth of the intra-erythrocyte parasite by inducing its abnormality within 1 hr without affecting the morphology of RBCs. These results suggest that PcFK1 and PcFK2 have specific effect on P. falciparum- infected RBCs and will provide basic information to determine their mode of action for the rational development of novel antimalarial drugs. Key words:Antimalarial peptide, tarantula toxin, Plasmodium falciparum, intra- erythrocyte stage.
배 "新高" 품종의 체窪部突出果 발생 원인과 방지에 관한 연구
최진호,김점국,장한익,김월수 전남대학교 농업과학기술연구소 2000 農業科學技術硏究 Vol.35 No.-
This study was conducted to find out the cause of basin protruded fruit in oriental pear cultivar "Niitaka" and to minimize the occurrence of deformed fruits. The obtained results are as follows. The occurrence rates of basin protruded pear were 15.4% in Namwon, 15.5% in Ansung and 18.7% in Naju, respectively. By the application of 50 ppm GA3 and 100 ppm GA4-7 on the pear trees at full bloom period, the occurrence of basin protruded fruit were increased. There was no difference in the shapes of fruit between open pollination and artificial pollinations, and the some as with pollen grains including cv. Imamura-aki, Chojuro and Gamcheonbae. Calyx end perpetual fruit at the fruit thining stage resulted in 77.4% basion protruded fruits at the harvest, but calyx end decicluous fruits was 12.3%. It was recommendable to thin the calyx end perpetual young fruits to diminish the occurrence of the basin protruded fruits at the harvest. Though the fresh weight of a basin protruded fruit was heavier than normal one soluble solid of basin protruded fruit was lower than normal one, but firmness and acidity were similar in both type of fruits. In spite of the big size, the market price was lower about 8% in deformed fruits than in normal fruits.
Mivacurium 투여후 혈청 K^+치의 변동 및 근육통에 관한 연구
최세진,손수창,허동식 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2
Hyperkalemia and muscle pain after succinylcholine induction of general anesthesia are disturbing and rarely fetal complications. Nondepolarising muscle relaxant mivacurium similar to depolarizing muscle relaxant succinylcholine with respect to rapid onset, short action time, and metabolized by plasma cholinesterase. Thus we think what happen after mivacurium induction, potassium, sodium and muscle pain, respectively. 18 patients are randomly choose and sampling before and 5, 10, 15 minutes after mivacurium induction and intubation of general anesthesia and analyzed. And we evaluated muscle pains after mivacurium induction of general anesthesia postoperatively.