한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

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.

蓄熱用 TMA 包接化合物의 熱物性에 關한 實驗 硏究(Ⅰ)

최영범,한영옥,하옥남,김병철,김진흥 조선대학교 동력자원연구소 1996 動力資源硏究所誌 Vol.18 No.2

This paper presents the test-tube experimental results of thermal properties of TMA clathrate compounds for latent heat storage applications. The results are : ⅰ) subcooling in TMA clathrate compound is the lower than water, ⅱ) Phase change temperature in TMA clathrate compound is the higher than water. ⅲ) Latent heat of 25wt% TMA clathrate compounds of 220.4kJ/㎏K appear to be maximum. ⅳ) Comparing with water, volume of TMA clathrate compounds decreased as the phase change. ⅴ) TMA clathrate compounds precipitated because of increase of density as phase change. Thus, TMA clathrate compounds are found to be the promising compounds for the heat storage from the viewpoint of thermal property.

미국의 구기지도에서 본 전술학습 모델의 검토

최경범,육조영,김진국 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.6

The purpose of this study was to examine the model of tactical approach in games teaching bt analyzing the models of games education in the United States. As a result of this study, the following were clarified: 1) Although the traditional approach to games teaching focused on teaching skills, it didn't bring about any development on student's game performance. For this reason, tactical approach has come to attract a great deal of attention. 2) The model of tactical approach in games teaching guides students to learning both tactical awareness and skill execution which are necessary in a game setting. As a result, it makes it possible for students to develop their game performance. 3) The effectiveness of tactical approach leaves some indistinct points. To put it to practical use, it is necessary for us to add modifications to it's research design and test it continously.

의료환경 변화에 대비한 의학기술부문의 교육방향

최종학,윤범철,조경진,이준협,임국환,고성진,최경호 高麗大學校 倂設 保健大學 保健科學硏究所 2003 保健科學論集 Vol.29 No.1

Under the pressure to open the service market as proposed by World Trade Organization, we can easily expect our educational systems for allied health professions will experience a lot of changes in near future. Accordingly, we compared our current educational systems for allied health professions with the foreign ones and mapped out some strategies predicting the forthcoming enormous changes. Major investigations and analysis are summed up as follows, The educational programs for allied health professions which was started in 1963 in Korea are stilled remained as 2 to 3 school years, while the systems in advanced countries have already been changed or been changing from 2 year to 4 year college levels. We can hardly find the uniform educational system or school years for the allied health professions in the world except for Korea. Fortunately, university level four-year programs for the profession was established in 1979 in Won-joo for the first time in Korea. However, there are still only few four-year programs in this country. To meet the rapidly changing needs we have faced in the health areas we should supply appropriate health personnel through various efforts. Now we would like to suggest followings, <Educational goals for the allied health professions> 1) reconfirming characteristics for the educational goals of health professions 2) extending school years for the allied health professions 3) strengthening clinical training and internship 4) expanding opportunities for the continuing education through lifelong education 5) upgrading from old-fashioned technologies to advanced technologies 6) cultivating competencies of health professionals for the global competition <Suggestions for the Development of Allied Health Professions> 1) reforming the school years of educational programs for the allied health professions to meet the global standards 2) expanding the role of junior college programs for the allied health professions through the development of intensive courses in the professions. 3) diversifying and specializing the allied health professions mainly through 4 year B.S. degree programs.

血府逐瘀湯이 癌轉移 抑制에 미치는 影響

李眞華,沈範相,安圭錫,崔昇勳 대한한방종양학회 1999 대한한방종양학회지 Vol.5 No.1

To examine the effect of XuehdRUIng on the metastasis of cancer, the following experiments were carried out. Before the main experimnts, the cytotoxicity was measured by putting Xuefuzhuyutant sample in HT1080. Then zymography was made to examine the change of gelatinolytic activity. Weste blotting was carried out to examine the changes of Fos, Jun, Ets, Erk, md JNK. In vitro invasion assay with transwells coated by collagen and mangel was carried out. From the above reams the following conclusions were obtained. 1. The eXperimental result about cytotoxicity of Xuefuzhuyutang agaitst HTlO8O was a below. The stained cell count after beingtreated by by Xuefuzhuyutang sample 4M㎍/㎖ for 24 hours was 0.9% of total cells, and the stained cell count by Xuefuzhuyutang sample 100㎍/㎖ was 1.5% of total cells. Both were near the level of control group which showed O.6% stained. 2. Thee result of collagenase assay was as below. In Xuefuzhuyutang sample 400㎍/㎖, MMP2 was reduced as compared with TPA control group, and the band of MMP-9 induced by TPA disapappeared. In Xuefuzhuyutang samle 800㎍/㎖ both bands of MMP-2 and MMP-9 diSamared. 3. The results of westem blots for Jun, Fos, Ets, Erk, JNK were a below. In Xuefuzhuyutang sample 200㎍/㎖, Ets was reduced, and Jun, Fos were increased. 4 The result of invasion assay was as below. The number of cells which migrated gross trayswell membrane in Xuefuzhuyutang-treated group was less than that of control(+TPA) group. From the above results, it was concluded that Xuefuzhuyutang might inhibit the activity of collagenase not by the MMP-2, MMP-9 promoter but by the Other way.

혈액보존제 ACD-B,CPDA-1 및 SAG-M에 보존된 혈액의 혈액학적,생화학적 변화에 관한 연구

나동진,문희주,최범열 서울보건대학 1997 서울보건대학 부설 한국보건과학연구소 논문집 Vol.4 No.1

Backgrounds ; Study as to blood preservative solution is continuousely performed to prolong period of donor blood preservation which will cope with demand increase and autologous transfusion. In Korea, CPDA-1 solution, preserved 35 days, substituded ACD-B(21days), is currently used for anticoagulant preservative solution of blood. But SAG-M solution(42days) were widely used in other contries for longer preservation as RBCs additive solution. Authors compared the survival of RBCs preserved with ACD-B, CPDA-1 anticoagulant preservative solution, SAG-M RBCs additive solution to study changes of hematological and biochemical. Materials and Methods ; Blood were collected from 15 healthy male donors aged 22 to 23years, for three sorts of preservative solution bag made in home(Company Green Cross, Korea) at the same time. 5 of them were drawn into the blood bags containing ACD-B and another 5 into the CPDA-1 bags, the other 5 donors were collected into the blood bags with CPDA-1, plasma was removed by centrifugation serparation at 4,000rpm in 5minutes and replaced by 90 ml of SAG-M additive solution. All of blood bags were stored in blood bank refrigerator at 1 to 60℃. Samples were drawn at 1, 5, 10, 15, 20, 25, 30, 35 and 42days in each through blood bags tubing under sterile condition used SCD(Sterile Connection Device) so as to measure changes of hematological and biochemical. Results ; 1) A TP level is very important preservation index of hematological test. On 1 days, ATP levels of ACD-B anticoagulant preservative solution were measured by 4.85μmol/gHb, CPDA-1 5.05μmol/gHb, SAG-M additive solution 8.91μmol/gHb. After storage for 42days ATP levels ACD-B were measured by 1.54μmol/gHb, CPDA-11.72μmol/gHb, SAG-M 2.36μmol/gHb. 2) Plasma hemoglobin in bloods stored in ACD-B, CPDA-1 and SAG-M were 24.6mg/dl, 24.3mg/dl and 16.7mg /dl, respectively, on 1days, and increased to 221mg/dl, 154.5mg/dl and 146.4mg/dl, respectively, On 42 days. 3) Another hematological study cannot be seen remarkable discrimination between three sorts of preservative solution and preservation days. 4) pH, sodium, chloride and glucose level in bloods stored in ACD-B, CPDA-1 and SAG-M were slightly descresed according to storage days, whereas pottasium and phosphorus concentration increased according to storage days, However, there was no significant difference between bloods stored in three anticoagulants. Conculusion ; In 42 days, SAG-M RBCs additive solution is more excellent than other solution(ACD-B, CPDA-1 anticoagulant preservative sol) and has merit to separate plasma from the unit blood. Therefore we concluded that SAG-M RBCs additive solution should be used to overcome the state of b, SAG-M additive solution 8.91μmol/gHb. After storage for 42days ATP levels ACD-B were measured by 1.54μmol/gHb, CPDA-11.72μmol/gHb, SAG-M 2.36μmol/gHb. 2) plasma hemoglobin in bloods stored in ACD-B. CPDA-1 and SAG-M were24.6mg/dl, 24.3mg/dl and 16.7mg/dl, respectively, on 1 days, and increased to 221mg/dl, 154.5mg/dl and 146.4mg/dl, respectively, On 42 days. 3) Another hematological study cannot be seen remarkable discrimination between three sorts of preservative solution and preservation days. 4) pH, sodium, chloride and glucose level in bloods stored in ACD-B, CPDA-1 and SAG-M were slightly descresed according to storage days, whereas potasium and phosphorus concentration increased according to storage days, However, there was no significant difference between bloods stored in three anticoagulants. Conculusion ; In 42 days, SAG-M RBCs additive solution is more excellent than other solution(ACD-B, CPDA-1 anticoagulant preservative sol) and has merit to separate plasma from the unit blood. Therefore we concluded that SAG-M RBCs additive solution should be used to overcome the state of imported plasma in our country.

기저질환이 없는 사람에서 발생한 Campylobacter fetus에 의한 재발성 심내막염 1예

전재범,정진원,김성혜,송문희,오형철,안성기,최상호,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

C. fetus 심내막염은 드물게 발생하는 질환으로 주로 면역능이 저하된 환자에서 발병하고 대동맥판을 침범하는 경우가 많으며 적절한 치료가 되지 않을 경우 치사율이 높다. 저자들은 기저질환이 없던 69세 남자에서 C. fetus 심내막염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 발열로 내원하여 시행한 혈액배양 검사상 C. fetus가 동정되었고 경식도 초음파 검사상 삼첨판에 증식증이 발견되어 심내막염 진단하에 ceftriaxone에 이어 meropenem으로 총 4주간 항생제를 투여받고 호전되었다가 한달 후 다시 재발하였고 판막부전 소견 진행하여 삼첨판 치환술을 시행받고 전신상태 호전되어 퇴원하였다. Campylobacter fetus is a rare cause of endocarditis. To date, only about 30 cases of C. fetus endocarditis have been reported mainly in the elderly with chronic underlying illnesses. Most cases showed tendency to involve aortic valve. This report describes a case of native tricuspid valve infective endocarditis in a 69-year-old man without any underlying disease. Despite adequate antibiotic therapy for 4-weeks, endocarditis recurred and leading to surgical valve replacement.

다발성 외상 후 횡문근융해증 환자에서의 손상초기 급성신부전의 예측인자

문중범,이강현,황성오,이진웅,한병근,최승옥,강성준 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma. Methods: This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creating phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF. Results: Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin. Conclusion: We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.

인체측정변인에 의한 펜싱 종목의 경기력 판별분석

신범철,유종만,최태석,박재현,김혜진 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.14 No.4

The purpose of this study was to analyze on the morphological characteristics of elite fencing players. In this study, 32 male fencing players completed the measurement of 39 anthropometric variables. To assess of the differences between elite fencing player and non-elite fencing players' morphological characteristics, discriminant test and morphological analysis were used. The results of this study were follows. There were no statistical differences in all the morphological characteristics between elite player and non-elite players in length variables except length variables. In conclusion, elite and non-elite players of fencing become most discriminant by length variables.