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.

식도발성의 숙련 정도에 따른 모음의 음향학적 특징과 자음 산출에 대한 연구

최성희,최홍식,김한수,임성은,이성은,표화영 한국음성과학회 2003 음성과학 Vol.10 No.3

Esophageal Speech uses the esophageal air during phonation. Fluent esophageal speakers frequently intake air in oral communication, but unskilled esophageal speakers are difficult with swallowing lots of air. The purpose of this study was to investigate the different of acoustic characteristics of vowel and consonants production according to the speech proficiency level in esophageal speech. 13 normal male speakers and 13 male esophageal speakers (5 unskilled esophageal speakers, 8 skilled esophageal speakers) with age ranging from 50 to 70 years old. The stimuli were sustained /a/ vowel and 36 meaningless two syllable words. Used vowel is /a/ and consonants were 18 : /k, n, t, m, p, s, c, ch, kh, th, ph, h, I, k', t', p', s', c'/. Fundamental frequency (Fx), Jitter, shimmer, HNR, MPT were measured with by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). 36 meaningless words produced by esophageal speakers were presented to 3 speech-language pathologists who phonetically transcribed their responses. Fx, Jitter, HNR parameters is significant different between skilled esophageal speakers and unskilled esophageal speakers (P<.05). Considering manner of articulation, ANOVA showed that differences in two esophageal speech groups on speech proficiency were significant; Glide had the highest number of confusion with the other phoneme class, affricates are the most intelligible in the unskilled esophageal speech group, whereas in the skilled esophageal speech group fricatives resulted highest number of confusions, nasals are the most intelligible. In the place of articulation, glottal /h/ is the highest confusion consonant in both groups. Bilabials are the most intelligible in the skilled esophageal speech; velars are the most intelligible in the unskilled esophageal speech. In the structure of syllable, 'CV+V' is more confusion in the skilled esophageal group, unskilled esophageal speech group has similar confusion in both structures. In unskilled esophageal speech, significantly different Fx, Jitter, HNR acoustic parameters of vowel and the highest confusions of Liquid, Nasals consonants could be attributed to unstable, improper contact of neoglottis as vibratory source and insufficiency in the phonatory air supply, and higher motoric demand of remaining articulation due to morphological characteristics of vocal tract after laryngectomy.

韓國寺刹의 空間構造와 信仰形態에 關한 硏究

최창길,예명해,신상화,이용대 대구대학교 과학기술연구소 1999 科學技術硏究 Vol.6 No.2

This research takes up DONG HWA(桐華) temple, PA GYE(把溪) temple, UN HEA( 銀海 ) temple, UN BU(雲浮) temple, and the HWAN SUNG(環城) temple, which makes clear the space structure and the belief form of those Buddhist temples. The above-mention temples have been already investigated in other research's. However Now day, The temples are a lot of changes so it is necessary to clarify the current situation. Moreover Each Buddhist temples was not investiaged detaily. So this research's aim is current temple's situation investigation and each temple's detailed reserch 1) The construction of all temples goes back even to the Silla Dynasty. However, the arrange ment structure of then Buddhist temple was completion of the arrangement structure with the courtyard clearly now in a Chosun Dynasty. Especially, the construction time of the grand gate which the component of such an arrangement structure to be assumed the 17th century of which the middle of a Chosun Dynasty. 2) Moreover, it is a building where it was built to be paid objects is deified to these buildings are 山神(SAN SIN), 獨聖(DOK SUNG), and 七星(CHIL SUNG). Especially being paid attention is 山神(SAN SIN) belief. There was a belief to 山神(SAN SIN) from ancient times. However, coming to be deified in the temple is from a furnace in the 17th century. By the way, it was able to be confirmed to have come to be built in the temple which had been investigated by this research in the 20th century in the latter half of the 19th century.

ADSL을 위한 전화선로의 특성분석 및 등화기 설계

최성환,전진화,권호열 강원대학교 정보통신연구소 1999 정보통신논문지 Vol.3 No.-

In this paper, we evaluate transmission channel characteristics of telephone cable to be used in general. First, we measured the impedances of open and short circuits in order to obtain the RLCG parameters per unit length of transmission line. And we obtained the frequency-dependent transfer function and propagation constant for transmission line using these values. The channel impulse response is derived from the inverse Fourier of transfer function. We design channel equalizer for ADSL(Asymmetrical Digital Subscriber Line) using the measured impulse response of channel. The results shows that the transfer characteristics decrease sharply according to the length of transmission line. Finally, we verify efficacy of the proposed method by means of simulation.

ATM네트윅과의 접속을 위한 MAN을 이용한 사용자 - 망 인터페이스 설계

최황규,최경,서주하,김화종,이상희 江原大學校 産業技術硏究所 1991 産業技術硏究 Vol.11 No.-

In this paper the functional requirements of a B-ISDN access network based on MAN are investigated . Firstly, criteria of designing access network for the B-ISDN is studied. Secondly, the types of subscribers and their service requirements are defined. Thirdly, various artchitectures of CPNs(Customer Premises Networks) are considered and their characteristics are studied, Finally, the interworking funtions of a DQDB MAN as an access network are investigated.

醫療保險制度의 變化에 따른 醫療利用 樣相과 病床利用度 比較硏究

최병록,함정오,김화성,이병국 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

This study was conducted to identify the effects of rural-fishing village health insurance system and the whole national health insurance system on the number of out-patient and in-patient cases and the hospital bed utilization, and the number of hospital persons in a university located in Choong Chung Nam Do. The results were as follows. 1. The number of out-patients was increased by 6.8% and 18.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. The number of out-patient visit cases was increased by 31.5% and 63.5% after implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. 2. The number of in-patients was increased by 13.8% and 22.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. The number of bed days was increased by 27.1% and 32.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. 3. The hospital bed utilization rates were 77.3% and 98.4% before and after the rural fishing village health insurance system respectively, and 102.6%, after the whole national health insurance system. The bed rotation rate was increased from 23.6 times before the rural fishing village health insurance system to 27.0 times after the system. After the whole national health insurance program, it was also increased to 29.1 times. The average length of stay was 11.9 days before the rural fishing village health insurance system and 13.3 days after that, and 12.9 days after the whole national health insurance system. 4. Before the rural fishing village health insurance system the physicians per 100 beds was 19.0 persons. The physicians per 100 beds was increased to 25.2 persons and 29.3 persons, after the rural fishing village health insurance system and the whole national insurance system respectively. Before the rural fishing village health insurance system the nurses per 100 beds was 26.8 persons. The nurses per 100 beds was increased to 35.4 persons and 38.3 persons, after the rural fishing village health insurance system and the whole national health insurance respectively. Before the rural fishing village health insurance system the manpower per 100 beds was 101.6 persons. The manpower per 100 beds was increased to 128.6 persons and 138.9 persons, after the rural fishing village health insurance system and the whole national insurance respectively.

RCV(Rated Composite Vectors)를 이용한 적응적 특징점 추출에 관한 연구

崔寅浩,金炯澈,李相勳,鄭日和,李大寧 慶熙大學校 1995 論文集 Vol.24 No.-

The dominant point detection is an effectual step on pattern recognition, feature description, and ogject reconstruction. In this paper, we propose a novel measurement of curvature along tje digital planar curve. We call it the rated composite vectors for cosine(RCV-cosine) measurement because of the analogy to the k-cosine measurement advocated by Rosenfeld for describing angle detection. We define the RCV as a composite vector obtained by iteratively and adaptively rating the vectors described in our algorithm. We estimate "angle" with RCV replacing a fixed window size k for cosine measurement. For each point in the curve we find both left and right RCVs that are similar to left and right tangents, and thus calculate the angle, called RCV-cosine value, between two RCVs through cosine measurement. The dominant points are obtained by local maximum of RCV cosine values. The proposed algorithm is robust on raw synthetic images and extracts the dominant points effectively and correctly. We present several experimental results and illustrate that our approach is invariant to translation, rotation and slight scaling, and it is closer to human percption.

통신설비의 Pulse성 Nosie 현상 분석과 Noise 대책

崔寅浩,崔種和,金炯澈,李相寧,鄭日和,李大寧 慶熙大學校 1993 論文集 Vol.22 No.-

The use of electric-power-distribution circuits for communications is of continued and growing interest. Impedence, attenuation, and noise characterize any communication channel and are needed for design of digital communcation systems. The purpose of this paper is to present the method of Measurement and countermeasure of the temporal and spectral properties of the magnetic and electronic fields of radio noise that emanates from power lines.

Aspergillus oryzae를 이용한 캡슐형 메주의 품질특성

최재훈,권선화,이상원,남상해,최상도,박석규 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2003 한국식품저장유통학회지 Vol.10 No.3

전통메주의 표면에서 발행하는 야생곰팡이 착생, 유해곰팡이에 대한 mycotoxin 생성 및 메주 표면의 과도한 건조 등을 해결하기 위하여 메주 외층에 Aspergillus oryzae로 만든 쌀 종국(0.3%, w/w)을 혼합시킨 증자 검정콩으로 얇게 코팅한 후, 25℃, 상대습도 80%에서 14일간 발효시킨 캡슐형 메주를 개발하였다. 캡슐형 메주의 표면에서 야생곰팡이의 오염은 발견되지 않았으나, 대조구 메주는 12일 이후에 푸른곰팡이가 많이 관찰되었다. 메주의 수분 함량은 평균 32.7%로서 34.7~29.4%의 범위를 나타내었다. 적정산도는 캡슐형 메주가 대조구 메주보다 높게 나타났으며, 대두 캡슐형 메주와 검정콩 캡슐형 메주는 비슷하게 나타났다. 유리당의 함량은 검정콩 캡슐형 메주가 123.98㎎%로 대조구 메주 15.02㎎%와 대두 캡슐형 메주 59.85㎎%보다 각각 10배, 2.1배, 높게 나타났다. 아미노산성 질소의 함량은 대조구 메주에서 147.00㎎%였으며, 검정콩 캡슐형 메주는 255.50㎎%로서 대두 캡슐형 메주 187.25㎎%보다 약 1.37배 높은 함량을 나타내었다. 총 유기산의 함량은 캡슐형 메주(대두 119.98㎎%, 검정콩 95.94㎎%)가 대조두 메주(26.44㎎%)보다 함량이 높게 나타났으며, 캡슐화에 따라 lactic acid와 malic acid 가 가장 큰 변화를 나타내었다. 색차계 색도는 검정콩 캡슐형 메주가 대두 캡슐형 메주보다 명도값(L)이 크게 나타났으며 지방산 조성은 메주의 종류에 따라 큰 차이를 나타내지 않았다. 총 유리 아미노산의 함량은 검정콩 캡슐형 메주(1039.70㎎%)가 대두 캡슐형 메주 (556.07㎎%)와 대조구 메주(236.45㎎%) 비하여 각각 2.4배, 4.4배 높았다. In order to improve some problems such as contamination of undersirable mold, mycotoxin production and excessive drying on the surface of traditional meju, we developed a capsule type-meju(CM) coated with steamed black bean and Aspergillus oryzae - rice koji(0.3%, w/w) mixture to surface of traditional meju and fermented at 25℃ for 14 days under 80% relative hunmidity. Contamination of undersirable mold on the surface of CM was not detected within 2 weeks and some genus Penicillium molds on control meju without koji were found naturally after 12 days of fermentation. The moisture content of meju was showed to be in the range of 34.7 - 29.4% being 32.7(w/w) of mean value. Titratable acidities in CMs prepared with black bean(BCM) and soybean(SCM) were much higher than that in control meju, and BCM was similar to SCM. Free sugar content in BCM(123.98 ㎎%) was 10 times and 2.1 times higher than that in control meju(15.02 ㎎%) and SCM(59.85㎎%), respectively. Amino type nitrogen content in control meju was 147.00 ㎎% and its content in BCM(255.50㎎%) was 1.37 times higher than that in SCM(187.25 mg%). Total organic acid content in BCM(95.98㎎%) and SCM(119.98㎎%) were much higher than that in control meju(26.44 ㎎%), and then latic and malic acid contents were markedly changed according to capsulation of meju. Lightness value(l) of Hunter color index was much higher in BCM than in SCM. Fatty acid composition of CM was not different as compared to control meju. Total free amino acid content in BCM(1039.70 ㎎%) was 4.4 times and 2.4 times higher than that in control meju(236.45 ㎎%) and SCM(556.07 ㎎%), respectively.

부적절한 예방화학요법 후 지연 발현된 Plasmodium vivax 말라리아 1 예

최수철,장상필,김상화,서환조,서진태,김구엽 대한내과학회 1998 대한내과학회지 Vol.54 No.3

Malaria is the world's most important parasitic infection. Although it has been erw5cated from temperate zones including Korea, increasing numbers of travellers visit tropical malarious countries and imported malaria becomes important medical problem in the developed countries. In Korea with increasing travellers to malaria-endemic area, the incidence of imported malaria shows rising tendency same as the developed countries. It becomes important to personal general personal protective measures and chemoprophylaxis to trevellers, when employed in appropriate manner, that can be highly effective in preventing malaria. We recently experienced a case of in Plasmodium vivax malaria with delayed manifestations due to inadequate chemoprophylaxis. A 53-year-old woman with history of trevel to East Africa 4 months ago and chief complaint of fever was diagnosed as tertian malaria. She had irregularly taken prophylatic antimalarial during travel and had not taken it after return but should have taken it at least 4 weeks after return.