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.

일부 성인의 치과 공포감 관련 요인

김수경 ( Soo Kyung Kim ),김미희 ( Mi Hee Kim ),최현지 ( Hyun Ji Choi ),황정근 ( Jung Geun Hwang ) 한국치위생학회(구 한국치위생교육학회) 2014 한국치위생학회지 Vol.14 No.6

Objectives: The purpose of the study was to investigate the related factors to dental fear in some adults. Methods: A self-reported questionnaire was filled out by 320 adults in Seoul and Gyeonggi-do from April to June, 2013. Except 14 incomplete answers, data were analyzed by SPSS 18.0 program. The questionnaire consisted of general characteristics of the subjects(7 questions), dental fear related factor(18 questions), distrust for dentist(15 questions), and distrust for dental hygienist(11 questions). The instrument for dental treatment fear was Dental fear Survey(DFS) adapted from Kleinknecht and partly modified by Choi. Out of 20 questions, 18 questions were reconstructed and score by Likert 5 scale. Higher score means higher dental fear. Cronbach alpha was 0.959 in the study. The distrust for dentist and dental hygienist was adapted from Choi and reconstructed and score by Likert 5 scale. Higher score means higher distrust for dentist and dental hygienist. Cronbach alpha was 0.937 in distrust for dentist and 0.874 in distrust for dental hygienist in the study. Results: Those who experienced dental pain tended to have dental fear. The reasons for dental fear were as follows; bad breath(2.96 out of 5 points, hereafter represented as of 2.96/5), dental caries(2.88/5), missing teeth(2.87/5) and tooth pain(2.77/5). The distrust for the dentist was the main dental fear in the adults. Conclusions: The dental fear was closely related to gender, experience of dental pain, oral symptoms and distrust for the dentist. As the psychological pain in the patients was mainly influenced by the trustful atmosphere, it is necessary to make the patient easy before treatment.

五加皮의 效能에 대한 硏究

최민호,이계복,조규원,박진영,김경수,송정석,한종현 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

The purpose of this study is to measure the changes of regional cerebral blood flow (rCBF) and blood pressure (BP) of Cortex Acanthopanacis in rats, and to determine the effect of Cortex Acanthopanacis on phenylephrine (PE) induced contraction of isolated rat thoracic aorts. The measurement was continually monitored by laser-doppler flowmeter (Transonic Instrument, USA) and pressure transducer (Grass, USA) in anesthetized adult Sprague-Dawley rats through the data acquisition system composed of MacLab and Macintosh computer. Contractile force was measured with force displacement transducer under 1.5 g loading tension. The result of this experiment was as following; 1. Cortex Acanthopanacis did not effect the changes of rCBF and blood pressure significantly. 2. Contractions evoked by phenylephrine were decreased significantly by Cortex Acanthopanacis 3. L-NNA, ODQ, atropine and indomethacin significantly altered the relaxation of Cortex Acanthopanacis. 4. Propranolol did not change the relaxation of Cortex Acanthopanacis. These results indicate that Cortex Acanthopanacis did not change the rCBF and BP, but Cortex Acanthopanacis can relax PE induced contraction of isolated rat thoracic aorta and that this increasing contraction related to endothelium and various mechanism.

五神에 관한 연구

최성욱,강정수 대한동의병리학회 2001 동의생리병리학회지 Vol.15 No.3

Spirit and body are inseparable relations in Oriental Medicine. Functions of spirit and body are regarded as one in Oriental Medical physiology. Spirit is the essence of a function which an organism reveal and it is regarded in the same with life. For this reasons, identification spirit with life is special feature of Oriental Medicine. It explain physiological and pathological phenomenon in consider spirit in relation to Five viscera. The spirit was divided Five Spirits, Five Spirits associate closely with Five viscera, and act different operation of mind. Five Spirits are an important matter to understand mental activity in human. Shin(神) controls all mental activities. Shin(神) was divided into Hun(魂), Beak(魄), Yi(意), Zhi(志), related to Heart. it works material base on Essence of Life. Hun(魂) is an mental activity in unconscious state related to Liver. Beak(魄) is sensuous activity like instinct related to Lung. Yi(意) is a short period memory in conscious state related to Spleen. Zhi(志) is concentration of spirit, fixed state of Yi(意), means a long period memory related to Kidney.

불소용액이 우식 법랑질의 표면경도, 우식병소깊이 및 내산성에 미치는 영향

최정수,홍석진 전남대학교 치과대학 1990 전남치대논문집 Vol.2 No.1

A pH-cycling model has been used to examine the effcts of fluoride solutions on remineralization of artificial caries in virto. Fluoride solution was NaF, SMFP, NaF and Ca, SMFP and NaF containing 1,000ppm fluoride, respectively. Enamel remineralization was evaluated by surface hardness, lesion depth and acid resistance. A comparative study of the results obtained have led to the following conclusions. 1. Surface hardness of NaF and Ca, SMFP and NaF group was more increased than that of NaF, SMFP group. That of control group was less increased than that of others. 2. Lesion depth of fluoride treated group was from 53.50 to 56.17㎛ and that of control group, 79.83㎛. 3. NaF solution was more effective than other fluoride solution on enhancing acid resistance 4. NaF and Ca, SMFP and NaF group were more effective on increasing surface hardness. However, they were as effective as other fluoride groups on lesion depth, acid resistance.

핸드볼 선수의 상해에 관한 조사 연구 : 남자 중학교 핸드볼 선수를 중심으로

최금석,김정수 公州大學校스포츠科學硏究所 1995 스포츠科學硏究所論文集 Vol.- No.9

This study was aimed at the research of the sports injuries with 140 handball players in boys' middle school who took part in the 23rd National Athletic Meeting in 1994. With the analysis of their reply for the questions, we could found the time, the causes, the region, the sort and the treatment of the sports injuries. Analysis of these data was used by the percentage and χ²verification(p< .05). The results are as follows; 1) There were 135 players gotten sports injuries among 140 members (96%) and we found 382 times' sports injuries, that is, 2.7 times per all players and 2.8 times per injured players. 2) We found that 70.9% of the target players were injured in training and 29.1% in the game. By the player's experience, we could see that the more experience, the less injuries in training and the more injures in the game. With the season, there were a lot of injuries players in spring. 3) The causes for the sports injuries, in warming up, turned out to be 39.3% by the players carelessness, 24.5% by the lack of enough warming-up and 13.4% by the excessive will for winning the game. 4) With the regions of the sports injuries, some players (38.5%) had injured on their arms, some players (30.1%) on their legs and others (17.0%) on their abdomen. With the playing positions, many players got injured on their arms and legs. 5) In the kinds of the sports injuries, we found that many players had injured on the part of joint (37.2%), the muscle (25.9%), the bone (18.6%) and on the skin (18.3%). As the playing positions, most goal-keepers had injured on the part of muscle and many field-players had on the joint and muscle regardless of the playing positions. There seemed to be no difference between the playing positions and the kinds of sports injuries in range of p>0.05. With the injuries of the bone, we could found the bruise (69.0%) and the fracture of the bone (28.2%). But among the target players, there were found only two players who had the osteomyelitis. In the sports injuries of the joint, many players got the asprain (50.7%), the injury of ligament (29.6%) and the luxation (16.9%). Most goal-keepers got the the injury of ligament (45.0%) but most field players got the injuries of the the part of skin, we could get the results of laceration (54.3%), abrasion (35.7%) and the fracture (10.0%) for all playing positions. In the injuries of muscle, there were the muscle bruise (67.7%) and the muscle regidity (32.3%). 6) In the methods of the first aids, after gotten the sports injuries, most players were treated for themselves (49.0%), and some players (3.4%) by a herb doctors.

국내 조혈모세포이식 환자에서 Human Cytomegalovirus gB 유전형의 분포와 질환과의 연관성 : 예비 보고

최수미,김진희,이동건,박선희,최정현,유진홍,박철민,이종욱,민우성,황응수,신완식,김춘추 대한감염학회 2007 감염과 화학요법 Vol.39 No.2

목적 : 사람 거대세포바이러스(Human cytomegalovirus, 이하 HCMV) glycoprotein B (gB)는 UL55 유전자에 의해 부호화되는 당단백으로, UL55 유전자의 염기서열변화에 따라 4가지 유전형으로 나뉜다. 본 연구에서는 국내 조혈모세포이식 환자들에서 HCMV gB 유전형의 분포와 그 특성을 알아보고, gB 유전형에 따라 특정 HCMV 질환 발생과 연관이 있는지 그 임상적 의미를 분석해 보고자 하였다. 재료 및 방법 : 동종 조혈모세포이식 환자 52명의 혈액검체 94개에 대해, Chou 등이 제시한 방법에 따라, 먼저 UL55 유전자 부위를 nested PCR로 증폭한 후, RsaI과HinfI으로 Restriction fragment length polymorphism(RFLP) 분석을 시행하였다. 결과 : gB type 1은 73.1% (38/52), gB type 2는 13.5%(7/52), gB type 3는 1.9% (1/52), gB type 1과 type 2에 의한 혼합감염은 9.6% (5/52)로 나타났다. gB type 4는 관찰되지 않았다. 1명(1.9%)에서 gB 유전형을 결정할 수 없었는데, RFLP 패턴으로 보아 Trincado 등이 제시한 gB type 7에 해당하는 것으로 생각되었고, 이 새로운 아형에 대해서는 현재 염기서열 분석 중이다. 52명 중 5명(9.6%)에서 HCMV 질환이 발생하였고, 3명에서 HCMV 폐렴, 1명에서 망막염과 위장관염, 나머지 1명에서 망막염이 발생하였다. 5명 중 HCMV 질환과 관련하여 사망한 예는 없었고, 감염된 HCMV는 모두 gB type 1이었다. HCMV gB유전형과 HCMV 질환 발생 사이에 유의한 연관성은 없었고, 단일 주에 의한 감염과 혼합감염에 따른 HCMV 질환발생 사이에도 유의한 연관성은 관찰되지 않았다. 자료 분석 중 gB type 2에 감염되어 있던 환자에서 gB type 1에 재감염 되면서 발열, 간효소 수치 상승 및 pp65 HCMV 항원혈증이 나타난 예가 있었다. 결론 : 연구결과 gB type 1이 아주 우세하고, gB type 4는 검출되지 않았으며, 혼합감염의 빈도가 비교적 낮은 분포를 보였다. 이는 외국의 보고와는 다른 국내 조혈모세포이식 환자에서의 독톡한 감염 양상으로 추정된다. 본 연구에서 HCMV gB 유전형과 질환 발생과의 연관성을 밝힐 수는 없었으나, HCMV 유전형에 대한 연구는 바이러스 감염의 발병기전이나 전파 경로 및 양식과 같은 역학적 연구에 중요한 자료가 될 것이다. 현재 더 많은 수의 조혈모세포이식 환자를 대상으로 연구가 진행 중에 있으며, 앞으로 다른 질환군의 환자나 건강한 잠복 감염자에서의 추가 연구가 필요할 것으로 생각된다. Background : Human cytomegalovirus (HCMV) glycoprotein B (gB) is the major envelope glycoprotein, encoded by the UL55 gene. Based on sequence variation in the UL55 gene, HCMV can be classified into four gB genotypes. Previous studies have suggested an association between HCMV gB genotypes and clinical outcome in the immunocompromised hosts. The goal of this study was to determine the distribution of HCMV gB genotypes and the effect of gB genotype in the developement of HCMV diseases in hematopoietic stem cell transplant (HSCT) recipients in Korea. Materials and Methods : DNA was extracted from 94 blood specimen of 52 allogeneic HSCT recipients with HCMV infection. HCMV gB genotype was determined using polymerase chain reaction to amplify a region of UL55, followed by restriction fragment length polymorphism (RFLP) analysis based on RsaI and HinfI digestion. Results : The distribution of gB types were as follows: gB1, 73.1% (38/52) of patients; gB2, 13.5% (7/52); gB3, 1.9% (1/52) and mixed infection (gB1 and gB2), 9.6% (5/52). While gB4 was not detected, a new genotype (described as gB7 by Trincado et al, 2000) was identified on the basis of their RFLP pattern. During average 708 days’ follow up period, HCMV diseases developed in 5 patients. All of them had gB1 genotype. There was no statistically significant association between the incidence of HCMV diseases and the gB genotypes. Re-infection with gB1 strain was detected in one patient who had been previously infected with gB2. This episode was associated with fever, elevated liver enzyme and positive antigenemia. Conclusion : HCMV gB1 was the dominant genotype and no gB4 was detected in allogeneic HSCT recipients in Korea, which is an unique pattern compared with the previous reports. Although we can not find significant association between the HCMV diseases and the gB genotypes, genotyping of HCMV will serve in the study of pathogenesis and transmission of this virus in transplant patients. Further study is underway with large study population.

人乳中의 高分子糖蛋白質에 관한 硏究

崔禎延,李守遠 成均館大學校 科學技術硏究所 1992 論文集 Vol.42 No.2

This study was carried out to compare the high molecular weight glycoprotein isolated from human milk fat globule membrane and whey, and to investigate biochemical or immunological properties of two materials. The results are summerized as follows : 1. The milk fat globule membrane (MFGM) of human milk contained about 15 proteins and 5∼6 major glycoproteins, while human whey contained about 10 proteins and 3∼4 major glycoproteins. 2. Human MFGM and whey contained a high molecular weight glycoprotein, termed PAS-O, which did not migrate in 10% SDS-acrylamide gel elecrophoresis. 3. PAS-O isolated by Sepharose CL-4B chromatography had maximum absorption at 208nm and no absorption at 280nm. 4. On the agglutination test with eight lectins, WGA, PNA, LPA reacted with PAS-O and HM-glycoprotein that suggested to act as surface receptor of them in human milk. 5. Serine, glycine, alanine and glutamic acid were predominant amino acids in the both high-Mr glycoprotein, PAS-O and HM-glycoprotein. On the other hand, sulfur containing amino acids were present in very small amount. 6. The patterns of reactivity of these two glycoproteins, PAS-O and HM-glycoproteins, with some lectins, the similarities in their amino acid compositions and electrophoretic mobilities, suggested that they may be the same molecules.

"Tinidazole"(Fasigyn)에 依한 Giardia Lamblia의 驅蟲效果

崔源永,李玉蘭,李元求,이규면,朴定圭,李水月 中央醫學社 1973 中央醫學 Vol.25 No.4

"Tinidazole a new antiflagellate drug, was given orally for 3-7 days to 99 children infected with G.lamblia. Stool examination for detection and evaluation of therapeutic on giardiasis were made by formaline-ether concentration techniques. The children were grouped according to doses and the duration of administration of the drug. The results were summarized as follows; 1) Except 1 case out of 99 children, none of the children showed G. lamblia in the stool examination 2 weeks after administration of the drug, regardless of groups. 2) 4 weeks after administration of the drug, group A (10 mg per kg for 7 days) and group B (5 mg per kg for 7 days) children showed 100% of negative conversion, but group C (10 mg per kg for 5 days) children revealed 84.6% of negatives. 3) 6 months later, the negative conversion rates in groups A, B and C were reduced to 54.5%, 57. 1% and 50. 0% respectively. 4) Mild or transient side effects-nausea, abdominal pain, headache or fever and diarrhea were noted in 16 cases (27. 1%) out of 59 cases.

폐모세포종 : 1례보고 A Case Report

최영호,서홍주,임영혁,김정중,박성강,이석기,임진수,김은규 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pulmonary blastoma is a very rare primary neoplasm of the lung. We experienced a case of pulmonary blastoma in a 40 years old man. The mediobasal segmentectomy of the right lower lobe was performed. The patient was discharge on the postoperative days 6. There is no evidence of recurrence or metastasis on followup study during 7 months period after operation.