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.

나노 파우더 제조용 비드밀 제작에 관한 연구

손재엽,남권선,김병희 강원대학교 산업기술연구소 2005 産業技術硏究 Vol.25 No.B

Manufacturing methods of Nano particles can be distinguished by top-down technology as physical method and bottom-up technology as chemical synthetic method. Top-down technology is a kind of method for making microstructure as like carving after forming a macroscopic structure in advance and its typical methods are ball milling, gas condensation method and so on. Nano Particles synthesized by bottom-up method have got to do dispersing process for using them as actual nano particles because their viscosity are very strong and so easy to shape cohesive substances. Therefore, this study is about a particle separating device which separates a certain constant size of grains processed already in mill and mixer because we mostly use media agitating mill as a device of milling and dispersing and we necessarily use very slight balls as media for manufacturing nano particles in the machine. The centrifugal device has been designed for passing and separating below a certain type of grain size after final process of particles in the mill.

예견퍼지 알고리즘을 사용한 트럭-트레일러의 자율주차 제어 시스템에 관한 연구

손준익,박희경,박재현,강신출,임영도 東亞大學校 附設 情報通信硏究所 1999 情報通信硏究所論文誌 Vol.7 No.1

본 논문에서는 예견퍼지 알고리즘을 사용하여 트럭-트레일러의 자율주차 제어 시스템의 시뮬레이션을 행한다. 트럭-트레일러의 전·후진 동특성 방정식을 설정하여 예견퍼지 제어기의 설계시에 사용하고, 새상 시스템으로도 사용한다. 제안한 알고리즘으로 시뮬레이션을 통해서 일정 지역내의 임의의 출발점에서 적절한 도중목표를 설정하여 전후진을 하면서 핸들조작 횟수가 적게 최종목표 위치에 잘 주차됨을 입증하였다.

환경 가치지향에 따른 피해 지각 유형별 수업의 효과

손명희,남영숙,정재우 한국환경과학회 2004 한국환경과학회지 Vol.13 No.4

The education effect of environmental impact cognitive instruction on high school students was investigated. Environmental values of students could be classified into egocentric, social-altruistic and biospheric values like those of Schultz's three kinds of categories. The value distribution of students consists 44.7% of egocentric and biospheric value groups and 12.5% of social-altruistic value group, respectively. The environmental function such as knowledge and skill did not show remarkable differences between value groups. The environmental value only affected the attitude function. The biospheric value group had the higher attitude function than other value groups. The environmental impact cognitive instruction enhanced the environmental functions irrespective of the value group or instruction type. However, significant variables were different according to environmental functions. Environmental functions such as knowledge and skill were influenced by the instruction itself. The attitude function was dependent on instruction itself, value type and instruction type. The optimum application of the environmental impact cognitive instruction can be efficiently achieved through class division into egocentric value group and biospheric value group. Alternatively, the proper combination of instruction methods focused biospheric and egocentric impacts in a class can be recommended.

회분식 생물반응기를 이용한 BDOC_(rapid)와 BDOC_(slow) 결정

손희종,노재순,강임석 한국물환경학회 2004 한국물환경학회지 Vol.20 No.4

In this study, biodegradable organic matter was divided into a rapidly biodegradable fraction(BDOC_(rapid)) and a slowly biodegradable fraction(BDOC_(slow)) for various waters with different types of DOC. These fractions(BDOC_(rapid) and BDOC_(siow)) were defined by using a shaking incubation method modified from Carlson's method. Also, in this study, optimum incubation time and accuracy were investigated to determine BDOC_(rapid) and BDOC_(slow). When suspended bacteria obtained from raw water and BAC effluent, or attached bacteria from BAC was respectively used as an inoculum, the difference in total BDOC(BDOC_(total)) was minimal. Therefore, total BDOC was determined in 7~8 days by the shaking method, which is comparable with Servais's method by which BDOC was determined in 28 days. In addition, the difference of BDOC between these two methods was within 7%. Although BDOC_(rapid) and BDOC_(slow) were effectively determined by a method defined by Klevens, the difference in optimal incubation time was significant for different water samples. However, when using the shaking method, optimal incubation time for BDOC_(rapid) was found to be 3 days, therefore, the BDOC_(rapid) was defined as the difference between DOC_0 and DOC_(3days), and BDOC_(slow) was defined as the difference between BDOC_(total) and BDOC_(rapid). As a conclusion, for determining the fraction of BDOC using the shaking method, the concentrations of an inoculums and optimal incubation times used in this study were very effective.

플라즈마 반응기를 이용한 실내공기중의 NOx 제거

박재윤,손성도,고희석,박상현 경남대학교 공업기술연구소 2000 硏究論文集 Vol.18 No.-

인간은 하루 중 대부분의 시간을 다양한 형태의 위협적인 환경오염의 요인들이 있는 가정, 사무실, 공장, 지하 시설물 등과 같은 폐쇄된 실내공간에서 생활하고 있다. NO 가스는 저농도에서도 인체에 커다란 해를 끼치므로 이를 제거하기 위한 새로운 기술을 적용한 공기 정화기가 절실하게 요구되는 실정이다. 따라서, 본 연구에서는 여러 가지 형태의 플라즈마 반응기와 각종 파라메타의 변화에 따른 실내공기중의 NO 제거 효율을 측정하였다. 실험에 사용된 파라메타는 자계의 유무, 반응기 형태, 전원 및 초기농도에 따른 NO 제거율을 비교하였다. 모든 반응기 형태에서 자계를 인가했을 때가 인가하지 않았을 때 보다 NO 제거효율이 증가하는 것으로 나타났으며, AC전원에서 약 20[%], DC전원에서 약 10[%]이상 증가되었다. 그리고, DC전원보다는 AC전원에서 제거율이 높게 나타났으며, 초기농도가 낮을수록 제거율이 높게 나타났다. 반응기 형태에 따라서는 wire-cylinder type이 가장 제거율이 좋은 것으로 나타났다. In this paper, NOx removal efficiency from indoor air was measured for the four types of plasma reactor. The variation of NO removal rate was compared with experimental condition, such as magnetic field, reactor type, voltage type and NO concentration. NO removal rate in the reactor applied magnetic field was shown higher than that in the reactor without magnetic field. NO removal rate with magnetic field was high by 20[%] for AC voltage and was high by 10[%] for DC voltage and AC voltage was better than DC voltage for NO removal. When the flow rate of gas was increased. NO removal rate decreased.

고도정수처리 공정에서의 천연유기물질 특성변화 및 소독부산물 전구물질의 제거특성 평가

노재순,손희종,박은주,황영도,최동훈,배석문,신판세 慶星大學校 環境問題硏究所 2002 環境硏報 Vol.12 No.1

In this research the movement and apparent molecular weight distribution of hydrophilic/hydrophobic organic matters in advanced water treatment process were investigated using the raw water of Maeri area, located in downstream of Nakdong river, and the variation of the disinfection by-product formation potential was also investigated. In the raw water used in experiments, the content of BDOC (biodegradable dissolved organic carbon) in dissolved organic carbon (DOC) was about 39%, and this value is far above a normal, Pre-ozone treatment showed an increase of 40% in the BDOC content, and this means that biodegradability was remarkably increased by ozone treatment BDOC concentration in BAC treated water was 0.09 mg/L, which means 84% of BDOC removal rate compared with that in post-ozone treated water. The variation of chlorine disinfection by-product formation potential in each process unit of water treatment process was analyzed. TOXFP concentration in raw water was 449 ㎍/L, and the contents of THMFP and HAAFP among TOXFP were 24% and 23%, respectively. The removabilities of these materials BAC process had an order of TOXFP > HAAFP > THMFP. BAC process was less effective for THMFP than others. The distribution of hydrophilic organic matters were evaluated in each treatment process. Hydrophilic and hydrophobic matters in the raw water had a ratio of 50 : 50, and the ozone treatment decreased the content of hydrophobic matters. The BAC treatment made the ratio 85:15. These mean that the removal of hydrophilic matters is more difficult than that of hydrophobic materials in water treatment process. In addition the portions of humic and fulvic acid in hydrophobic matters were analyzed. Fulvic acid a large portion among hydrophobic matters in the raw water, and the portion was 78%. Ozone treatment was more effective on the removal of fulvic acid than humic acid. After BAC treatment, the concentration of residual fulvic acid was high than humic acid. Chlorine disinfection by-product formation for hydrophilic and hydrophobic mattrts was compared in each process unit. in the raw water TOXFP and THMFP formation for hydrophobic matter was higher, and HAAFP was highly formated for hydrophobic matter. After post-ozone or BAC treatment, chlorine disinfection by-product formation has high potential for hydrophobic matters. Comparing humic and fulvic acids, chlorine disinfection by-product formation potential was higher for humic acid than for fulvic acid in all processes. In the comparison of the reactivity with chlorine disinfection by-product per unit DOC, THMFP and DOXFP showed higher reactivity with hydrophobic matter than with hydrophilic matter in all processes, and HAAFP was highly reacitive with hydrophilic matter. Apparent molecular weight distributions of organic matters were investigated in each process step.The content of low molecular weight organic matters less than 1000 Da in DOC was high in all processes except raw water, but molecular weight organic matters more than 1000 da was higher than molecular weight organic matters less than 1000 Da in the formation potential of chlorine disinfection by-product.

응력 상호작용과 연속압입 기법을 이용한 SS400 강봉의 굽힘 잔류응력 평가

李潤熙,池原宰,孫東一,張宰溢,權東一 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.10

Apparent mechanical properties of welded structural components are deviated from the initially designed values due to the residual stress. Thus, exact assessment of the residual stress using a nondestructive method became an important issue in reliability researches. A nanoindentation model for evaluating the equi-biaxial thin film residual stress was proposed in the previous study. However, the surface residual stress in the welded joint is a non-equi-biaxial state and complex elastic/plastic deformations are involved in the macroindentation. Therefore, the previous model was modified to evaluate the real non-equi-biaxial residual stress by considering a new stress-proportional factor and a significant effect of the plasticity. The newly modified stress-analyzing model was verified empirically by comparing the evaluated uniaxial stress with the already known residual stress of 4-point bended specimen.

스테로이드 여드름과 여드름양 발진에서 Malassezia (Pityrosporum) 효모균의 출현 빈도

이수근,김재홍,양홍윤,김윤석,유희준,손숙자 대한의진균학회 1998 대한의진균학회지 Vol.3 No.1

Background: Steroid acne is a folliculitis that can result from a systemic or topical administration of steroid and has been described as showing similar clinical pictures to Malassezia folliculitis, but there have been few reports about the incidence of Malassezia in steroid acne and other acneiform eruptions. Objective: Our purpose was to describe the incidences of Malassezia in acneiform eruptions and to discuss about the relationship between clinical steroid acne and Malassezia folliculitis. Methods: The history, clinical features, direct microscopy, histopathological analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared. Results: Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of Malassezia in the lesional follicle. Conclusion: Steroid acne and other acniform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk or acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Malassezia folliculitis. [Kor J Med Mycol 3(1): 24∼32]

Lesch-Nyhan 증후군 환아의 자해에 의한 혀의 외상

김지희,최병재,김성오,최형준,손흥규,이제호 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.3

Lesch-Nyhan 증후군은 드물게 나타나는 X 염색체 열성 유전 질환으로 purine의 대사 장애를 보이는 질환이다. Purine의 대사 장애는 대사에 관여하는 효소인 hypoxanthine guanine phosphoribosyl transferase의 결손 또는 활성 감소로 인하여 나타나며,요산의 과다 생산에 의한 요산과다혈증,요산과다뇨증 등의 신장계 증상과 정신지체,무도증 등의 신경학적 장애를 보이고,구강이나 손가락에 대한 자해를 나타낸다. 이 중 자해 행위는 입술과 혀,손가락을 깨무는 경우가 흔하고,심하면 혀와 손가락이 완전히 절단될 수도 있다. 이 경우 자해로 인한 통증뿐 아니라,연조직 결손으로 인한 심미적인 문제와 상처 부위로의 2차 감염이 발생할 수 있다. 이러한 Lesch-Nyhan 증후군 환자에서 자해를 막기 위해 여러 방법이 사용되고 있는데,이 중 치과적으로 접근하는 방법으로는 마우스 가드나 lip bumper 등의 장치를 이용하는 방법과 해당 치아들을 모두 발거하는 방법,악교정 수술을 통해 개방 교합을 형성해 주는 방법 등이 있다. 본 증례는 13세 9개월의 Lesch-Nyhan 증후군 환아로서 자해에 의해 혀에 심각한 외상을 가한 경우로 마우스 가드를 이용한 보존적인 방법을 사용하였으나 계속적으로 혀에 외상을 가해 하악 전치 뿐 아니라 구치까지 발거하여 치료하였다. Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their liP, tongue and finger, In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.