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.

감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자1례와 축산 부산물 시장에서의 역학조사 : Sero-epidemiology Study on Market, by-product, Stock-raising

정성주,김성범,박대원,정혜원,기세윤,권정아,박만석,박미연,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중에 하나로서, 본 증례는 국내에서 감염된 가축에 대한 노출력이 없는 집단에서 현증 브루셀라증이 발생한 첫 증례이기에 문헌 고찰과 함께 보고한다. 또한 환자가 근무하였던 축산물 부산물 시장에서 역학 조사를 실시하여, 현증환자 및 기감염자를 발견하여 축산물 부산물 시장 근무자에서 현증 브루셀라증이 발생할 위험성을 평가하였다. 역학 조사 결과 축산물 부산물을 다루는 일을 하는 사람들에서 감염된 가축과의 직접 접촉이 없이도 브루셀라증이 발생할 수 있음을 알 수 있었다. Brucellosis is a world-wide zoonotic disease. We report the first case of brucellosis in South Korea that is not related to direct contract with intected cattles. The patient had been working in the market of by-product, stock raising for twenty years and complained of 1-month history of fever, chill, and intermittent epistaxis. We confirmed brucellosis by anti-brucella antibody test and PCR. After 6 weeks' treatment with rifampicin and doxycycline, fever and chilling subsided, and, generalized weakness and oral intake improved. We performed seroepidemiology study against workers who were working in the same market as the patient. However, we couldn't find out other cases with seropositivity. We concluded that although the workers of by-product market have a risk of getting brucellosis, the risk is low.

공동주택 유지관리 FCI 모니터링에 관한 연구

범성우,정영한,박태근 대한건축학회 2004 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.24 No.1

After the 1980' s governmental housing business policy was vigorously attained, demand of apartment housing is still on the increase, but systematic maintenance is not following this current incerase trend. A promotion about the realization on the importance of maintenance due to life-time degradation of apartment housing and a plan of life-long practice of maintenance established together with longterm stratergy for maintance upkeep must be imperative. Purpose of this study presents application plan about FCI from rifle cycle viewpoint of building. Expect that is used laying plan that is middle part of a song miracle in actuality and expense arbor in the mountains of longtimer line plan of apartment house. As administration subject establishes well-timed repair time and more strategic budget, may behave better maintenance.

정신분열병 환자의 신경인지 결함의 특성

정성원,김희철,김정범 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

Objective : This study compared the neurocognitive functions between schizophrenic patients and normal controls by verbal fluency test, auditory verbal learning test, and Vienna computerized neuropsychological test. Method : The subjects were 19 schizophrenic patients who were hospitalized in Keimyung University Medical Center from February 2001 to July 2001, and were diagnosed as schizophrenia by the DSM-Ⅳ diagnostic criteria. They were all clinically stable and cooperative patients whose drug dosages were not changed at least for 2 weeks. Twenty normal controls were all healthy volunteers who were matched in sex and age to patients group. The cinical symptoms of schizophrenic patients were evaluated with the PASS and BPRS. Results : The neurocognivite functions of schizophrenic group were impaired in verbal fluency, auditory verbal learning test, continuous attention test, perseveration test, standard progressive matrix, reaction text, Corsi block taping test, visual pursuit test, and cognitrone. The performance of Wisconsin Card Sorting Test was not impaired in schizophrenic group. In schizophrenic group, the positive PANSS scores had no relation with any other neurocognitive test, however the negative and general PANSS scores had relation with verbal fluency test, auditory verbal learning test, standard progressive matrices, visual pursuit test, and cognitrone. Conclusions : There results suggest that the schizophrenic patients have more pervasive neurocognitive deficits and the negative symptoms are related with neurocognitive deficits.

재발성 호흡기 유두종증의 임상양상과 보조 치료의 유용성

성명훈,최병윤,진정욱,성원진,박범정,노종렬,김대우,원태빈,김광현 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.12

상호상관 함수를 이용한 지중선로 고장점 추정

朴星完,林泳範,鄭州桓,成洛煥,金喆煥,申明徹 成均館大學校 科學技術硏究所 1994 論文集 Vol.45 No.2

This paper is intended as an investigation of fault location for underground line. Over the past few decades a considerable number of studies have been made on protection of underground line. However, these approaches require the interruption of electric power supply from source for fault location estimation. Therefore, we proposed fault location algorithm for underground line protection without interruption of electric power supply. Cross correlation function is used in this algorithm. Also, EMTP data is used to demonstrate the capability of the proposed fault location algorithm.

운동이 일부 남녀 대학생들의 혈청과 뇨중 칼슘, 마그네슘 및 아연함량에 미치는 영향

임상선,김형락,차연수,안창범,정복미 여수대학교 1997 論文集 Vol.11 No.2

This study investigated the effect of regular exercise on mineral status in college students. Mineral status for calcium, magnesium, and zinc was evaluated prior to beginning the study and again after 35 days of exercise training for 30 minutes per day. The results obtained were summarized as follows: 1) Serum concentrations of calcium and magnesium were decreased in female subjects but were not affected in males. 2) Urinary excretion of calcium and magnesium was significantly increased in male subjects but unchanged in females. 3) Serum and urinary zinc concentrations were not affected in either male or female subjects. These results suggest that regular exercise may have different effect on calcium and magnesium in humans, depending on gender.

측두하악관절염에서 발생한 희귀한 골화현상

신미정,안상헌,박재범,장헌수,김종필,안재진 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondro-membrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis in more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

InGaP/GaAs Heterojunction Bipolar Transistor의 Thermal Resistance 측정

문태정,황성범 慶南專門大學 1999 論文集 Vol.27 No.1

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6