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      • KCI등재

        한국 메르스 감염의 역학현황과 공중보건학적 대응조치 방향

        최재욱,김경희,조용민,김상후 대한의사협회 2015 대한의사협회지 Vol.58 No.6

        Since May 20, 2015, when the first case of Middle East respiratory syndrome (MERS) in South Korea was confirmed, the cluster case in South Korea has grown to become the largest observed case following Saudi Arabia within the span of one month. Akin to what was observed in the Middle East, confirmed cases were infected through nosocomial transmission where the cluster is largely limited to patients, healthcare workers, and visitors to patients in healthcare facilities with confirmed cases. A major difference from the outbreaks in the Arabian Peninsula has been the large number of tertiary transmission cases in South Korea, which had reached forty cases by June 12. This observation may suggest that despite the lack of genetic mutation of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea, the virus may be behaving differently from that of the Middle East. The higher infectiousness of ‘super-spreaders’ in South Korea also suggests that this assertion should be under further investigation. Suggestions of inadequate triage in emergency rooms, particularly at Samsung Medical Center which accounts for the most nosocomial infection with 60 cases, have been made by several organizations as the basis for this rapid spread. This, however, does not account for the fact that triage was impossible to implement, since the presence of MERS-CoV in South Korea was unknown during the index patient’s stay at the healthcare facilities. This paper aims to identify the key factors in the amplified spread of MERS-CoV in South Korea. The first is the initial failure to confirm diagnosis promptly and to isolate the index case after confirmation of MERS in hospital and the lack of detail in tracking potential exposures in the community of the index case before isolation. The second is the early inadequate measures the Korea Centers for Disease Control and Prevention took in categorizing close contacts. Due to inconsistencies in defining what constitutes close contact, a number of cases were neglected from quarantine and were not subjected to investigation. Finally, confirmed or potential MERS patients were admitted for treatment and observation at medical facilities without adequate disease control measures or rooms, such as ventilated single rooms or airborne precaution rooms. Due to the rigid position that MERS-CoV cannot be transmitted via airborne means, infection control measures has so far neglected evidence that smaller droplets (aerosol) containing the virus can act similar to airborne agents, which may account for the widespread and rapid transmission in a emergency room and a patient’s room in hospital. Although the South Korean government expects newly confirmed cases to abate in the coming few weeks, without stringent implementation of clearly defined guidelines to control further transmissions, the cessation of the current trend may continue for an extended period. Additionally, due to the high infection rate of super-spreaders in South Korea, efforts to screen for potential super-spreaders and a thorough investigation of those confirmed to be super-spreaders should be done to quickly identify source of infection, to potentially lower the number of secondary, tertiary transmissions and prevent possible quaternary transmissions.

      • KCI등재

        백서 혀에서의 4-nitroquinoline 1-oxide 유도 발암과정에서 Bcl-2 계 유전자의 발현

        최재욱,정성수,이금숙,김병국,김재형,국은별,장미선,고미경,정권,최홍란,김옥준 대한안면통증∙구강내과학회 2005 Journal of Oral Medicine and Pain Vol.30 No.3

        The number of patients with tongue carcinoma is increasing rapidly among young individuals in many parts of the world. Oral carcinoma progresses from hyperplastic lesion through dysplasia to invasive carcinoma and the concept of "field cancerization" with molecular alteration has been suggested for oral cavity carcinogenesis. Significant improvement in treatment and prognosis will depend on more detailed understanding of the multi-step process leading to cancer development. To induce tongue carcinoma in rat by 4-NQO, each drinking water was made to 10 ppm, 25 ppm, 50 ppm and control (only D.W. without 4-NQO). Specimens were classified into 4 groups such as control, I (mild & moderate dysplasia), II (severe dysplasia and carcinoma in situ), III (carcinoma). The mRNA expressions of Bcl-2 family were evaluated by RT-PCR technique. For anti-apoptotic Bcl-2 family, mRNA expression of Bcl-w was down-regulated in all stages of tongue carcinogenesis model. However, mRNA expression of Bcl-2 was up-regulated. For pro-apoptotic Bcl-2 family, all members were down-regulated in all stages of tongue carcinogenesis model except for Bad mRNA in group III. In terms of BH3 only protein, mRNA expressions of Bok and Mcl-1 were down regulated in all stages of specimen, but Bmf in group II and BBC3 in group III were up-regulated. Our current findings demonstrated the involvements of mRNA expression of Bcl-2 family in multi-step tongue carcinogensis. This highlights the necessity for continued efforts to discover suitable biomakers (Bcl-2 family) for early diagnosis of the disease, and to understand its pathogenesis as a first step in improving methods of treatment. The discovery of these potential biomarkers and molecular targets for cancer diagnostics and therapeutics has the potential to significantly change the clinical approach and outcome of the disease. 전 세계적으로 구강암의 빈도는 점점 증가 추세이며, 특히 한국인의 있어 혀(tongue)는 구강암이 가장 호발하는 장소이다. 구강암은 발암 단계에서부터 과증식 병소(hyperplastic lesion), 이형성(dysplasia) 및 상피내암(carcinoma in situ) 을 거쳐 악성 암종으로 발전하는 다단계 발암과정을 보이며, 분자 생물학적 변이가 구강암을 진행시킴이 널리 알려져 있다. 또한, 구강암은 일반적으로 암세포의 증식 및 고사(apoptosis)의 억제가 중요한 역할을 하고 있다 알려져 있다. 그리고, Bcl-2 family 는 세포 고사에 주요한 역할을 하고 있음이 알려져 있다. 그러나, 이들과 관련한 구강암 발생과정의 변화에 대해서는 널리 연구된 바가 없다. 본 연구는 백서에서 발암 물질인 4-NQO로 구강암을 유도시키고, 구강암 발생 다단계별로 Bcl-2 family의 mRNA 변화를 RT-PCR을 이용해 살펴보았다. Bcl-2 family는 크게 3군, 즉 1) anti-apoptotic, 2) pro-apoptotic, 그리고 3) BH3 only protein으로 분류할 수 있으며, 본 연구에서 anti-apoptotic molecules인 Bcl-w는 모든 군에서 발현이 감소되었으며, Bcl-2는 발현이 증가 되었다. pro-apoptotic molecules에서는 Bad가 제 3군 (편평세포암종)에서 발현이 증가 되었고, 나머지는 감소하였다. BH-3 only protein에서는 Bmf가 제 2군에서, BBC3가 제 3군에서 발현이 증가하였고, 나머지는 모든 군에서 감소하였다. 결론적으로, 4-NQO로 유도된 백서의 발암단계에서, Bcl-2 family의 mRNA 양상은 다양하게 관찰되었으나, Bad 및 BBC3 mRNA가 제 3군에서, Bmf mRNA가 제 2군에서의 발현이 특별함을 알 수 있어, 다단계 발암과정에서의 구강암을 진단하는데 유용하리라 사료된다.

      • KCI등재

        메틸알콜의 화염전파속도에 관한 연구

        최재욱 한국화재소방학회 2005 한국화재소방학회논문지 Vol.19 No.3

        The flame propagation velocity and the flame arrival time of methyl alcohol, which is widely used as a material of paint industry and organic synthesis, a mixing solvent, and an analytical reagent, were examined at different temperatures and concentrations. It was found that the smaller the vessel size, the easier and faster the combustion. The maximum combustion velocity was 200cm/sec in the small vessel at 30oC. The flame arrival time was determined to be longer with larger vessels, and shorter with higher concentrations. 도료공업, 유기합성의 원료, 혼합용제 및 분석용 시약으로 광범위하게 이용되고 있는 메틸알콜에 대하여 작업장에서 발생할 우려가 있는 화재·폭발 예방 대책을 수립하기 위한 기초자료를 획득하기 위하여 화 염전파속도와 화염도달시간을 측정하였다. 용기의 크기를 변화시키고 온도 및 농도를 변화시켜 실험을 행 한 결과 시료의 용기가 적을수록 연소가 용이하고 연소속도는 빠르게 나타났으며, 최대연소속도는 소용기 30oC에서 200 cm/sec를 구하였다. 화염도달시간은 시료 용기의 크기가 클수록 길어지는 경향을 나타내었 으며, 시료의 온도 및 농도가 높아질수록 짧아졌다.

      • KCI등재

        선회충돌제트에 의한 배열 칩의 열전달 특성에 관한 실험적 연구

        최재욱,전영우,정인기,박시우 한국마린엔지니어링학회 2004 한국마린엔지니어링학회지 Vol.28 No.4

        The experimental study on heat transfer characteristics of protruding heated block array as conducted to investigate and to compare the performance of impinging single circular jet in fully developed tube with a twisted tape as a swirl generator. The effects of jet Reynolds number(Re=8700, 13800, 20000. 26500), dimensionless jet-to-block distance(H/d=1. 3, 5. 7) and swirl number(S=0.11, 0.23, 0.30) of the swirl jet on the average Nusselt number for each block and all blocks have been examined. Measurements of heat transfer rate on block surfaces were used naphthalene sublimation technique. Mean velocity and turbulence intensity of the jet along the axis were measured. Potential core length of the jet was 5 times of nozzle diameter because it was fully developed and initially turbulent. With the twisted tape in the nozzle, heat transfer coefficients were higher than those without the twisted tape. which are mainly caused with increasing the jet Reynolds number and swirl number.

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