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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

대두단백질 가수분해물의 특성

김동수,양승택,문윤희,류병호,김희숙,염동민,김진목 慶星大學校 1998 論文集 Vol.19 No.1

The present study was conducted to elucidate some characteristics of soy protein hydrolysates. The soy protein was obtained from defatted soy power by the treatment of n-hexan. The hydrolysates of soy protein were prepared from hydrolysis by bromelian and pepsin with the two kinds of samples of precooking for 30 min in steam oven and noncooking, and fractionated through Bio-gel P-4 column chromatography. Fractions of hydrolysates separated on the Bio-gel column chromatography were carried out to SDS-PAG electrophoresis, resulting to show some different bends from 66kD to 14.2kD of molecular weight. In addition, the fractions showed different activities of superoxide dismutase. From these results, it was found that the hydrolysates could be available to use in a lot of food industrial fields as new functional food materials because the hydrolysates had different characteristics in electrophoresis and could increase the activity of superoxide dismutase.

대학생의 취업스트레스와 자아존중감, 자아효능감, 외모관리행동의 관계

김보라,김유진,김지희,노혜진,오승희,홍지혜,황윤희,박선아 水原大學校 2016 論文集 Vol.30 No.-

Purpose: Many university students are under a lot of job-seeking stress because the employment rate is low. This study sought to determine the relationship between job-seeking stress, self esteem, self efficacy and appearance management behavior amongst university students focusing on nursing. Methods: This descriptive correlational study evaluated the relationships between job-seeking stress, self esteem, self efficacy and appearance management behavior of 340 university students was conducted between September 1 and October 5, 2015. Results: The correlational analysis between job-seeking stress, self esteem, self efficacy and appearance management behavior revealed a negative correlation between job-seeking stress, self esteem and self efficacy and a positive correlation between job-seeking stress and appearance management behavior. In addition, age also correlated with self esteem, self efficacy and appearance management behavior. Conclusion: Stress correlated with self esteem and self efficacy and appearance management behavior. Therefore job-seeking stress may be reduced through not only self esteem and self efficacy enhancement programs but also management according to age.

만성 승모판 패쇄부전증 환자에서의 안지오텐신 전환효소 억제제의 장기 투여 효과

김대희,이명묵,이해영,조현재,박승정,서재빈,서정원,양한모,윤창환,조상호,이준희,김용진,김명아,손대원,오병희,박영배 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

Adiponectin Attenuates the Inflammation in Atopic Dermatitis-Like Reconstructed Human Epidermis

( Hee-seok Seo ),( Ki Hyun Seong ),( Chang-deok Kim ),( Seong Jun Seo ),( Byung Cheol Park ),( Myung Hwa Kim ),( Seung-phil Hong ) 대한피부과학회 2019 Annals of Dermatology Vol.31 No.2

Background: Atopic dermatitis (AD) is a chronic disorder, with a vicious cycle of repetitive inflammation and deterioration of the epidermal barrier function. Adiponectin, an adipokine, has anti-inflammatory effects on various metabolic and inflammatory disorders. Recently, its level was found to be reduced in serum and tissue samples from AD patients. Objective: We aimed to investigate the effects of adiponectin on epidermal inflammation and barrier structures in AD skin. Methods: A three-dimensional in vitro epidermal equivalent model mimicking AD was obtained by adding an inflammatory substance cocktail to normal human epidermal equivalents (HEEs). The expression of epidermal differentiation markers, primary inflammatory mediators, and lipid biosynthetic enzymes was compared between adiponectintreated AD-HEEs, untreated control AD-HEEs, and normal HEEs. Results: Adiponectin co-treatment 1) inhibited the increase in mRNA expression of major inflammatory mediators (carbonic anhydrase II, neuron-specific NEL-like protein 2, thymic stromal lymphopoietin, interleukin-8, tumor necrosis factor-alpha, and human beta-defensin-2) from keratinocytes in AD-inflammatory HEEs, 2) enhanced the expression of lipid biosynthetic enzymes (fatty acid synthase, HMG CoA reductase, and serine-palmitoyl transferase), and 3) promoted the expression of differentiation factors, especially filaggrin. We also found that the expression of adiponectin receptor-1 and -2 decreased in the epidermis of chronic AD lesion. Conclusion: Activation of the adiponectin pathway is expected to enhance epidermal differentiation and barrier function as well as attenuate inflammatory response to AD as a therapeutic approach. (Ann Dermatol 31(2) 186∼195, 2019)

카이토산을 이용한 방사성스트론튬 오염의 치료

김지열,송호천,양광희,최근희,채기문,범희승,김광윤 대한방사선 방어학회 1994 방사선방어학회지 Vol.19 No.3

본 연구에서는 마우스에 이미 오염된 방사성스트론튬(Sr-85)을 제거하는데 수용성카이토산이 어느정도 효과가 있는지 알아보고자 하였다. Sr-85를 정맥주사한 경우 주사후 1일째의 체내 잔류량은 72.9 ±5.7%, 5일째는 57.7 ±1.9%, 7일째는 54.2 ±1.4%로 서서히 감소하였으며, Sr-85를 복강내 주사한 경우는 주사후 5일째 54.4 ±1.2%, 15일째 50.6 ±0.8%로 정맥주사에 비해 낮은 잔류량을 보였다(5일째 잔류량의 비교, P<0.05), 0.3% 수용성카이토산을 1회 정맥주사해준 제21군 및 10% 수용성카이토산을 식이중에 섞어 먹인 제5군은 각각의 대조군에 비해 체내 잔류방사능의 차이가 없었으나 (P>0.05), 0.3% 수용성카이토산을 3일간 정맥주사한 제3군과 3% 수용성카이토산을 이틀 간격으로 15일간 복강내 주사한 제6군에서는 각각의 대조군에 비해 낮은 잔류방사능을 보였다. (P<0.01). 결론적으로 수용성카이토산을 연속적으로 정맥투여하거나 복강내 투여하는 경우에는 스트론튬의 골대사촉진 또는 골중의 스트론튬과의 반응등을 통해 그 배출을 촉진시킬 것으로 사료되었다. The aim of the present study was to elucidate the effect of the water soluble chitosans on the removal of contaminated radiostrontium(Sr-85) from the bone of mice. The remaining radioactivities in intravenously injected controls(group 1) were higher than in intraperitoneally injected controls (group 4, P<0.01). The % retention at day 5 were 57.7 ±1.9%, 54.4 ±1.2%, respectively. Single intravenous injection of 0.3% water soluble chitosan and continuous oral ingestion of 10% water soluble chitosan for 15 days were ineffective on the removal of contaminated radiostrontiums. Multiple intravenous or intraperitoneal injections of water soluble chitosan effectively removed contaminated radiostrontiums (P<0.01 vs controls). In conclusion, water soluble chitosan might remove once incorporated radiostrontium from bones of mice. further studies were needed to elucidate the mechanism of the removal.

플라즈마 이온주입기에서의 시변환 쉬스 연구

김곤호,김건우,김영우,최영도,김종식,김상진,한승희,홍문표 漢陽大學校 工學技術硏究所 1998 工學技術論文集 Vol.7 No.1

Abstract- In a plasma source ion implantation, the target is successively biased by negative voltage pulses with an intrinsic finite rise time, resulting in the time-dependent sheath formation around the target. Measurement of time-dependent sheath during the pulse rise show the ion matrix sheath development which is in proportion to square root of time and pulse rise rate over plasma density but independent of the ion mass.

흰쥐의 원위콩팥단위내 칼슘결합단백질 (calbindin-D28k)에 관한 면역세포화학적 연구

김영희,김완영,김인범,한승호,오수자,차정호,김진 대한해부학회 1997 Anatomy & Cell Biology Vol.30 No.6

주물공장 근로자에서 발생한 국한성 석면폐증 1예

김태우,고동희,김민기,유승원,류향우,한정희,정순희 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

배경: 주물공장 근로자에서 발생한 석면폐증의 작업 관련성을 평가하고 그 증례를 보고하고자 한다. 증례: 30년간 주물공장에서 근무한 환자로 인후통, 기침, 노란 가래가 있어 검사한 결과 결핵이 의심되어 치료 하였으며, 치료 중 석면폐증으로 진단되었다. 작업 관련성 평가를 위해 실시한 폐 조직의 조직학적 검사에서 1 cm^(2)당 3개의 석면소체가 발견되었고, 투과전자현미경으로 분석한 석면 함유량은 23.26x10^(6) fibers/g이었다. 결론: 작업환경조사, 폐 조직의 석면 분석 등을 통해 작업 관련성이 높다고 판단하였다. Background: Foundry workers are known to be exposed to silica and have an increased risk of Silicosis. There are also reports that state these foundry workers were associated with asbestos-related change in the X-ray results of the lungs. This report discusses a case of localized asbestosis developed in a foundry worker who worked in 12 Korean foundries. Case report: A 49-year-o1d man who worked at molding and melting for 30 years, Presented with sore throat, cough and yellow sputum for 1 month. From physical and clinical examination, Pulmonary tuberculosis was highly suspicious; therefore, he was medicated for 6 months. After tuberculosis medication, the radiological finding was reactivation of tuberculosis, and an asbestos body was detected at a trans-bronchial lung biopsy. During an operation, operators found multiple palpable masses and bullae 10calized in the right upper lobe (RUL) and performed right upper lobectomy and right middle lobe wedge resection. Using hematoxylin-eosin stain and iron stain, we could detect asbestos bodies by light microscopy. We analyzed the asbestos fiber burden in dry lung tissue by transmission electron microscopy with energy dispersive X-ray spectrometer (TEM-EDX). The fiber type was chrysotile and the fiber burden was 23.26 x 10^(6) fiber/g dry lung. Discussion: This case study of a foundry worker with localized asbestosis is uncommon in Korea. We found an occupational relationship between the foundry worker and localized asbestosis through various investigative techniques such as measurements taken at his working environment, clinical, radiological and pathological examination of the foundry worker and mineralogical examination of the asbestos fiber.