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        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.

      • 췌장 선방세포암 1예

        이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

        Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

      • KCI등재

        양격산화탕(凉膈散火湯)의 항염증(抗炎症) 효과에 대한 연구

        탁미진,탁명림,강경화,고우신,윤화정,Tak, Mi-Jin,Tark, Myoung-Rim,Kang, Kyoung-Hwa,Ko, Woo-Shin,Yoon, Hwa-Jung 대한한방안이비인후피부과학회 2010 한방안이비인후피부과학회지 Vol.23 No.1

        Objective: Yang Geouk San Hwa - Tang (YGSHT) has been widely used in Sasang Constitutional Medicine of Korea for treatment of acute inflammatory symptom, such as palatine tonsillitis, polydipsia, headache, papule, pimple however, the mechanism of its anti-inflammatory activity has not been clarified. In this study, therefore, we investigated the mechanism of the inhibitory effect of YGSHT on LPS-induced inflammation. Materials and methods: The effect of YGSHT was analyzed by ELISA, RT-PCR and Western blotting in LPS-stimulated RAW264.7 cells. Results: We found that YGSHT suppressed not only the production of pre-inflammatory cytokines (IL-$1{\beta}$ and TNF-$\alpha$), the generation of nitric oxide (NO) and prostaglandin E (PGE)2, but also the mRNA expression of pre-inflammatory cytokines, inducible nitric oxide synthase (iNOS), and cyclooxygenase (COX)-2. Furthermore, YGSHT was shown to inhibit the phosphorylation of ERK1/2 and JNK1/2 and the activation and translocation of NF-kB from cytosol to nuclear in LPS-stimulated RAW264.7 cells. Conclusions: These results suggest that YGSHT exerts an anti-inflammatory effect through the regulation of the ERK1/2 and JNK1/2 pathway and NF-kB pathway, thereby decreasing production of pre-inflammatory cytokines, NO, and PGE2.

      • 원발성 후복막 점액낭샘암종 1예

        지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

        Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

      • KCI등재

        청간소요산으로 호전된 설통 환자 3례

        김연진,양승보,김정화,이상화,조승연,박성욱,박정미,고창남,Kim, Yeon-jin,Yang, Seung-bo,Kim, Jeong-hwa,Lee, Sang-hwa,Cho, Seung-yeon,Park, Seong-uk,Park, Jung-mi,Ko, Chang-nam 대한한방내과학회 2017 大韓韓方內科學會誌 Vol.38 No.4

        Objectives: This clinical study reports the effects of Cheonggansoyo-san (CSS) on three patients with glossodynia. Methods: Three patients with glossodynia were treated with CSS (i.e., an herbal medicine) and acupuncture. Numeric rating scales (NRSs) for glossodynia and dry mouth and hwa-byung questionnaire scores were evaluated, and the results from heart rate variability (HRV) evaluations were analyzed. Results: After treatment with CSS, three patients' glossodynia symptoms, such as burning sensations, tingling, and numbness of the tongue, were improved. NRS ratings for glossodynia and dry mouth and the hwa-byung questionnaire scores also improved, and HRV parameters were closer to the normal range. Conclusion: Cheonggansoyo-san could be used to treat glossodynia.

      • KCI등재

        고사리잎 추출액을 이용한 견직물 염색성

        정진순,설정화,장정대 한국의류학회 2003 한국의류학회지 Vol.27 No.3,4

        In this study, the characteristics of catechol tannin and pyrogallol tannin contained in Pteridium aquilinum were analysed by IR spectrum. Silk fabrics were dyed with Pteridium aquilinum extracts using various mordants, and their dyeing properties were discussed. Additionally the fastness to the water digestion, perspiration liquid digestion and light irradiation were investigated. IR spectrum of catechol tannin showed bands of O-H at 2417㎝^(-1), C-H at 2930㎝^(-1), C-O at 1722^(-1), C=C at 1644㎝^(-1), CH₂ at 1402㎝^(-1). And IR spectrum of pyrogallol tannin showed bands of O-H at 3409㎝^(-1), C-H at 3003㎝^(-1) and 2933㎝^(-1), C=O at 1701㎝^(-1), C=C at 1582㎝^(-1), CH₂ at 1401㎝^(-1), CO at carboxylic acid and carboxylic acid ester at 1287㎝^(-1) and 1135㎝^(-1). The maximum absorption wavelength of the extracts appeared at 270.0nm and 311.5nm. The optimum conditions for dyeing silk fabric with Pteridium aquilinum extracts were 80℃, 60min. Surface color of the silk fabric dyed with Pteridium aquilinum extracts was 2.7Y. Surface color of the pre-mordanted fabrics with Al, Cu and Fe were 4.3Y, 2.5Y and 4.7Y, respectively. And Surface color of the post-mordanted fabrics with Al, Cu and Fe were 3.7Y, 2.8Y and 0.2GY. The water fastness and the alkaline perspiration fastness were improved in the Al-mordanted silk fabrics. By acidic and alkaline perspiration treatment, △E of the unmordanted fabrics was lower than that of pre-and post-mordanted fabrics. Also after 40hour irradiation, △E of the unmordanted fabrics was lower than that of pre-and post-mordanted fabrics.

      • 인터넷 화장품 쇼핑몰에 대한 소비자 만족도 평가

        정해선,김진숙,이경화 가톨릭대학교 생활과학연구소 2001 생활과학연구논집 Vol.21 No.1

        The purpose of this study is to activate the internet cosmetic shopping mall by evaluating customer's satisfaction. The results of the customers' satisfaction in internet cosmetic shopping mall shows that the average of the follows are high: "ordering in convenient time is possible "received the highest point and "comparison with the other brand's goods is easy", "time can be saved" and "price is low" are received fairy high point. But "buying colored cosmetic is easy", "refund is easy" showed low satisfaction. These shows that customers have negative feeling in choosing colored cosmetic and refunding when they use cosmetic shopping mall. The analysis of the total points of the shopping mall reveals that compound shopping mall show many superiorities in contents, and specialized cosmetic shopping malls show superiorities in satisfaction but compound shopping mall is more convenient to the customers than specialized cosmetic shopping mall.

      • 위선암에 병발된 혈액학적 합병증 1예 : 백적아구증, 파종성 혈관내 응고, 미세 맥관성 용혈성 빈혈

        정혜경,김희진,이선영,최진혁,이순남,이홍수,정화순,한운섭 梨花女子大學校 醫科大學 醫科學硏究所 1994 EMJ (Ewha medical journal) Vol.17 No.2

        Among the hematologic complications of solid tumors, leukoerythroblastosis, DIO and MAHA have been known to be clinically significant According to the recent increasing incidence of cancer, these hematologic complications have been reported frequently. However, the simutaneous developement of such manifestations is rare. Recently, we have experienced a patient with gastric adenocarcinoma in which case severe bleeding tendency were observed and laboratory studies including bone marrow examination demonstrated the findings of leukoerythroblastosis, DIC and MAHA. She died of upper gastrointestinal bleeding despite the supportive care such as vlood transfusions. We should give attention to the findings of peripheral golld smear for the patient with malignancy and it is mandatory for therapeutic plan to perform bone marrow examination if the above mentioned hemorrhagic complications are suspected.

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