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.

정서유발단어에 대한 주의이동시 뇌신경망의 활성 양상

김연희,장은혜,고명환,신승훈,양경혜,손진훈 한국뇌학회 2002 한국뇌학회지 Vol.2 No.2

본 연구는 fMRI를 사용하여 정서유발단어에 의한 주의이동과 관련한 뇌신경망을 규명하기 위하여 12명의 오른손잡이 여대생을 대상으로 수행하였다. fMRI 실험을 위한 뇌활성화 과제는 예비실험을 통하여 선정된 행복, 슬픔, 위협에 해당하는 각각 36개씩의 단어와 각 단어의 짝을 이루기 위한 중성단어를 이용하여 변형된 Posner 패러다임을 블록디자인으로 고안하였다. fMRI 영상은 1.5T Simens Vision scanner를 사용하여 실시하였으며, single-shot EPI 기법으로(TR/TE:3840/40ms, flip angle: 90, FOV: 220, 64x64 matrix, Slice thickness: 6mm) 이미지를 얻었고 피험자의 반응시간을 기록하였다. 자료분석은 SPM-99 소프트웨어를 사용하였다. 정서유발단어는 중성단어에 비하여 반응시간이 의미있게 빨라 효과적인 주의이동이 일어났음을 알 수 있었다. 정서유발단어와 중성단어에 의한 뇌활성화 상태를 감산분석한 결과, 좌측 상두정엽, 양측 후두엽 및 소뇌에서 뇌활성화를 보였고, 이들 영역은 정서유발단어에 의한 주의이동시 특징적으로 활성이 일어나는 뇌영역임을 보여주었다. 또한 여러 가지 정서가를 가진 단어에 의해 유발되는 주의의 정도가 특징적인 신경망의 활성과 관련되어 있음을 알 수 있었다. The purpose of this study is to delineate the neural network related to the shift of attention and its modulation by emotion-provoking words using functional MRI (fMRI). Twelve right-handed normal female volunteers participated in fMRI study. Their mean age was 24 years and the mean modified Edinburgh score was +90. Emotion-provoking words representing happy, sad, threatened, and neutral emotional valences respectively were chosen by the assessment of 60 normal volunteers using semantic differentiation and Mannequin scales. The activation tasks were designed using modified Posner's paradigm to have 4 blocks of each emotional and control periods, Imaging was conducted on a 1.5T Siemens Vision scanner. Single-shot echoplanar images (TR/TE = 3840/40 ms, flip angle = 90, FOV = 220, matrix = 62 ? 64, slice thickness = 6㎜) were acquired in 20 contiguous slices parallel to the AC_PC line as well as conventional T1-weighted images. Response times were obtained during the scanning, Imaging data were realigned, coregistered, normalized, smoothed, and statistically analyzed in group using SPM-99 software. The results showed that emotional valence of word stimuli produced the effect of attentional engagement. The left superior parietal, inferior frontal, bilateral occipital lobes and cerebellum were main area of modulation of attentional network by emotional words stimuli. The different extent of brain activation induced by different emotion-provoking words were determined.

주거시설 바닥의 보행감 평가방법에 관한 연구(Ⅱ) : 바닥의 보행감에 관한 평가지표 및 평가방법 제시 Presentation of Evaluation Index and Method of sensation Hardness

고은정,김두호,최수경 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

This paper presents the process of the make a hardness tester and presentation of the evaluation method on sensation hardness of residential floors. Evaluation index of hardness is based on the relation between the physical value of floors measured with the hardness tester and the evaluating scales of hardness reported in part (I). Evaluation index of sensation hardness difference the distinction of sex and shoes type. And liking for sensation hardness is a great difference between Korean and Japanese.

비인강폐쇄부전 환자의 언어교정을 위해 발음 보조장치를 이용한 증례

김은주,고승오,신효근,김현기 한국음성과학회 2002 음성과학 Vol.9 No.4

VPI occurs when the velum and lateral and posterior pharyngeal wall fail to separate the nasal cavity from the oral cavity during deglutition and speech. There are a number of congenital and acquired conditions which result in VPI. Congenital conditions include cleft palate, submucous cleft palate and cogenital insufficiency (CPI). Acquired conditions include carcinoma of the palate or pharynx and neurologic disorders. The speech characteristics of VPI is characterized by hypernasality, nasal air emission, decreased intraoral air pressure, increased nasal air flow, decreased intelligibility. VPI can be treated with various methods that include speech therapy, surgical procedures to reduce the velopharyngeal gap, speech aid prosthesis, and combination of surgery and prosthesis. This article describes four cases of VPI treated by speech aid prosthesis and speech therapy with satisfactory result.

쪽파[Allium ascalonicum L.] 재배기간 중 Diazinon, Iprodione 및 Chlorfenapyr의 잔류랑 변화

고광용,나은식,김성헌,김상준,장영희,이규승 충남대학교 농업과학연구소 2005 농업과학연구 Vol.32 No.2

In order to know the residual pattern of pesticides and predict to the degradation period until below MRL, we experimented diazinon, iprodinon and chlorfenapyr for shallot. They were the most detected pesticide in shallot by NAQS (National Agricultural product Quality management Service) survey. In this experiment, we sprayed those pesticides 15days before harvest and analyzed 0, 1, 2, 3, 5, 7, 10, 14 day sample to establish logical equation and to calculate DT_(50). During the cultivating period, the residue amount of diazinon was changed from 1.02 mg/kg (0 day) to 0.01 mg/kg (14 day), DT_(50) was 2.19 days, and iprodione was changed from 1.45 mg/kg (0 day) to 0.14 mg/kg (14 day), DT_(50) was 4.15 days, and chlorfenapyr was changed from 1.5 mg/kg (0 day) to 0.01 mg/kg (14 day), DT_(50) was 1.97 days. The DT_(50) of double amount in those pesticides, diazinon was 2.24 days, iprodione was 4.82 days, and chlorfenapyr was 2.24 days, respectively.

상표자산과 구매의도와의 관계에 관한 국제비교연구 : 아시아와 유럽의 의류시장을 중심으로

김경훈,고은주,Graham Hooley,Nick Lee,이동해,정홍섭,전병주,문학일 가야대학교 2009 가야대학교 논문집 Vol.18 No.-

본 연구는 상표자산의 구성요소에 대한 선행요인을 분석하고 이를 토대로 하여 상표자산 구성요소와 상표자산 영향요인간의 관계 그리고 상표자산 구성요소와 구매의도간의 관계를 규명하고 한국과 영국을 중심으로 비교하여 상표자산관리 방안을 도출해보고자 하였다 연구결과, 정보탐색은 제품지식에 정(+)의 영향을 미치며, 상표태도와 상표지식은 상표 충성도와 상표 가치에 정(+)의 영향을 미치는 것으로 나타났다 그리고 상표충성도와 상표가치는 구매의도에 정(+)의 영향을 미치는 것으로 나타났다. 정보원천의 경우, 한국에서는 제품지식에 정(+)의 영향을 미치고 있는 반면, 영국에서는 영향을 미치지 않는 것으로 나타났다. Brand equity is one of the most important concepts in business practice as well as in academic research. Successful brands can allow marketers to gain competitive advantage (Lassar et al.,1995), including the opportunity for successful extensions, resilience against competitors' promotional pressures, and the ability to create barriers to competitive entry (Farquhar, 1989). Branding plays a special role in service firms because strong brands increase trust in intangible products (Berry, 2000), enabling customers to better visualize and understand them. They reduce customers' perceived monetary, social, and safety risks in buying services, which are obstacles to evaluating a service correctly before purchase. Also, a high level of brand equity increases consumer satisfaction, repurchasing intent, and degree of loyalty. Brand equity can be considered as a mixture that includes both financial assets and relationships. Actually, brand equity can be viewed as the value added to the product (Keller, 1993), or the perceived value of the product in consumers' minds. Mahajan et al. (1990) claim that customer-based brand equity can be measured by the level of consumers’ perceptions. Several researchers discuss brand equity based on two dimensions: consumer perception and consumer behavior. Aaker (1991) suggests measuring brand equity through price premium, loyalty, perceived quality, and brand associations. Viewing brand equity as the consumer’s behavior toward a brand, Keller (1993) proposes similar dimensions: brand awareness and brand knowledge. Thus, past studies tend to identify brand equity as a multidimensional construct consisted of brand loyalty, brand awareness, brand knowledge, customer satisfaction, perceived equity, brand associations, and other proprietary assets (Aaker, 1991, 1996; Blackston, 1995; Cobb-Walgren et al., 1995; Na, 1995). Other studies tend to regard brand equity and other brand assets, such as brand knowledge, brand awareness, brand image, brand loyalty, perceived quality, and so on, as independent but related constructs (Keller, 1993; Kirmani and Zeithaml, 1993). Walters(1978) defined information search as, "A psychological or physical action a consumer takes in order to acquire information about a product or store." But, each consumer has different methods for informationsearch. There are two methods of information search, internal and external search. Internal search is, "Search of information already saved in the memory of the individual consumer"(Engel, Blackwell, 1982) which is, "memory of a previous purchase experience or information from a previous search."(Beales, Mazis, Salop, and Staelin, 1981). External search is "A completely voluntary decision made in order to obtain new information"(Engel & Blackwell, 1982) which is, "Actions of a consumer to acquire necessary information by such methods as intentionally exposing oneself to advertisements, taking to friends or family or visiting a store."(Beales, Mazis, Salop, and Staelin, 1981). There are many sources for consumers’ information search including advertisement sources such as the internet, radio, television, newspapers and magazines, information supplied by businesses such as sales people, packaging and in-store information, consumer sources such as family, friends and colleagues, and mass media sources such as consumer protection agencies, government agencies and mass media sources. Understanding consumers’ purchasing behavior is a key factor of a firm to attract and retain customers and improving the firm’s prospects for survival and growth, and enhancing shareholder’s value. Therefore, marketers should understand consumer as individual and market segment. One theory of consumer behavior supports the belief that individuals are rational. Individuals think and move through stages when making a purchase decision. This means that rational thinkers have led to the identification of a consumer buying decision process. This decision process with its different levels of involvement and influencing factors has been widely accepted and is fundamental to the understanding purchase intention represent to what consumers think they will buy. Brand equity is not only companies but also very important asset more than product itself. This paper studies brand equity model and influencing factors including information process such as information searching and information resources in the fashion market in Asia and Europe. Information searching and information resources are influencing brand knowledge that influences consumers purchase decision. Nine research hypotheses are drawn to test the relationships among antecedents of brand equity and purchase intention and relationships among brand knowledge, brand value, brand attitude, and brand loyalty. H1. Information searching influences brand knowledge positively. H2. Information sources influence brand knowledge positively. H3. Brand knowledge influences brand attitude. H4. Brand knowledge influences brand value. H5. Brand attitude influences brand loyalty. H6. Brand attitude influences brand value. H7. Brand loyalty influences purchase intention. H8. Brand value influence purchase intention. H9. There will be the same research model in Asia and Europe. We performed structural equation model analysis in order to test hypotheses suggested in this study. The model fitting index of the research model in Asia was X2=195.19(p=0.0), NFI=0.90, NNFI=0.87, CFI=0.90, GFI=0.90, RMR=0.083, AGFI=0.85, which means the model fitting of the model is good enough. In Europe, it was X2=133.25(p=0.0), NFI=0.81, NNFI=0.85, CFI=0.89, GFI=0.90, RMR=0.073, AGFI=0.85, which means the model fitting of the model is good enough. From the test results, hypotheses were accepted. All of these hypotheses except one are supported. In Europe, information search is not an antecedent of brand knowledge. This means that sales of global fashion brands like jeans in Europe are not expan

충북 지역 초등학교 과학교육의 실태 조사

김찬종,이선경,김수환,고은성 淸州敎育大學校 科學敎育硏究所 科學과 數學敎育論文集 Vol.23 No.-

A survey was carried out comprehensively to investigate the present status of science education in primary schools 496 teachers in 199 primary schools in Chungbuk area participate in the survey. They questionnaire used in this study included items regarding goals or objectives for science education, approaches for instruction, teaching-learning strategies, assessment for instruction, teaching-learning strategies, assessment for instruction, computer use in science classes students' activity and the status of experimental equipment or tools for science education. Items on science textbooks and the understanding of the 7th national curriculum were also included in it. The results based on the teachers' responses were summarized and provided in this paper and it showed practices of science education in Chungbuk area.

자동화학 분석기 ISP-1000의 평가 Ⅱ

김문연,고은하,하경임,김지용,전창호 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

검사방법의 평가로서 자동화기기에 대한 적절한 평가는 특히 수입에 전적으로 의존하는 국내여건을 생각할때 중요한 과제이다. ISP-1000은 대용량, 다항목의 선택적 생화학 자동 분석기로 국내에서는 거의 채택된 경험이 없는 기기로서 효율적인 선정을 하기위하여 4가지 화학검사에 대한 평가를 하였다. 시판되는 대조물질 Level Ⅰ,Ⅱ로 검사내 정밀도, 검사일간 정밀도, 직선성을 구하였으며 100명의 환자검체로는 Cobas Mira와의 상관성을 구하였다. 검사내 정밀도는 Level Ⅰ대조물질에서는 변이계수가 4.31-8.73%, Level Ⅱ 대조물질에서의 변이계수는 1.32-8.22%이었으며, 검사일간 정밀도는 Level Ⅰ 대조물질로 얻은 변이계수는 6.29-8.974%, Level Ⅱ 대조물질로 검사한 경우는 5.78-8.22%이었다. 직선성의 평가에서는 0.9917-0.9998의 우수한 직선성을 보여주었고(P<0.01), Cobas Mira에 대한 상관관계는 0.8427-0.9857의 범위에 있었다(P<0.01). 결론적으로 ISP-1000에 대한 4가지 화학검사의 평가에 있어서 검사중 정밀도, 검사일간 정밀도, 직선성은 우수하였으며, 상관관계는 만족할만하였으나 더 좋은 결과를 얻기위하여 parameter등에 대한 재검토가 필요한 것으로 생각되었다. It is an important task to evaluate autochemical analyzers as one of the labortory method evaluations, especially considering of the domestic environments almost depending on the import. By analyzing 4 chemical tests, we evaluated the high throughoutput, multichannel, selective and rarely adopted chemical autoanalyzer ISP-1000. We analyzed within run precision, between day precision, lineality with the commercial control materials, and correlation with 100 patients samples. In within run precision, CVs were ranged from 4.31~8.73% in Level I control material, l.32-8.22% in Level Ⅱ control material. In between day precision, CVs were ranged from 6.29-8.974% in Level I control material, 5.78-8.22% in Level Ⅱ control material. The lineality was excellent(r²>O,9917, p<O.Ol). The correlation coefficients between ISP-l000 and Cobas Mira were ranged from 0.8247∼0.9857%(P<O.0l). In conclusion, 4 chemical tests of ISP-l000 were acceptable in within run precision, between day precision and lineality, and correlation with Cobas Mira was good but adjusting the parameters would be necessary for the better results.

Fontan Procedure이후 심장혈관계의 혈류역학적 특성에 관한 수치적 연구

고형종,김경훈,심은보 金烏工科大學校 1998 論文集 Vol.19 No.-

The aim of this study is to develop a computational model representative of the circulation in patients with a uni-ventricular heart sugically palliated by a total atrio-pulmonary connection. A model of the cardiovascular system is built using standard Iumped components such as resistance, voltage source, check valve and capacitor. We assume that there is only an atrium in the right heart part of the model after the Fontan procedure. In this study, baroreceptor reflex and cardiopulmonary reflex control model are implemented to explain the autoregulation of cardiovasculasr system. Another important aspect of the model is to utilize a beat-to-beat approach in sensing pressure deviations, in transferring these to autonomous nerve system, and in regulating the control variables such as heart rate, heart contractility, peripheral resistance, and venous tone. To verify the present code. we have computed the LBNP(Lower Body Negative Pressure)simulation and compared its results with the existing experimental data. The hemodynamic changes after the Fontan procedure are simulated and compared with the existion clinical data. After Fontan procedure, heart rate, CVP(Central venous pressure) and diastolic pressure increase whereas pulse pressure and systolic pressure go down. Increased CVP, induced by the removal of right ventricle, makes the heart rate go up via baroreceptor reflex control. The effects of known hazardous exposures after Fontan procedure are also investigated. We assume increased peripheral resistance to simulate the situation of exposure to cold. In this case increased arterial pressure induces the decrease of heart rate. which results in decrease of cardiac output. On the other hand, exposure to heat increases heart rate and cardiac output. Hemorrhage in cardiovascular system results in increase of ABP(Arterial Blood Pressure) and decrease of heart rate and cardiac output.

만성 C형 간염 환자에서 페그인터페론 알파2a와 리바비린 병합 치료중 발생한 벨마비 1예

김일환,장제혁,유충헌,최규남,고정해,김윤정,서광원,김지현,박성재,박은택,이연재,이상혁,설상영 인제대학교 2008 仁濟醫學 Vol.29 No.-

페그인터페론과 리바비린 병합요법은 만성 C형 간염의 일차 치료법이다. 저자들은 만성 C형 간염 환자에서 페그인터페론 과 리바비린 병합 요법 중에 발생한 벨마비 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 5년 전부터 만성 C형 간염을 앓아온 48세 남자이며, PEG-IFN α-2a 135μgm 피하주사 주1회와 하루 1200㎎의 리바비린을 투여하였다. 치료시작 후 9개월째 환자는 오른쪽 안면의 근력약화를 호소하였으며 벨마비로 진단되었다. 페그인터페론과 리바비린 병합요법을 지속하면서 관찰하였다. 환자의 벨마비는 페그인터페론 치료를 중단하지 않았음에도 3개월후 증상이 회복되고 이후 벨마비 재발 없이 현재 경과관찰 중이다. 만성 C형 간염에서 페그인터페론과 리바비린 병합 요법시 벨마비의 발생 가능성을 염두에 두어야 하겠다. A Case of Bell's Palsy Associated with Combination Therapy of Pegylated Interferon Alfa-2a (PEG-IFN) and Ribavirin for Chronic Hepatitis C Virus Infection Pegylated interferon alfa(PEG-IFN α) and ribavirin therapy is the first line treatment for chronic hepatitis C. Mild complications of the therapy are common, but more serious complications are rare. We report here a case of Bell's palsy that occurred in a patient with chronic hepatitis C virus infection during combination therapy of PEG-IFN α-2a and ribavirin. The patient was 49-year-old man with chronic hepatitis C (genotype 1b) for 8 years. He had compensated liver cirrhosis with splenomegaly. Therapy with PEG-IFN α- 2a 135mcg/week and ribavirin 1200mg/day was initiated. After 9 months of the therapy, the patient showed a loss of muscular tone on the right side of his face. A diagnosis of Bell's palsy was made. The Bell's palsy resolved over 3 months despite continuation of the combination therapy.