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.

인터페론 치료에 반응이 없었던 예들을 포함한 만성 B형 간염 환자에서 lamivudine의 단기 치료 효과

이상우,이엄석,김선문,서승원,양현웅,성재규,이승민,이병석,김남재,이헌영 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The efficacy and safety of lamivudine administration according to the presence or abscence of past history of interferon treatment were studied in 22 patients with chronic active hepatitis B who were diagnosed at ChungNam National Univerity Hospital. Nine of these patiens were no responders to interferon treatment. The change of HBV DNA, serum ALT and HBeAg values was analyzed during 12 weeks of lamivudine treatment. The results were as follow : 1. The mean values of HBV DNA and serum ALT were significantly reduced from 1793 9 to 2.0 pg/ml and from 202.5 to 36.3 IU/L after lamivudine treatment (p<0.001). The mean reduction rates of serum HBV DNA and serum ALT were 99.7% and 70.4%. 2. HBV DNA was undetectable in 18 patierits(81.8%) and serum ALT was normalized in 16 patients(68.2%%) after 12 weeks of lamivudine treatment. But there were temporary elevations of serum ALT value comparing to pretreatment value in 5 patients. 3. HBeAg was undetectable in 4 patients(18.1%) and in these 4 patients, anti-HBe was detected after 12 weeks treatment. 4. There was no significant difference of HBV DNA clearance rate and normalization rate of serum ALT between above and below 200 pg/mI group according to pretreatment HBV DNA values(p=0.74, p=0.08). 5. Each clearance rates of HBV DNA in patients without previous interferon treatment and patients with previous interferon treatment were 84.6% and 77.8%(p=0.68). Each clearance rates of HBeAg in patients without previous interferon treatment and with previous interferon treatment were 15.5% and 22.2%(p=0.683). 6. During the treatment periods, adverse effects of lamivudine were negligible in most patients except temporary leukopenia in one patient. Conclusively, lamivudine treatment over the short term period for patients with chronic active hepatitis B was effective in suppression of viral replication and improvement of abnormal serum ALT. Also the efficacy of lamivudine treatment was out of all relation to previous interferon treatment and adverse effects of this drug were negliable. But further study for the efficacy of long term period-lamivudine treatment and appearance of mutant shoud be necessary.

Performance of electrochemical double layer capacitors using highly porous activated carbons prepared from beer lees

Sang Guk Lee,Hee Moon,Kwang Hyun Park,심왕근,M.S. balathanigaimani 한국공업화학회 2011 Journal of Industrial and Engineering Chemistry Vol.17 No.3

Beer lees precursor is chosen to prepare activated carbons having different physical and chemical properties. The beer lees-based activated carbons (BL-ACs) are characterized by N2 adsorption/desorption isotherms, adsorption energy distributions (AEDs), and X-ray photoelectric spectroscopy (XPS). Furthermore the electrochemical properties of the BL-ACs are assessed using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and constant current charge/discharge method. The maximum specific capacitance (about 188 F/g at discharge current of l mA/cm2) is obtained in 0.1 M H2SO4 electrolyte solution, which is a relatively low electrolyte concentration. The overall results suggest that the BL-ACs are good candidates for EDLC electrode materials.

역행성 골수강내 금속정을 이용한 원위 대퇴골 간부 및 과상부 골절의 치료

이상홍,이준영,하상호,손홍문,이광철 대한골절학회 2004 대한골절학회지 Vol.17 No.2

상부소화관출혈에 있어서 내시경적 분말약제산포의 효과

김상균,조주영,송상훈,김진오,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Bleeding after endoscopic procedure of the stomach carries an increased risk of morbidity and mortality. In case of oozing hemorrhage, not in active hemorrhage, powdered sodium alginate may play a role in control of bleeding with convenience. Therefore, we evaluated the clinical effect and efficacy of sodium alginate powder in upper G-Ⅰ bleeding. Methods : Forty-five patients who had upper G-Ⅰ bleeding after endoscopic procedure were enrolled in this study. Twenty-five patients of them were managed by the application of powder preparation of Sodium alginate(ALTO). The others were observed without treatment. The next day, we performed endoscopy in all patients to ascertain the hemostasis. Results : Of 25 patients managed with Sodium alginate, only two patients(8%) had bleeding (hemostatic rate : 92%), On the other hand, of 20 patients who did not receive any treatment, 3 patient(15%) had bleeding (hemostatic rate : 85%). There was no statistical difference between the two groups(p>0.05). Using other endoscopic procedure, We successfully treated the patient who continued to bleed. Conclusion : We evaluated the effect of the spary of sodium alginate on oozing hemorrhage. Although there was no statistical significance in our study, it seems that the spray of sodium alginate may be a useful method for the prevention of bleeding after endoscopic procedure.

A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

≪매일신보≫에 연재된 이해조 산정 <강상련>의 특징과 의미

이문성 ( Moon Sung Lee ) 판소리학회 2011 판소리연구 Vol.32 No.-

<강상련(江上蓮)>은 1912년 3월 17일부터 4월 26일까지 총 33회에 걸쳐서 ≪매일신보(每日申報)≫에 연재된다. 이것은 창자 심정순(沈正淳 ; 1873~1937년)의 판소리 <심청가>를 이해조(李海朝 ; 1869~1927년)가 산정(刪正)한 작품이다. ≪매일신보≫에 연재된 이해조 산정 <강상련>의 특징과 그 의미를 살펴보면 다음과 같다. ``강상련``의 표제는 ``강상(綱常)의 도인 효를 실천하고자 목숨을 걸고 물에 빠졌다가 물 밖[江上]으로 살아 돌아온 심청``을 ``연꽃[蓮]``에 비유하여 명명한 이해조의 재치로 여겨진다. 신문 연재본 <강상련>에서 심봉사 안맹과 곽씨부인 죽음의 시점은 심청의 고난의 정도를 극대화한 설정이다. 이것은 극한의 역경에도 불구하고 출천대효로서 역할을 다하는 심청을 부각시킨다. 또한 심청과 심봉사의 연령을 나타내는 표지는 인물의 고난기간과 보상기간을 맞추고 있는 듯하다. 심봉사는 ``칠십 향수``, 일평생인 70세를 기준으로써 잃어버린 딸을 되찾고 잃어버린 시력을 되찾고 새 처자를 만나서 새 자식들과 새 가정을 갖게 된다. 심청은 인당수의 제수가 될 때까지 고단했던 15년의 삶을 용궁생활과 황궁생활의 ``15~16년``으로 보상받는다. 신문 연재본 <강상련>은 활자본에 비해서 선본(先本)일 뿐만 아니라, 문면이 정제된 선본(善本)으로서의 가치가 높다. 또한 신문 연재본 <강상련>은 판소리 장단 표지를 중심으로 사설을 담고 있어 소설뿐만 아니라, 판소리 예술 자료적 가치를 지닌다. 아울러 신문 연재본 <강상련>을 비롯한 일련의 판소리 산정 작품은 이해조의 식자로서의 면모와 수완을 이해하는 데에, 20세기 초 신문·출판문화를 이해하는 데에 기초자료가 될 만하다. 이에 신문 연재본에 대한 적극적인 고구가 필요할 듯하다. This article is a study on <Kangsanlyeon> published on ≪Maeil Shinbo≫ which is one of korean daily newspapers in the early 20th century. <Kangsanlyeon> is based on <Shimcheong-ga> which is sung by Sim, Jeongsun who is a famous vocalist of pansori and recreated by Lee, HaeJo. <Kangsanlyeon> published on ≪Maeil Shinbo≫ becomes a model of other pieces of novels, Kangsanlyeon and Simcheongjeon. <Kangsanlyeon> contains a lot of symbols that present filial piety and interest elements to readers. It is the first and the best work of Kangsanlyeon`s and Simcheongjeon`s since 1912. <Kangsanlyeon> published on ≪Maeil Shinbo≫ has various pansori modes of singing. It has the value of a musical text in the history of pansori because a sound and melody of <Shimcheong-ga> which was sung by Sim, Jeongsun has disappeared already. Through <Kangsanlyeon>, we can understand an ability of Lee, Haejo as a writer and recreator, the best model of Kangsanlyeon`s and an aspect of publishing culture in the early 20th century.

원통 연삭에서 가공 능률 향상을 위한 연삭 저항의 측정에 관한 연구

김원일,이진,이윤경,왕덕현,이상복,이관철,문원길 경남대학교 공업기술연구소 2000 硏究論文集 Vol.18 No.-

본 연구에서는 원통 연삭 가공에서 가공 능률 향상을 위한 연삭 저항을 측정하고자 연삭 가공 중에 발생하는 연삭 저항의 추이를 확인하였고 다음과 같은 결과를 얻었다. 숫돌과 공작물간의 연삭 강성은 공작 속도의 증가에 따라 지지계의 강성이 높은 경우 증가하였고 절삭 깊이와 연삭 숫돌의 속도에는 연삭 강성이 감소하는 경향을 보였다. 또한 총합 강성은 공작 속도, 절삭 깊이 및 연삭 숫돌의 속도 증가에 따라 지지계의 강성이 높을 수록 증가하였다. 연삭기의 강성 변형과 가공 능률에 영향을 주는 값으로 연삭 강성비는 지지계의 강성이 높을 수록 감소하였다. In this study, the measurement of grinding resistance to improve grinding efficiency in cylindrical grinding was studied and the following conclusions could be obtained. Relation grinding wheel and workpiece, grinding stiffness increases according to increase of work speed for high machine stiffness and decreases depth of cut and grinding wheel speed. Also, resultant stiffness increases high machine stiffness according to increase work speed, depth of cut and grinding wheel speed. The values of the effect stiffness deflection in grinding machine, grinding stiffness ratio decrease according to high machine stiffness.

추황배(Pyrus pyrifolia Nakai cv. Chuhwangbae) 과피로부터 1종의 Sterol과 3종의 배당체 화합물의 단리·동정

이유건(Yu Geon Lee1),조정용(Jeong-Yong Cho),이현주(Hyun Joo Lee),이용현(Yong Hyun Lee),이상현(Sang-Hyun Lee),한태호(Tae-Ho Han),김월수(Wol-Soo Kim),박근형(Keun-Hyung Park),문제학(Jae-Hak Moon) 한국식품과학회 2013 한국식품과학회지 Vol.45 No.5

본 연구에서는 배의 유용성 증명을 위한 일환으로 배의 화학성분을 분자수준에서 밝히고자 하였다. 이에 배 과피 MeOH 추출물을 용매분획하여 얻은 EtOAc-산성 분획과 EtOAc-중성분획을 대상으로 Sephadex LH-20, silica gel, 그리고 ODS colmn chromatography와 HPLC를 이용하여 정제 및 단리하였다. 그 결과, EtOAc-산성 분획과 EtOAc-중성 분획으로부터 각각 2종씩의 화합물을 단리하였다. 단리된 화합물 1-4는 1H- 및 13C-NMR 분석을 통하여 각각 (S)-(+)-2-cis-abscisic acid O-β-D-glucopyranosyl ester (화합물 1), 1-[4-O-β-D-glucopyranosyl]phenyl ethanone(piceoside, 화합물 2), β-sitosterol (화합물 3), 그리고 β-sitosteryl 3-O-β-D-glucopyranoside (화합물 4)로 동정되었다. 단리된 3종의 배당체 화합물(화합물 1, 2, 4)들은 본 연구에 의해 배로부터 처음 동정되었으며, 화합물 3은 추황배로부터 처음 동정되었다. 본 연구결과가 배 함유 성분연구는 물론 배의 기능성 해명 연구에도 추후 중요한 기초자료로 활용되길 기대한다. We isolated and identified antioxidants from acidic and neutral ethyl acetate fractions of the peel of pear (Pyrus pyrifolia N. cv. Chuhwangbae). We isolated 4 compounds from the methanol extract, by using 3 different types of column chromatography (Sephadex LH-20, silica gel, and octadecylsilane) and preparative HPLC. We identified the isolated compounds as (S)-(+)-2-cis-abscisic acid O-β-D-glucopyranosyl ester (compound 1), 1-[4-O-β-D-glucopyranosyl]phenyl ethanone (picroside, compound 2), β-sitosterol (compound 3), and β-sitosteryl 3-O-β-D-glucopyranoside (compound 4) by nuclear magnetic resonance analysis. We are the first to report the identification of compounds 1, 2, and 4 from pear.

비외상성 두개내 출혈 환자에서 심근손상의 발생과 예후에 미치는 영향

강구현,황성호,이강현,조준휘,김성환,문중범,박해상,이서영,이성수,김헌주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Objective: The aim of this study was to investigate the clinical significance of myocardial injuries in patients with nontraumatic intracranial hemorrhage by identifying the occurrence of myocardial injury and defining its correlation with subsequent cardiovascular events. Subjects and methods: One hundred twenty-four patients with nontraumatic intracraninal hemorrhage presented to the emergency department within six hours from onset of symptoms were enrolled. Brain CT, serial electrocardiography, and echocardiography were done at the emergency center. Blood samples for troponin I and creatine kinase(CK)-MB were drawn immediately and eight hours after admission, Troponin I and CK-MB were measured using a chemiluminescent immunoassay, respectively. Results: Electrocardiographic and echocardiography abnormalities were found in 65 cases(52.4%) and 21 cases(17%), respectively. Serum troponin I and creative kinase-MB were increased in 35 cases (28.2%) and in 58 cases(46.8%), respectively. Abnormal findings of echocardiography and ECG, as well as elevated levels of serum troponin I and creative kinase-MB, were associated with an increased risk of cardiovascular event and survival. Logistic regression analysis revealed that an abnormal echcocardiographic finding and elevation of serum troponin I were factors associated with the occurrence an adverse cardiovascular event and that electrocardiographic abnormalities and initial mental status were factors associated with poor prognosis. Conclusion: This study reveals that actual myocardial injury develops in a significant proportion of patients with nontraumatic intracranial hemorrhage and that the development of the myocardial injury is associated with an adverse cardiovascular event that occurs during admission.