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.

간호대학생의 영적안녕에 관한 연구

강은실(Kang Eun-Sil),김숙자(Kim Sook-Ja),강성년(Kang Sung-Nyun),최성은(Choi Sung-Eun) 고신대학교 전인간호과학연구소 2008 전인간호과학학술지 Vol.3 No.-

The purpose of this study was to describe the spiritual well-being of nursing students to provide a basic data for the development the curriculum of Spiritual Nursing Care in nursing collages. The subjects for this study were consist of 58 nursing students in K University of Pusan city in Korea. All of them were educated about Spiritual Nursing Care for 100 minutes in a week, during totally 8 weeks in one semester. The data were collected during 7days from July 11 to July 18,2004 by using structured questionnaire method. The measurement of the spiritual well-being was performed with 6 points-index which is composed of 21 items and is modified by Sang-Soon Choi(1990)from Palau tzian & Ellison(1983) s. Its high score means that the degree of spiritual well-being of the subject is high. The data were analyzed by using the SPSS WIN 10.1 program according to the purpose of this study. The general characteristics of the subjects were analyzed by calculating the real quantity and the percentage, and the spiritual well-being scores were identified through calculating the mean value of individual domain. The significant difference of the general characteristics with the spiritual well-being was analyzed by t-test and ANOVA, Scheffe s test. The results of this study were as follow; 1.The spiritual well-being of the subjects The average value for the spiritual well-being of the subjects was 97.78(SD=±10.53) among the possible ranges of 21-126. The mean value of all items was 4.66(SD=±0.502) and high relatively. 2. The spiritual well-being according to general characteristics of subjects The analysis of the spiritual well-being according to general characteristics of the subjects showed statistically significant difference on the degree of life satisfaction in faith(F=4.327, P= .004),the degree of recognition about God s initiation in their daily life(F=3.933, P= .013),the degree of satisfaction about Nursing as their major(F=6.608, P= .000), their assurance of salvation(t=4.557,P= .037). among the personal religious actions, praising(F=3.32,p= .017), The group of nursing students responded that they were satisfied in their faith life, always God has the initiative in their daily lives personally, they were satisfied about Nursing as their major very much, and they have their assurance of salvation showed the highest degree of the spiritual well-being than any other group. In conclusion, in this study we observed that the spiritual well-being of nursing students was high relatively. The general characteristics of subjects were related to the spiritual well-being of them were the degree of satisfaction in their faith lives,their recognition about God s initiation in their daily life, their satisfaction about Nursing as their major, among the personal religious actions, regular praising and their assurance of salvation. Therefore this study s results can be used for developing a spiritual nursing education and program to strengthen nursing student s spirituality to practice in spiritual nursing care.

치간 삭제 후 불소 또는 수산화인회석 도포 시 재광화 및 탈회억제에 관한 연구

홍현실,김호영,성지영,조진형,김상철 대한치과교정학회 2010 대한치과교정학회지 Vol.40 No.4

치간 삭제 후 재광화 및 치아우식 예방법을 찾기 위한 노력의 일환으로 1.23% 인산화불소 젤 또는 5%, 10% 수산화인회석함유 페이스트를 치간 삭제된 법랑질 표면에 도포하였고, 그 후 젖산탈회용액으로 처리하였다. 법랑질 표면의 재광화 및 탈회 후 결정구조 변화를 주사전자현미경으로 관찰하고 칼숨, 인, 불소 함량 등의 변화를 energy dispersive X-ray spectroscopy 로 분석해서 비교하였다. 치간 삭제 후 5%, 10% 수산화인회석함유 페이스트를 도포한 군에서 칼숨과 인 합량이 증가하였고, 1.23% 인산화불소 젤 도포 군에서는 불소 함량이 증가하였다. 또한 모든 재광화 제제에서 법랑질 표면이 매끄럽고 부드러워졌으며 결정구조가 작고 치밀해짐을 관찰할 수 있었다. 10% 수산화인회석합유 페이스트로 재광화한 군은 탈회 후에도 칼슐과 인 함량이 증가된 채로 유지되었고, 5% 수산화인회석합유 페이스트로 재광화한 군은 탈회 후 인 함량이 증가된 채로 유지되었다. 치간 삭제 후 탈회 처리 시 대조군의 법랑질은 파괴양상이 심해 거친 굴곡으로 이루어진 불규칙한 표면 상태를 나타내었으나 불소 및 수산화인회석으로 재광화한 군에서는 법랑질의 파괴양상이 적어 작은 결정입자들과 미세공극이 유지되었다. Objective: The aim of this study was to evaluate the effect of remineralization and inhibition to demineralization after fluoride gel (acidulated phosphate fluoride, APF) or hydroxyapatite (HAp) paste application on interdentally stripped teeth. Methods: After interdental stripping, 1.23% APF or 5%, 10% HAp paste were applied for 7 days for remineralization. Afterwards, teeth were exposed to lactate carbopol buffer solution for demineralization. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to compare change in surface contents and crystal structures after remineralization, and then after demineralization. Results: EDS analysis indicated that calcium (p < 0.001) and phosphate (p < 0.01) contents were increased after 10% HAp paste application on stripped enamel, calcium (p < 0.05) and phosphate (p < 0.01) contents were increased after 5% HAp paste application, and fluoride (p < 0.01) contents were increased after 1.23% APF application. SEM image showed that enamel surfaces became smoother and crystal structures became small and compact after APF or HAp application. After demineralization, calcium (p < 0.05) and phosphate (p < 0.05) contents remained increased on the enamel remineralized with 10% HAp paste, and phosphate (p < 0.05) contents remained increased on the enamel remineralized with 5% HAp paste. After demineralization, surfaces looked less destroyed in the enamel remineralized beforehand than those of the control, and small pores between crystal structures, formed by remineralization were remained. Conclusions: Hydroxyapatite paste and fluoride gel were helpful to remineralize and inhibit deminerlization on stripped enamel.

烏梅의 肝디스토마 殺蟲性 물질에 관한 硏究

곽영실,류성호,백병걸,이재구,안병준 충남대학교 약학대학 의약품개발연구소 1985 藥學論文集 Vol.1 No.-

The anthelmintic substance of the roasted fruits of Prunus mume against Clonorchis sinensis was isolated and its structure was identified by chemical and physical methods. The results obtained from the experiments are as follows: 1) The methanol extract of the roasted fruits of P. mume was fractionated into four parts: petroleum ether, ethyl acetate and water soluble part. Among these, etherial fraction was found to have strong wormicidal effect on liberated metacercarial of Clonorchis sinensis. 2) From the etherial fraction, the wormicidal substance was isolated by silica gel, polyamide and sephadex column chromatography and identified to be 5-hydroxymethyfurfural (5-HMF) by chemical and spectral data. 3) 5-HMF was synthesized and administered to the rabbits infected with C. sinensis. On the 2nd day after administration, the EPG (eggs per gram in feces) reached to the maximal value. Among the adult worms isolated from the bile duct of the treated animal, 84% of worms were damaged morphologically. 4) The content of 5-HMF in the fruits of P. mume which were roasted in an oven at 90~110℃ for 52 hours and that in the fresh fruits was evaluated by HPLC. The content of 5-HMF was 0.8% in the roasted fruits and 0.02% in the fresh ones.

환경농업 성립요건에 관한 선호분석 : 사과 영농을 중심으로

김충실,이상호 慶北大學校出版部 1998 經商論集 Vol.26 No.1

Guar gum의 섭취 수준과 기간이 흰쥐의 영양소 흡수율에 미치는 영향

김상연,선영실,장유경 漢陽大學校 韓國生活科學硏究所 1993 韓國 生活 科學 硏究 Vol.- No.11

This study was performed to investigate apparent absorption of nutrients according to level and duration of guar gum intake. Eighteen male rats of Sparague-Dawley strain weighing 50g were blocked into three groups : FF, 5G, 10G(Fiber Free, 5% Guar gam, 10% Guar gum). Balance studies were conducted at 2nd week, 4th week and 8th week. Feed in-take body weight gains, apparent absorption of protein, fat, Ca and P were measured. The results obtained in this study were summarized as follows : (1) Feed intake was not significantly different among the groups during each balance studies. Weiht gain was decreased according to level of guar gum intake during each balance studies. (2) Protein apparent absorption of 5G were not significantly different with that of 10G at 2nd week and 4th week but at 8th week protein apparent absorption of 10G was singificantly lower than that of 5G According to duration of guar gum intake, protein apparent absorption of FF and 5G were not significantly different. Wherease protein apparent absorption of 10G was significantly decreased at 8th week. (3) Fat and Ca apparent absorption were not significantly different among groups at 2nd week. Fat apparent absorption of 10G was not significantly lower than that of 5G at 4th week and 8th week. According to duration of guar gum intake, fat and Ca apparent absorption of FF and 5G were not significant different. But fat and Ca apparent absorption of 10G was significantly decreased according to duration of fur gum intake. (4) Phosphorus apparent absorption were not significantly different among groups at 2, 4th week. But phosphorus apparent absorption of 10G were significantly higher than that of 5G at 8th week. According to duration of guar gum intake, phosphorus apparent absorption of FF and 10G were not influenced. But Phosphorus apparent absorption of 5G was significantly decreased according to duration of guar gum intake. From the results of this study, we could recommend 5% guar gum in diet of obese man and di abetics.

염증성 근섬유모세포종의 증례보고

은상아,박혁,차인호,김현실,정호걸,김기덕,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.3

The inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

돼지 신장세포(PK15)의 이종이식 거부반응에 대한 재조합 IL-18의 영향

최연실,김은미,김영관,박상연,심정현,윤도영,강형식,명평근 충남대학교 생물공학연구소 2004 생물공학연구지 Vol.10 No.1

Various cytokines including IL-1β, IL-2, IL-4, IL-10, IL-12p40, IFN-γ, and TNF-α have been recently reported to play important roles in both host and donor cell activations during xenotransplantation. Interleukin (IL)-18, a proinflammatory cytokine, can induce IL-4 and IL-13 production in T cells, NK cells, B cells, mast cells, and basophils. IL-18 has the capacity to stimulate innate immunity and both Th1-and Th2- mediated responses, but little is known to involve in the xenograft rejection. In order to investigate the role of IL-18 in xenograft rejection, we transplanted the pig kidney (PK15) cells to C57BL/6 mouse with or without intraperitoneal injection of mouse recombinatant IL-18. It was analyzed the population of T cell, B cell and NK cell in the mice transplanted with PK 15 cells and recombinant IL-18 by flow cytometry. We found that splenic CD3+ T cells were increased in mice injected PK15 cells with recombinant IL-18. These results suggest that recombinant IL-18 is critical in the xenograft rejection by increasing T cell population of the recipients.

장중첩증을 동반한 맹장 지방종 1예

홍의실,나병규,김민옥,유일영,채지영,채희복,윤세진,이상전,송형근,박길선,정현용 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

대장 지방종은 주로 우측 결장에 호발하고 특히 회맹판 부위와 맹장 부위에 호발한다. 또한 50~60대에 빈도가 높고 증상이 있는 환자에서 장중첩증이 높게는 40~50%에서 보고되고 있어 성인 장중첩증의 원인으로 중요한 비중을 차지한다. 특히 성인 장중첩증 및 장폐쇄의 중요 원인인 악성 종양과 임상 양상이 유사하여 감별진단이 중요하다. 저자들은 반복적인 복통을 주소로 내원한 환자에서 맹장의 4×5㎝의 점막하 지방종이 말단 회장부위와 반복적인 장중첩중이 발생했던 1례를 부분 절제술로 치료하여 양호한 임상 경과를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lipomas are one of the most common benign nonepithelial tumors of the colon which are often detected incidentally by radiologic investigation or on operation. These tumors are usually without specific symptoms. Colonic lipomas occur most often in the right colon, particularly in the ileocecal valve and the cecum. Most patients are asymptomatic. but tumors larger than 2 cm tend to produce a change in bowel habit. abdominal pain. rectorrhagia and complications including luminal obstruction or intestinal intussusception. Diagnosis can be made by colonoscopy abdominal CT. MRI, or barium enema. We report a case of lipoma of the cecum that originated in the submucosa and presented as a intussusception in a 50-year-old woman with a brief review of the literature.

GIS를 이용한 지역농업 특성 분석과 정책방향

김충실,이상호 韓國農業政策學會 1999 농업경영정책연구 Vol.26 No.1