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.

한국비서자격시험의 개선점과 비교연구

남자현,이미정,이미영,이아영,정해금,최유정,이미숙,전인선,정혜림 이화여자대학교 법정대학 비서학과 1997 비서학연구 Vol.- No.17

한국해안으로부터 Purple, Non-Sulfur Photosynthetic Bacterium, Rhodobacter sp. EGH-24의 분리 및 특성

차미선,김기한,조순자,이나은,이정은,이재동,이상준,박재림 한국환경과학회 2003 한국환경과학회지 Vol.12 No.12

A species of facultative photo-organotrophic, purple, non-sulfur bacterium was isolated from the 47 point at west and south coast of Korea in September 2001. Separated 13 samples of changes with red color under 28~32 ℃, 3000 lux, anaerobe conditions for 7 days cultivated in basal medium. For pure isolation from 13 samples, we used agar-shake tube method (0.4 % agar) and separated 5 strains through 13-repetition test. EGH-24 and EGH-30 was identified as the same strain through the RAPD(Random Amplified Polymorphic DNA)-PCR of strain EGH-9, EGH-13, EGH-23, EGH-24, EGH-30. Four isolates cultivated in synthesis wastewater for wastewater biodegradation test. EGH-24 was selected with efficient wastwater treating strain. Based on the results obtained from morphology, nutrient requirements, major bacteriochlorophyll content, 16S-rDNA phylogenetic analysis, EGH-24 strain may be identified as a new strain of the genus Rhodobacter and named Rhodobacter sp. EGH-24.

PT조건하 V_2O_5에 의한 Alcohol의 산화

강선희,김미련,김선자,김현옥,노복자,이기화,이정숙 曉星女子大學校 藥學大學 學生會 1988 曉星藥誌 Vol.4 No.-

2, 3; 5,6-di-O-isopropylidene-α-D -mannofuranose(ManA) were oxidized to their cor-responding 2, 3;5,6-di-O-isoprolylidene-α-D-manno-1.4-lactone(ManB) using calcium chlorite as oxidant in a phase transfer catalysis system. But identified results were not obvious. V_2O_5 catalzed oxidation of primary and secondary alcohols to aldehydes and ketones respectively at alkali conditions under Solod-Liquid phase transfer conditions. This reaction affords good overall yields of products without formation of undersirable.

GC-ECD를 이용한 유기염소계 및 Pyrethroid계 농약 동시 분석법

김우성,이선화,김재이,정지윤,이명자,박영채,이영자,정성욱,이봉헌,박흥재 한국환경과학회 2003 한국환경과학회지 Vol.12 No.4

Pesticides were extracted from samples with 70% acetone and methylene chloride in order, and then cleaned up via open-column chromatography apparatus packed with florisil, and finally analyzed simultaneously the organochlorine and pyrethroid pesticides using GC(ECD). An ultra-2 fused silica capillary column was used to separate and identify the products. The resolution between the last isomeric peak of cypermethrin(59.987min) and the first isomeric peak of flucythrinate(60.043min) was not satisfactory. The last isomeric peak of fenvalerate(62.344min) and the first isomeric peak of fluvalinate(62.397min) were overlapped. Recoveries of soybean sample for the most pesticides were 73.3% to 102.4%. Detection limits were between 0.004 and 0.063 ㎍/㎎ when this method was used.

농촌 지역 주민의 주관적 건강상태와 건강행위에 대한 연구

이홍자,백선복 대불대학교 2002 論文集 Vol.8 No.1

This study was to investigate perceived health and health behavior of residents in a rural community, with a purpose of finding a relationship between the two notions. The 676 subjects were selected from residents who were over 20 years old living in a rural county(Kun) in Chonam Province by convenient sampling. The data was collected from face to face interviews using a modified instrument developed by the Korea Institute for Health and Social Affairs. The rating scale was composed of a total of 15 items: 8 sociodemographic, 3 health behavior, 3 perceived health, and 1 stress items. The data was analyzed by percentage, t-test, ANOVA, and Pearson Correlation by employing SPSS/PC program(V.8.0). The results were as follows: 1) There was statistically significant difference in perceived health of the subjects by age and marriage status, but no difference was found by sex and family types. 2) The rating score of perceived health of the higher age group (70 years old and over) was significantly lower than that of the younger subjects, suggesting that the more the rural residents age, the less they are confident in their health. 3) While most subjects were reported to not smoke, they were likely to drink. It was also found that about 60 percent of the subjects were not practicing physical exercise. Significant difference was found in smoking by age. 4) There was statistically significant difference in health promoting behavior by sex. The female subjects were more likely to practice health promoting activities than the male subjects. It was also found that there was significant difference in health behavior by marriage status. The divorced subjects reported lower rating scores for the health behavior than those of unmarried and bereaved groups. In conclusion, the results of this study suggested that a comprehensive and practical health promoting program be developed for the rural community residents.

조·일간의 교역품이 조선의 복식문화에 미친 영향(Ⅰ) : 일본으로 부터의 수입품을 중심으로 Centered on the imported goods from Japan

이자연,박춘순 한국의류산업학회 2003 한국의류산업학회지 Vol.5 No.4

This study is to research the influence of Caesalpinia sappan which was imported through the exchanges between the Chosun dynasty and Japanese envoys during the early Chosun dynasty. Korea interchanged politically and culturally with Japan since ancient times. Particularly, the good-neighbor foreign policy toward Japan grew into trade relations. The diplomatic mission, under the name of Tongshinsa, was dispatched 12 times in total. Plenty of goods were exchanged through the visiting of Japanese envoys as well as through the activities of Korean envoys. In other words, the Korean-Japanese relations were at first focused on the political and diplomatic etiquette and gradually evolved into economic exchanges. Trading goods were various, including food, clothing, etc. Caesalpinia sappan, a red dye, was the most imported goods from Japan, but it was sold at a very high price, which caused luxurious trends in clothing. However, these sumptuous moods of the upper classes were decreased in the 16th century. Some of the reasons are : the difficulties of Japan's trade with the Caesalpinia sappan producing countries in South-east Asia, the transition of the high classes' preference from red clothing into Chinese BaecSa and SaraNeungDan, and the comparative decrease in the demand of Caesalpinia sappan by the changed understanding of Honghwa. Therefore, the early Chosun dynasty's clothing trends were due to the relationships between the Chosun dynasty and Japan.

항결핵 치료과정에서 호전되었다가 악화된 뇌 결핵종 1예 보고

이대훈,유진홍,강미자,김홍기,김선화,고동훈,천지성,유원종 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.3

In spite of nationmide tuberculosis control program, tuberculosis is still prevalent in Korea. Accordingly, tuberculous meningitis also poses one of the main trouble some problems. Recently, We experienced a perplexing case of tuberculous menin-gitis and tubercdoma in a 24-year old female patient. She was admitted to our hospital owing to meningeal irritation sign, aphasia, VI nerve palsy, and ,fever. CSF analysis showed a finding consistent with that of presumptive tuberculous meningitis.. Initial MRI of the brain revealed a large mass(tuhercu1oma) on left parieto-temporal area. Antitubeculous regimen(1soniazid (INH), rifampin(RMP), ethambutol(EMB), pyrazinamide(PZA)} of meningeal dose was given immediately, and her symptoms and signs were dramatically disappeared with a few days after treatment. She was discharged with improved condition and under maintenance treatment of tuberculosis. Follow-up one year after treatment. revealed that the previous lesion was nearly diminished. She showed no symptom at all until she recognized a total blindness of sudden onset on her left eye a t the 18th month of treatment. Brain MRI checked at that time showed multiple masses of tuberculoma scattered over the brain base and one of them invaded left optic nerve. In our opinion, the cause of relapse in this patient might he explained by the selection and ultimate replication of a minor population of resistant strain. Although such relapse is an extremely rare event, we think that we should always pay attention to this possible resistance problem every time we meet patients with tuberculous meningitis.

B형 만성 활동성 간염 환자에서 Prednisolone 단기이탈 및 Alpha Interferon 병합요법의 효과

이종선,김병호,성자원,허승식,이기천,정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To evaluate the safety and efficacy of Pd withdrawal followed by recombinant alpha- Interferon 2b therapy. Nine patients were given a single daily subcutaneous injection of ^α-Interferon at a dose of 3 x 10 exp(6) units/day for first weeks and thrice weekly for next 15 weeks (maintenance) after pd tappered over 6 weeks. To evaluate the efficacy of therapy, we measured serum aminotransferase activities monthly during and after therapy, and also measured serm HBsAg, HBeAg and DNA probe before and after therapy. To evaluate the safety of therapy, all patients checked peripheral blood WBC, Hemoglobin, Platelet, BUN and Creatinine. The results were as follows : 1. In control group, the normalization of s-AST & ALT level, negative seroconversion of DNA probe & HBeAg were observed in 1/12(8%) & 7/10(17%), 0/10(0%) & 0/12(0%) at 6 months later, and maintained response in 1/11(9%) & 1/11(9%), 2/9(22%) & 2/11(18%) until 1 years later. 2. In treatment group, Serum AST and ALT returned to normal in 8/9 & 8/9 cases (89%) after 1 montns Tx. (mean serum AST : 33±8, ALT : 34±12 IU/ml) and maintained to normal response in 5/9(56%) & 6/9 cases(67%)after 6 months Tx. (mean s-AST : 55±43, ALT : 66±84 IU/ml), 3/9(33%) & 4/9 cases(44%) after 1 years Tx. It was statistically significant reponse except s-AST of after 1 years Tx. 3. In treatment group, s- HBeAg returned to normal in 3/9 cases(33%) after 1 months Tx., and maintained to normal response in 1/7 & 1/4 cases among follow up patients in after 6 & 12 months Tx. Serm DNA probe level were observed significantly negative seroconversion in 8/9 cases(89%) after 1 months Tx. (p<0.003), and maintained to negative response in 2/6 & 1/3 cases after 6 & 12 months Tx. 4. Serum AST, ALT, HBeAg and DNA probe were not significantly correlated with therapeutic response in relation to histologic diagnosis. 5. Fever and myalgia were noted in 9(100%) & 6(67%) cases. Headache, mild hair loss, anorexia, nausea, facial flushing & diarrhea were noted in few cases. Peripheral WBC(3cases) & platelet counts(3cases) were decreased transiently. This study shows that Pd withdrawal followed by recombinant alpha Interferon 2b therapy may be safe and effective in decrease the level of s-DNA probe, transaminase activity, loss of HBeAg and less adverse effect of clinical and hematologic examinations in patients with CAH type B. But it was necessary for study with large number of patients, more prolonged follow up duration and more strict control study.

산화법에 의한 N-치환 히드라존의 합성

이기창,권순자,양천회 明知大學校 産業技術硏究所 1983 産業技術硏究所論文集 Vol.2 No.-

In acetone-ammonia system with amines, N-Substituted hydrazone was synthesized by the oxidation of hydrogenperoxide. The results are as follows : 1. The yield of phenylhydrazone was increased and that of azone decreawed with increasing the aniline added. 2. The excess of aniline was unfarorable for preparation of both azine and hydrazone. 3. Similar behavior was observed for t-butylamine to afford acetone t-butylhydrazone and azine, while cyclohexylamine resulted in the exclusive formation of 2-cyclohexyl-3, 3-dimethyloxaziridine.