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.

만성 간장 질환자에서 뇌 MRI 상의 pallidal index와 생물학적 망간지표들 간의 관련성

최영희,박능화,신정우,김효경,김성률,정태흠,박지강,이헌,유철인,이충렬,이지호,김양호 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 만성 간장 질환자를 대상으로 T1강조 자기공명영상(MRI)에서 나타나는 담창구 부위의 고신호강도 소견(pallidal index, PI)과 생물학적 망간 지표들 간의 관련성을 알아본다. 방법 : B형간염 바이러스에 의한 간경변증으로 진단 받은 40세 이상의 환자 31명과 정상 대조군 10명을 대상으로 설문조사와 혈액 및 소변검사, 뇌 MRI를 시행하였다. 전체 41명 가운데 검사 전 수혈을 받았던 환자군 9명을 제외하고 전체 32명의 자료를 분석하였다. 망간 축적에 관련된 객관적 지표로서 T1 강조 MRI에서 나타나는 담창구 부위의 고신호강도를 전두부 백색질 신호강도로 나눈 수에 100을 곱하여 구한 PI를 택하였다. 환자군과 대조군 사이의 PI와 망간농도들의 평균을 비교하였다. 여러 변수들과 PI와의 상관성을 보기 위해서는 상관분석을 시행하였다. 결과 : 간장 질환자 22명 가운데 18명(81.8%)에서 뇌 MRI 상 고신호강도가 나타났다. 대조군 10명에서는 아무도 MRI 소견상 고신호강도가 나타나지 않았다. 간장 질환자에서의 평균 PI는 122.62로 대조군의 106.23보다 유의하게 높게 나타났다(p<0.01). 간장 질환자의 전혈에서 망간농도는 2.34㎍/㎗으로 대조군의 1.44㎍/㎗와 비교하여 유의하게 높게 나타났다(p<0.05). 혈장과 소변 내 망간농도는 대조군에서 다소 높게 나타났으나, 통계적으로 유의하지는 않았다. 또한 혈색소, 빌리루빈, AST가 대조군과 환자군 사이에서 유의한 차이가 있었다(p<0.05). 전혈(p=0.489, P<0.01, n=29)과 적혈구(p=0.573, P<0.01, n=22) 내 망간농도와 PI 사이에는 각각 유의한 상관관계가 있었다. 그러나 혈장과 소변 내 망간 농도와 PI와의 상관관계는 통계적으로 유의하지 않았다. 총빌리루빈 또한 PI와 유의한 상관관계를 나타내었다(p=0.509, P<0.01, n=32). 결론 : 전혈 또는 적혈구 내의 망간 농도가 뇌 내 망간 침착으로 인한 T1 강조 MRI상 담창구 부위의 고신호 강도를 잘 반영하는 유용한 지표이다. Objectives: The objectives of this study were to clarify which biological manganese exposure indices reflect the pallidal signal intensities in magnetic resonance imaging (MRI) in liver cirrhotics. Methods: We examined whole blood, plasma, RBC and urinary manganese concentrations, as well as, brain MRI in 22 cirrhotic patients and 10 healthy controls. From MRI scans we calculated the signal intensity of the globus pallidus using the pallidal index (PI), the ratio of the globus pallidus to subcortical frontal white-matter signal intensity in axial T1 -weighted MRl planes multiplied by 100. In addition, we studied the relationships between PI and other measurements. Results: The high signal intensity in the globus pallidus on T1-weighted MRI was observed in 18 (81.8%) patients. There was a significant correlation between whole blood and RBC manganese concentration, and PI on MRI. According to multiple linear regression, whole blood and RBC manganese concentration reflected PI on MRI better the other indices did. Conclusions: Whole blood and RBC manganese concentrations could be useful as biological manganese exposure indices that reflect PI on MRI.

醫療保險制度의 變化에 따른 醫療利用 樣相과 病床利用度 比較硏究

최병록,함정오,김화성,이병국 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

This study was conducted to identify the effects of rural-fishing village health insurance system and the whole national health insurance system on the number of out-patient and in-patient cases and the hospital bed utilization, and the number of hospital persons in a university located in Choong Chung Nam Do. The results were as follows. 1. The number of out-patients was increased by 6.8% and 18.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. The number of out-patient visit cases was increased by 31.5% and 63.5% after implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. 2. The number of in-patients was increased by 13.8% and 22.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. The number of bed days was increased by 27.1% and 32.8% after the implementation of the rural fishing village health insurance system and the whole national health insurance system respectively. 3. The hospital bed utilization rates were 77.3% and 98.4% before and after the rural fishing village health insurance system respectively, and 102.6%, after the whole national health insurance system. The bed rotation rate was increased from 23.6 times before the rural fishing village health insurance system to 27.0 times after the system. After the whole national health insurance program, it was also increased to 29.1 times. The average length of stay was 11.9 days before the rural fishing village health insurance system and 13.3 days after that, and 12.9 days after the whole national health insurance system. 4. Before the rural fishing village health insurance system the physicians per 100 beds was 19.0 persons. The physicians per 100 beds was increased to 25.2 persons and 29.3 persons, after the rural fishing village health insurance system and the whole national insurance system respectively. Before the rural fishing village health insurance system the nurses per 100 beds was 26.8 persons. The nurses per 100 beds was increased to 35.4 persons and 38.3 persons, after the rural fishing village health insurance system and the whole national health insurance respectively. Before the rural fishing village health insurance system the manpower per 100 beds was 101.6 persons. The manpower per 100 beds was increased to 128.6 persons and 138.9 persons, after the rural fishing village health insurance system and the whole national insurance respectively.

통신설비의 Pulse성 Nosie 현상 분석과 Noise 대책

崔寅浩,崔種和,金炯澈,李相寧,鄭日和,李大寧 慶熙大學校 1993 論文集 Vol.22 No.-

The use of electric-power-distribution circuits for communications is of continued and growing interest. Impedence, attenuation, and noise characterize any communication channel and are needed for design of digital communcation systems. The purpose of this paper is to present the method of Measurement and countermeasure of the temporal and spectral properties of the magnetic and electronic fields of radio noise that emanates from power lines.

Head-Space SPME에 의한 생체시료 중 메스암페타민류 분석(Ⅱ)

최화경,양원경,한은영,최상길,정희선 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

Aspergillus oryzae를 이용한 캡슐형 메주의 품질특성

최재훈,권선화,이상원,남상해,최상도,박석규 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2003 한국식품저장유통학회지 Vol.10 No.3

전통메주의 표면에서 발행하는 야생곰팡이 착생, 유해곰팡이에 대한 mycotoxin 생성 및 메주 표면의 과도한 건조 등을 해결하기 위하여 메주 외층에 Aspergillus oryzae로 만든 쌀 종국(0.3%, w/w)을 혼합시킨 증자 검정콩으로 얇게 코팅한 후, 25℃, 상대습도 80%에서 14일간 발효시킨 캡슐형 메주를 개발하였다. 캡슐형 메주의 표면에서 야생곰팡이의 오염은 발견되지 않았으나, 대조구 메주는 12일 이후에 푸른곰팡이가 많이 관찰되었다. 메주의 수분 함량은 평균 32.7%로서 34.7~29.4%의 범위를 나타내었다. 적정산도는 캡슐형 메주가 대조구 메주보다 높게 나타났으며, 대두 캡슐형 메주와 검정콩 캡슐형 메주는 비슷하게 나타났다. 유리당의 함량은 검정콩 캡슐형 메주가 123.98㎎%로 대조구 메주 15.02㎎%와 대두 캡슐형 메주 59.85㎎%보다 각각 10배, 2.1배, 높게 나타났다. 아미노산성 질소의 함량은 대조구 메주에서 147.00㎎%였으며, 검정콩 캡슐형 메주는 255.50㎎%로서 대두 캡슐형 메주 187.25㎎%보다 약 1.37배 높은 함량을 나타내었다. 총 유기산의 함량은 캡슐형 메주(대두 119.98㎎%, 검정콩 95.94㎎%)가 대조두 메주(26.44㎎%)보다 함량이 높게 나타났으며, 캡슐화에 따라 lactic acid와 malic acid 가 가장 큰 변화를 나타내었다. 색차계 색도는 검정콩 캡슐형 메주가 대두 캡슐형 메주보다 명도값(L)이 크게 나타났으며 지방산 조성은 메주의 종류에 따라 큰 차이를 나타내지 않았다. 총 유리 아미노산의 함량은 검정콩 캡슐형 메주(1039.70㎎%)가 대두 캡슐형 메주 (556.07㎎%)와 대조구 메주(236.45㎎%) 비하여 각각 2.4배, 4.4배 높았다. In order to improve some problems such as contamination of undersirable mold, mycotoxin production and excessive drying on the surface of traditional meju, we developed a capsule type-meju(CM) coated with steamed black bean and Aspergillus oryzae - rice koji(0.3%, w/w) mixture to surface of traditional meju and fermented at 25℃ for 14 days under 80% relative hunmidity. Contamination of undersirable mold on the surface of CM was not detected within 2 weeks and some genus Penicillium molds on control meju without koji were found naturally after 12 days of fermentation. The moisture content of meju was showed to be in the range of 34.7 - 29.4% being 32.7(w/w) of mean value. Titratable acidities in CMs prepared with black bean(BCM) and soybean(SCM) were much higher than that in control meju, and BCM was similar to SCM. Free sugar content in BCM(123.98 ㎎%) was 10 times and 2.1 times higher than that in control meju(15.02 ㎎%) and SCM(59.85㎎%), respectively. Amino type nitrogen content in control meju was 147.00 ㎎% and its content in BCM(255.50㎎%) was 1.37 times higher than that in SCM(187.25 mg%). Total organic acid content in BCM(95.98㎎%) and SCM(119.98㎎%) were much higher than that in control meju(26.44 ㎎%), and then latic and malic acid contents were markedly changed according to capsulation of meju. Lightness value(l) of Hunter color index was much higher in BCM than in SCM. Fatty acid composition of CM was not different as compared to control meju. Total free amino acid content in BCM(1039.70 ㎎%) was 4.4 times and 2.4 times higher than that in control meju(236.45 ㎎%) and SCM(556.07 ㎎%), respectively.

부적절한 예방화학요법 후 지연 발현된 Plasmodium vivax 말라리아 1 예

최수철,장상필,김상화,서환조,서진태,김구엽 대한내과학회 1998 대한내과학회지 Vol.54 No.3

Malaria is the world's most important parasitic infection. Although it has been erw5cated from temperate zones including Korea, increasing numbers of travellers visit tropical malarious countries and imported malaria becomes important medical problem in the developed countries. In Korea with increasing travellers to malaria-endemic area, the incidence of imported malaria shows rising tendency same as the developed countries. It becomes important to personal general personal protective measures and chemoprophylaxis to trevellers, when employed in appropriate manner, that can be highly effective in preventing malaria. We recently experienced a case of in Plasmodium vivax malaria with delayed manifestations due to inadequate chemoprophylaxis. A 53-year-old woman with history of trevel to East Africa 4 months ago and chief complaint of fever was diagnosed as tertian malaria. She had irregularly taken prophylatic antimalarial during travel and had not taken it after return but should have taken it at least 4 weeks after return.

새로운 무기 응집제 개발에 따른 특성

최성우,우성훈,윤철종,곽명화,서향미,박승조 동아대학교 환경문제연구소 2000 硏究報告 Vol.23 No.1

This study has carried out the coagulation tests for tannery wastewater including high-level suspended solids and organic matters to determine the optimum pH and coagulant dosage and to characterize several coagulants for coagulation. In case of optimum pH range test, we know that multi-coagulants are not only cost-effective but also applicable from acidic pH range to alkaline pH range widely, while single-coagulant are useful in limited pH range. Removal efficiency for using of the multi-coagulants appeared more efficient than that of single-coagulant. Especially, sulfates(alum-ferric sulfate : AFS & alum-magnesium sulfate : AMS) are more effective than chlorides (alum-ferric chloride : AFC & alum-magnesium chloride AMC). In comparison of residual turbidity related to settling time between alum and alum-ferric sulfate-magnesium sulfate(AFM), it took to 40 minutes using of alum but 5 minutes using of alum-ferric sulfate-magnesium sulfate(AFM) until constant residual turbidity are reached.

ATM네트윅과의 접속을 위한 MAN을 이용한 사용자 - 망 인터페이스 설계

최황규,최경,서주하,김화종,이상희 江原大學校 産業技術硏究所 1991 産業技術硏究 Vol.11 No.-

In this paper the functional requirements of a B-ISDN access network based on MAN are investigated . Firstly, criteria of designing access network for the B-ISDN is studied. Secondly, the types of subscribers and their service requirements are defined. Thirdly, various artchitectures of CPNs(Customer Premises Networks) are considered and their characteristics are studied, Finally, the interworking funtions of a DQDB MAN as an access network are investigated.

冬蟲夏草의 抗轉移와 免疫增進에 關한 硏究

최우진,유화승,이용연,서상훈,조정효,이연월,손창규,조종관 대전대학교 한방병원 2000 惠和醫學 Vol.9 No.2

This experimental study was carried out to evaluate the effects of Cordiceps sinensis on the antimetastasis and immune activity. In order to investigate the effect of Cordiceps sinensis, the followings were performed; Cytotoxicity, inhibition of MMP-2 & MMP-9 gene expression, fraction of CD4+, CD8+, CD19+ in splenic cell, the moprphological change of splenic cells, gene expression of IL-12(p35), IL-12(p40), IFN-?? and splenic cell proliferation by CS-E. The results were obtained as follows. 1. CS-E did not present cytotoxic effect on L+14, B16-F10 melanoma cells and HMCB. 2. CS-E inhibited MMP-2 and MMP-9 gene expression more effectively compared with control group. 3. CS-E inhibited invasion of B16-F10 melanoma cells more effectively compared with control group. 4. CS-E helped CD4+, CD8+, CD19+ expression more effectively compared with control group. 5. CS-E activated phagocytic cells in spleen more effectively compared with control group. 6. CS-E helped IL-12(p35), IL-12(p40), IFN-?? gene expression in splenic cell more effectively compared with control group. 7. CS-E activated splenic cell proliferation more effectively compared with control group. From above findings, it is suggested that CS-E is able to inhibit metastasis of cancer and activate immune response system.