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.

직류전동기 위치제어용 Neuro-Fuzzy 제어기 설계

고성균,이택종 成均館大學校 科學技術硏究所 1994 論文集 Vol.45 No.1

This paper describes a scheme that the fuzzy logic controller(FLC) compensates for variable load while a neural controller holds the control of the DC motor using pre-learned information without relearning. FLC can be used effectively to minimize the variable loading effects in the positon control of DC motor. The proposed controller consists of FLC, which is added in parallel to neural controller. The proposed controller has implemented with low cost DSP processor (ADSP-2105) in order to be directly applicable in the industrial field and the results show the proposed scheme is very effective to attain good cntrol characteristics under the variable load condition.

이성관계 증진을 위한 온 마음 집단상담 프로그램 개발

고성식,윤호균 西江大學校 學生生活相談硏究所 2009 人間理解 Vol.30 No.1

본 연구에서는 이성관계 증진을 위한 온 마음 집단상담 프로그램을 개발하고 효과성을 검증하고자 하였다. 우선 프로그램 개발을 위해 온 마음 상담의 이론을 바탕으로 공상의 자각을 돕는 구체적인 내용을 조직하였다. 그리고 예비연구를 실시하여 프로그램을 보완, 개발하였다. 두번째로 완성된 집단 프로그램을 실시하고 효과를 검증하였다. 실험집단에는 이성관계 증진에 관심 있는 남·녀 총 22명에게 실시하였고 그 중 13명의 자료를 효과검증에 사용하였다. 통제집단은 처치를 하지 않은 13명이었다. 효과검증을 위한 연구대상은 총 26명으로, 설계방법으로는 사전-사후검사설계를 사용하였고 효과측정을 위해 paired t-test와 공변량분석(ANCOVA)을 실시하였다. 효과 측정 도구는 마음챙김, 애정관계 행동 척도를 사용하였다. 통제집단과의 비교를 위해 공변량 분석을 실시한 결과 각 척도점수가 유의미하게 향상되었다. 마지막으로 본 연구의 의의와 제한점 및 향후 과제 등이 논의되었다. The purpose of this study was to develope a On-maeum group counseling program intended toenhance romantic lelationship and to evaluate the effects of the program. The program was developed based mainly on On-maeum counseling theoiy. The experimental group were sampled from 13 who be interested in close romantic relationship. The control group were 13 who were not treated. The effects of the program were measured by Mindfulness Scale, Romantic Relationship Behavior Scale. The result showed that the experimental group's posttest level of Mindfulness Scale, Romantic Relationship Behavior Scale were meaningfully improved compared to control group. Finally, the implications and limitations of this study and the directions of the future study were discussed.

독소루비신과 알로퓨리놀이 화학적 근절제에 미치는 영향

정원균,고한웅,강동희,구상환,박승하 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.3

극단 저체중 신생아에서의 동맥관 개존증 결찰술을 위한 진정맥 마취 경험 2례

최영균,고명진,이상은,조광래,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Running title: Cases of anesthesia for extremely low birth weight infant. Extremely low birth weight infants (birth weight < 1000 g) are prone to various morbidities such as respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, patent ductus arteriosus, necrotizing enterocolitis and retinopathy. To accomplish successful anesthetic management, many precautions must be continuously taken during the operation. First, inspired oxygen concentration should be adjusted to avoid oxygen toxicity. Second, body temperature must be maintained adequately. Third, hemodynamic parameters should be kept stable. We report 2 cases of successful anesthetic management for extremely low birth weight infant who underwent ligation of patent ductus arteriosus at the neonatal intensive care unit.

일부 부인과 양성 질환자의 지방조직 및 혈청의 PCBs와 DDE 농도

박성균,이강숙,노영만,구정완,민선영,한진구,고원경,김미란,정재근,이종승,김진홍 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 본 연구는 지방조직과 혈청의 PCBs와 DDE 농도를 측정하고, 이에 영향을 미치는 것으로 알려진 요인들과의 관련성을 평가하고자 하였다. 방법 : 유방암, 자궁내막증 등 유기염소계 화합물의 영향이 있는 것으로 알려진 호르몬 관련 질병을 제외한 부인과 환자 52명을 대상으로 지방조직과 혈청을 분석하였으며, 설문조사를 통하여 연령, 교육수준, 직업, 비만도, 흡연과 음주, 출산력, 수유력등을 조사하였다. 지방조직과 혈청의 PCBs와 DDE 농도는 가스크로마토그래피를 사용하여 측정하였다. 결과 : 지방조직의 경우, 13개 PCBs congeners 농도의 합은 중앙값이 48.29 ng/g, 기하평균값이 56.78 ng/g이었고, DDE 농도는 중앙값이 142.89ng/g, 기하평균값이 117.06 ng/g이었으며, 혈청의 경우는 PCBs congeners 농도의 합은 중앙값이 4.67 ㎍/L, 기하평균값이 4.85 ㎍/L이었고, DDE 농도는 중앙값이 1.75 ㎍/L, 기하평균값이 2.09 ㎍/L로 나타났다. 지방조직과 혈청의 DDE 농도 사이는 높은 상관성을 보였으나(r²=0.310, p=0,0002), PCBs는 상관성이 약한 것으로 나타났다(r²=0.029, p=0.2582). 영향요인을 범주화한 후 로그변환 시킨 지방조직과 혈청의 PCBs, DDE 평균의 차이를 분석한 결과, 지방조직의 DDE만이 출산자녀수(p=0.015), 초산연령 (p=0.014), 비만지수(p=0.035)와 연관성이 발견되었다 다중회귀분석의 결과 지방조직의 DDE는 출산자녀수가 적을수록, 초산연령이 늦을수록 증가하는 경향을 보였다. 결론 : 출산자녀수와 초산연령, 비만도가 지방조직의 DDE와 관련성을 보였으며, 또한 유기염소계 화합물의 장기간의 노출에 의한 영향을 평가하는데 있어서 혈청보다 지방조직이 더 유용한 생물지표임을 알 수 있었다. Objectives : This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. Methods : We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. Results : The median and geometric mean levels of PCBs were 48.29 ng/g, 56.78 ng/g for adipose tissue and 4.67 ㎍/L, 4.85 ㎍/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and 1.75 ㎍/L, 2.09 ㎍/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r²=0.310, p=0.0002), but those of PCBs didn't (r²=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.074) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. Conclusions : This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.

폐경기여성에서 시청각 교육이 호르몬대체요법의 시행과 골다공증관련 생활습관의 변화에 미치는 효과

정태흠,전태희,김문찬,김영일,전대준,양승오,함수연,고병균,김성률 大韓家庭醫學會 2000 Korean Journal of Family Medicine Vol.21 No.11

Cardiosulfa, a Small Molecule that Induces Abnormal Heart Development in Zebrafish, and Its Biological Implications

Ko, Sung-Kyun,Jin, Hui Juan,Jung, Da-Woon,Tian, Xizhe,Shin, Injae WILEY-VCH Verlag 2009 Angewandte Chemie. international edition Vol.48 No.42

<B>Graphic Abstract</B> <P>A change of heart: Cardiosulfa, a small molecule that induces heart deformation during zebrafish development, has been identified by using a forward chemical-genetic approach. Zebrafish embryos exposed to cardiosulfa have a narrow and elongated heart within an enlarged pericardial sac (see picture; heart marked with green fluorescent protein). <img src='wiley_img/14337851-2009-48-42-ANIE200902370-content.gif' alt='wiley_img/14337851-2009-48-42-ANIE200902370-content'> </P>

A Phase 1 Study Using Autologous Natural Killer Cells in Patients with HAIC-Hepatocellular Carcinoma

( Sung Bum Cho ),( Chung Hwan Jun ),( Sung Kyu Choi ),( Woo Kyun Bae ),( Je Jung Lee ),( Yang Jun Kang ),( Cheol Kyun Cho ),( Yang Seok Ko ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Natural killer (NK) cell-based immunotherapy has recently been tried with advances of understanding the role of immune defense against hepatocellular carcinoma (HCC). To improve NK cells therapy, we focused to increasing delivery of NK cells and synergic effect combined with hepatic arterial infusion chemotherapy (HAIC). Methods: We did a prospective, open label, phase 1 trial of the safety and efficacy of autologous NK cells through hepatic arterial infusion as sequential therapy after HAIC in advanced HCC patients. Between March 2016 and July 2017, 11 patients were included who showed favorable response more than stable disease (SD) after 2 sessions of HAIC in advanced HCC patients with child A. A total 4 sessions of HAIC were performed the protocols of infusion of cisplatin (25/m2) and 5-fluorouracil (750/m²) for 4 days every 3-4 weeks interval. The peripheral blood mononuclear cells of patients by leukapheresis were ob-tained after 3^rd HAIC and NK cells were expanded for 2 weeks under Current Good Manufacturing Practices (cGMP). Patients received planned dosage of NK cells through chemoport into hepatic artery for 5 days after 4^th HAIC (3 patients; 2.5x108, 3 patients; 5x10⁸, 5 patients; injection of 10x10⁸ NK cells). The primary end point was safety of NK cell injection; secondary endpoint included objective response rate (modified Response Evaluation Criteria In Solid Tumors), time to progression, dura-tion of response and immunologic efficacy. Results: Any adverse events of NK cells injection were none according to dosage. An objective response was observed in 7 patients (63.6%) included three complete responses and four partial responses. Stable disease was observed in 2 patients and progressive disease was in 2 patients and thus disease control rate was 81.8%. The mean duration of time to progression was 9.7±5.3 month and duration of response without chemotherapy was 6.1±5.2 month. The newly metastatic lesion was occurred in 3 patents (27.2%; lymph node 1 patients, Lung 2 patients). Two patients were died by tumor progression and others were still alive. The increasing immunologic response was observed in 5 patients (55 %) to evaluate cytotoxicity and NK cell proportion of peripheral mononuclear cells after NK cell injection. Conclusions: The HAIC and NK cells immunotherapy is safe and effective treatment in the advance HCC patient with favorable liver function. The additional studies are urgently required to establish the new novel treatment.

Zebrafish as a good vertebrate model for molecular imaging using fluorescent probes

Ko, Sung-Kyun,Chen, Xiaoqiang,Yoon, Juyoung,Shin, Injae Royal Society of Chemistry 2011 Chemical Society reviews Vol.40 No.5

<P>Fluorescent probes have been used extensively to monitor biomolecules and biologically relevant species <I>in vitro</I> and <I>in vivo</I>. A new trend in this area that has been stimulated by the desire to obtain more detailed information about the biological effects of analytes is the change from live cell to whole animal fluorescent imaging. Zebrafish has received great attention for live vertebrate imaging due to several noticeable advantages. In this <I>tutorial review</I>, recent advances in live zebrafish imaging using fluorescent probes, such as fluorescent proteins, synthetic fluorescent dyes and quantum dots, are highlighted.</P> <P>Graphic Abstract</P><P>Recent advances in zebrafish imaging using fluorescent probes such as fluorescent proteins, synthetic fluorescent dyes and quantum dots are reviewed. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c0cs00118j'> </P>