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.

특성불안이 높은 성인과 낮은 성인에서 알코올이 정신운동성 수행과 주관적 평가에 미치는 영향

용화영,윤보현,윤진상 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

Objectives : The purpose of this study was to evaluate effects of alcohol on psychomotor performance and subjective assessments in normal adults with high and low trait anxiety. Methods : The subjects consisted of 11 men in each group were tested with two doses of alcohol(0.25g/㎏ and 0.75g/㎏). Blood alcohol concentration(BAC), psychomotor performance(critical flicker fusion threshold, CFFT ; choice reaction time, CRT) and subjective assessment were measured at pre-alcohol baseline and 20, 40, 80, and 160 minutes after intake of alcohol. Results : 1) There was no significant difference in BACs between two groups at any time points after intake of each dose of alcohol. 2) After intake of 0.25g/kg alcohol, high anxiety group, compared to low anxiety group, reported less anxious and more relaxed feelings. In psychomotor performance test, however, there was no significant difference between the two groups. 3) After intake of 0.75g/kg alcohol, CFFT was increased in high anxiety group while it was decreased in low anxiety group. In subjective assessment, only high anxiety group tended to show more positive response. Conclusion : These results imply that alcohol may be more beneficial in individuals with high trait anxiety than those with low trait anxiety in terms of objective performance and subjective feelings. Furthermore, these suggest that the alcohol benefits might contribute to drinking more alcohol and frequently in individuals with high trait-anxiety.

염색체 4q21-qter에 대한 페인팅 Probe 제작

박선화,안희성,전용혁 대한해부학회 1995 Anatomy & Cell Biology Vol.28 No.6

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

..

Poly(2-hydroxyethyl methacrylate-co-γ-methacryloxypropyl triethyl silane) 및 Poly(2-hydroxyethyl methacrylate-co-γ-methacryloxypropylmethyl bistrimethyl siloxysilane)의 반응성과 열적 성질

성용길,정태화,이상영 동국대학교 1986 論文集 Vol.25 No.-

Hydrophilic poly(2-hydroxyethyl methacrylate) has been accepted as biocompatible material for medical applications. Some of its relatively poor physical property are still remained as problems to be improved. In order to improve its physical property, new copolymers of 2-nhydroxyethyl methacrylate(HEMA) with silane monomers have been developed and synthesized. The silane monomers are γ-methacryloxypropyl triethyl silane(MPTS) and γ-methacryloxypropyl methyl bistrimethyl siloxysilane(MPMBSS). The compositions of unreacted monomers in the copolymers were separated and determined by the intensity of each peak by gas chromatographic analysis. The monomer reactivity ratios determined by the Kelen-Tu¨dos method are as follows; r_1=0.80 and r_2=0.71 for poly(HEMA-co-MPTS), r_1=1.22 and r_2=0.21 for poly(HEMA=co-MPMBSS). The tendency of alternating copolymerization and the relative reactivty of MPTS and MPMBSS with HEMA were investigated. The Q and e values were also calculated by the Alfrey-Price equation. The synthesized monomers and copolymers were identified by infrared spectroscopy and nuclear magnetic resonance spectroscopy. The thermal properties of the copolymers were also measured by thermogravimetry and differential scanning calorimetry.

급성 심근경색증에 동반된 승모판 폐쇄부전증의 임상적 특징

정상만,조영일,조화상,유광하,송기호,인행환 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.- No.7

말초혈액에서 Tg mRNA에 대한 역전사 중합효소 연쇄 반응법의 갑상선 재발암의 분자생물학적 진단

권성일,박기룡,김현영,신채희,임영찬,최영식,박요한,이강대,장희경,이재화,염하용 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 갑상선암은 다른 조직에 발생한 암에 비해 비교적 천천히 자라므로 대부분 예후가 양호하지만, 일부에서는 주위 조직으로 침윤하거나 혹은 원격 전이로 인하여 치명적인 결과를 초래할 수 있다. 갑상선전절제술 및 131^I 제거술 후 경과 관찰시 갑상선암의 재발과 전이의 진단에 있어 131^I 스캔과 혈청 Tg의 측정이 현재 임상에서 가장 많이 이용되고 있으나 이 방법에는 여러 가지의 결점이 있다. 최근 Tg mRNA에 대한 RT-PCR법을 이용한 여러 연구결과는 131^I 스캔과 혈청 Tg 측정의 결점을 보완할 수 있는 좋은 보조적인 진단법으로 이용할 수 있을 가능성을 제시하였다. 이에 말초혈액에서 측정한 Tg mRNA에 대한 RT-PCR법이 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무의 진단에 유용한가를 알아보고자 이 연구 시행하였다. 방법: 분화된 갑상선암으로 진단된 후 갑상선전절제술을 시행받고 방사성요드 치료를 받은 환자 중 현재까지 한차례에 이상 추적 방사성요드 전신 스캔을 시행하고 추적관찰이 가능했던 유두선암 35예, 여포선암 5예를 대상으로 연구를 시행하였다. 대상군은 131^I 스캔 소견상 음성인 군(Group Ⅰ), 잔여조직이 있는 군(Group Ⅱ), 국소전이가 있는 군(Group Ⅲ), 및 원격전이 군(Group Ⅳ)으로 구분하였다. 정상 대조군은 갑상선질환이 없는 10예의 건강인으로 하였다. 대상환자의 말초혈액을 이용한 Tg mRNA에 대해 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행하였다. 결과: 본 연구 결과는 다음과 같다. 1) 131^I 스캔 소견상 음성인 군 21예 중 1예에서 Tg가 양성소견을 보였다. Anti Tg Ab가 양성인 4예 모두 Tg가 음성을 보였다. 잔여조직이 있거나 국소전이 및 원격전이를 보인 군 19예 중 Tg가 양성인 경우는 4예였으나, Tg mRNA는 전예에서 양성이었다. 2) 131^I 스캔에서 국소 및 원격전이 소견을 보인 8예 중 4예에서 Tg가 음성으로 131^I 스캔과 혈청 Tg 사이에 불일치 소견을 보였다. 3) 말초혈액에서 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행한 결과 대상군 40예 및 정상 대조군 10예 모두에서 Tg mRNA가 양성을 보였다. 결론: 본 연구에서 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무를 평가함에 있어 역전사 중합효소 연쇄 반응법을 이용한 Tg mRNA 측정의 의의는 재평가되어야 한다고 생각된다. Background: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyriod ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluated the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. Methods: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. Results: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131^I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. Conclusion: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications (J Kor Soc Endocrinol 17:501∼513, 2002).

인체 혈장에서 염산시프로플록사신(시프로플록사신으로서 250㎎) 정량을 위한 HPLC 분석법의 유효성검토

하용화,조성희,천성국,서성훈,류재환,최영욱,이경태 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.4

A simple HPLC method with ultraviolet detection of ciprofloxacin in human plasma was developed and validated. After protein precipitation with trichloroacetic acid, chromatographic separation of ciprofloxacin in plasma was achieved at 50℃ with a C_18 column and methanol-phosphate mixture (pH 2.5), as mobile phase. Quantitative determination was performed by ultraviolet detection at 278 nm. The method was specific and validated with a limit of quantification of 100 ng/ml. The infra- and inter-day coefficients of variation were between 1.67% and 10.55% and accuracy between 92.01% and 106.09%. The method has been successfully applied in a bioavailability study of 250 ㎎ ciprofloxacin hydrochloride tablet.

李箱 小說의 慾望構造

金用成,李鍾和 全北大學校 敎育大學院 1994 敎育論叢 Vol.14 No.-

공진 산란 실험 방법에 관한 연구

전상봉,정용화,안창회 嶺南大學校 工業技術硏究所 2003 工業技術硏究所論文集 Vol.31 No.2

Resonance Scattering Theory (RST) that was devised in the acoustic filed offers us an interpretation of the resonance phenomena in the scattered field. Experiments recently carried out in acoustic resonance signal that selective frequency that obtain by resonance scattering theory. Also the RST have been applied to the electromagnetic scattering problems. In this paper, we made an experiment on electromagnetic scattering with the RST.