세월호 침몰지점의 조류 특성

박준석(Jun-Seok Park),박진순(Jin-Soon Park),오영민(Young-Min Oh),김 응(Eung Kim),김동국(Dong-Guk Kim),최진용(Jin-Yong Choi),박광순(Kwang-Soon Park) 한국연안방재학회 2015 한국연안방재학회지 Vol.2 No.1

Departing Incheon port heading for Jeju Island, 6,825-ton the ferry, Sewol sank about 1.5 miles away from the North Sea in Byeongpung Island, Jindo-gun, Jeollanam-do at 8:48 a.m. on April 16, 2014. Right after the accident, Navy, National Emergency Management Agency, Coast Guard, and private divers were entered to save survivors and the missing underwater. However, 172 people were saved out of 476 people on board and 295 people died as of November 11, 2014. 9 people were missing. At the initial stage of rescue operation, for diving works, the data on tides (West Geocha Island) and currents (Maenggol Channel) were used. There were many difficulties encountered in the initial search operation as forecast location and ferry sinking point do not match, producing a lot of differences in the slack time and the velocity. Therefore, Korea Institute of Ocean Science & Technology(KIOST) installed ADCP (Acoustic Doppler Current Profiler) to observe real-time tidal current for 202 days from April 23 to November10 from the missing support barge for search operations. Analyzing the data, the trends of water speed, direction, flow, etc. were identified. The real-time tidal current data and analyzed findings were offered to divers and relevant agencies on site and effective search was supported. As a result of analyzing the observed data, slack time after flood tide was similar to that on broadcast for Maengol Channel at Sewol sinking point but slack time after ebb tide appeared average about 50 minutes in advance from the sinking point (based of July, 2014). In particular, at slack time after ebb tide, under 0.5m/s current velocity for divingpossible didn’t appear but lasting time appeared very short. On the other hand, at slack time after flood tide, the retention time for current velocity under 0.5m/s was long. From time to time, it lasted more than three hours. Besides, ebb tide started. In about two hours, short-cycle tidal current variability appeared. It is considered it was caused by geographical impact, in other words, the impact of Geocha Island, Maenggol Channel, Geocha Channel, etc. Such results were also found in the numerical model results for the relevant areas.

모균증(Mucormycosis)의 임상적 고찰

김준명,박형천,김 응,홍천수 대한감염학회 1994 감염 Vol.26 No.4

목적: 모균증은 치명적인 진균감염증으로 생체의 면역학적 방어력이 감소되었을때 잘 합병되는 기회감염이다. 모균은 자연계 도처에 존재하나 정상인에서는 잘 감염되지 않으며, 당뇨병, 백혈병, 임파종, 장기이식등과 같은 면역저하 상태에서 잘 발생한다. 국내에는 지금까지 약 13예가 산발적으로 보고되었으며 최근 각종 항생제의 사용증가, 스테로이드제제의 과용, 항암제의 사용 등으로 감염에 대한 환자의 저항력이 약화됨에 따라 모균증이 증가하는 추세를 보이고 있다. 방법: 저자들은 1986년 3월부터 1993년 6월까지 연세대학교 의과대학 세브란스병원에서 모균증으로 진단받은 15명의 환자의 임상적 특성을 관찰하여 다음과 같은 결과를 얻었다. 결과: 1) 모균증의 남녀의 비는 1:1.1로 남녀 성별 차이는 없었고, 연령분포상 50대에서 가장 많이 발생하였다. 2) 임상형태에 따른 분류상 총 15예 중 비대뇌형 모균증이 13예였고, 위장관형모균증이 2예 있었다. 3) 대부분 선행질환을 동반하였고, 비대뇌형모균증의 경우 당뇨병이 5예로 가장 많았고 위장관형모균증은 모두 급성백혈병에서 발생하였다. 4) 초기증상은 비대뇌형모균증의 경우 두통과 안와부동통이 가장 많았고 위장관형모균증의 경우 복부동통이 초기에 나타났다. 5) 치료는 근치적 절제술과 항진균제의 병합요법이 총 15예 중 10예에서 사용되었고, 4예에서는 외과적 수술만 시행하였고 1예에서는 스테로이드제제만 사용하였다. 6) 예후는 일반적으로 불량하여 전체 생존률이 64%였고, 비교적 전형적인 모균증의 증상과 증후를 나타낸 경우 모두 사망하였다. 결론: 모균증은 생체의 면역학적 방어력이 감소되었을때 호발하는 치명적인 진균감염증으로 조기진단과 초기치료가 중요하다. 치료는 대개 외과적 절제술과 항진균제의 병합요법이 사용되며 적극적인 치료에도 불구하고 상당히 불량한 예후를 보인다. Background: Mucormycosis is a highly virulent and rapidly progressive disease with a grave prognosis. It encompasses a distinctive group of infections caused by fungi belonging to order Mucorales. These fungi are widespread in nature, subsisting on decaying vegetation and diverse organic materials. The infection occurs almost exclusively in immunocompromised hosts and poses difficult diagnostic challenge to physicians. The aim of the study was to investigate the clinical characteristics of patients with mucormycosis. Methods: Clinical characteristics of mucormycosis was examined by retrospective review of 15 patients diagnosed as mucormycosis at Severance hospital from March 1986 to June 1993. Results: 1) Mucormycosis occured most frequently in the 6th decade. 2) Underlying diseases, frequently diabetes mellitus, were usually present. 3) Headache and ocular pain were the most common initial symptoms in rhinocerebral mucormycosis. 4) Ethmoid and maxillary sinuses were the most frequently involved sites. 5) Radical surgery combined with Amphotericin B was the treatment of choice. 6) Mortality rate was 36%(5/14) among those who were followed. Most patients with high mortality rate had underlying disease, especially diabetes and liver cirrhosis. Conclusion: Mucormycosis is a fatal fungal infection usually arising in immunocompromised patients. Early diagnosis and timely institution of aggressive treatment is sine qua non for patients with mucormycosis.

한국인에서 Coxiella burnetii PhaseⅡ 항원에 대한 항체 보유에 관한 연구

김주덕,조상래,김준명,이천균,김현옥,정윤섭,김 응,홍천수 대한감염학회 1994 감염 Vol.26 No.4

연구배경: 우리나라에서도 오래전부터 Q열의 발생이 예견되어오던 중 최근들어 Q열의 발생에 대한 간헐적인 보고가 있으면서 Q열의 원인체인 C.burnetii 감염상태를 알아보고자 하는 혈청역학적조사가 진행되어 보고된 바 있으나 이들 보고가 C.burnetii phase I 항원에 대한 항체 양성률에 근거 하였기에 이를 보완하고 보다 정확한 감염상태를 알아보고자 본 연구를 시행하였다. 방법: C.burnetii에 가장 감염 가능성이 높은 것으로 생각되는 목축업자 58명과 농민 25명을 대상으로 간접 형광 항체 검사법을 통하여 C.burnetii phase Ⅱ 항원에 대한 항체를 측정하였으며, 동시에 도시주민 71명에 대해서도 함께 조사하였다. 결과: 1) 농민 25명중 48.0%인 12명이 그리고 목축업에 종사하는 58명중 39.7%인 23명이 항체 양성을 보였고 도시주민 71명중 19.7%인 14명이 항체양성이었다. 2) 양성혈청의 74%(36례)가 항체 역가 1:20 또는 1:40의 양성반응을 나타내어 항체 양성자 대부분은 항체가가 비교적 낮았으며 항체 역가 1:80 이상을 보인 경우가 13례로서 양성혈 청의 27%였다. 3) 연령별 항체양성률 조사상 연령이 증가할수록 항체양성률이 중가하였는데, 10대에서는 항체 양성인례가 없었으며, 20대에서는 16.7%, 30대에서는 34.1%, 40대에서는 34.6%, 50대에서는 45.0%, 60대에서는 46.0%, 70대에서는 50.0%의 항체양성률을 보였다. 결론: 과거부터 우리나라에도 유입되었으리라 여겨졌던 C.burnetii 감염이 이미 상당수 존재하고 있음을 알 수 있었으며 이에 대한 광법위한 혈청역학적 조사와 함께 일선 임상의의 Q열에 대한 관심과 주의가 요구된다 하겠다. Background : Q fever is a worldwide zoonosis caused by Coxiella burnetii, and it manifests an influenza-like illness and pneumonia. Q fever was reported in more than 50 countries of five continents. In Asia, India, Saudi Arabia, Japan, and China Q fever had already occurred. In Korea no outbreaks of Q fever have been reported yet, although some potentials of a Q fever outbreak has been suggested on the basis of epidemiologic background. As recently several cases of Q fever have been reported, seroepidemiological surveys to determine the prevalence of Coxiella burnetii infection among Koreans were done. But these surveys had limitations. That is to say, while immunoglobulins produced during acute phase of Q fever are mainly directed against the phase Ⅱ antigen of the microorganism, these previous surveys were done with the phase I antigen, which is low titer during acute phase. Therefore to resolve this limitation and evaluate the prevalence of Q fever in Korea more exactly, we conducted this serosurvey with the phase Ⅱ antigen. Methods : We conducted a serosurvey for 58 stock breeders and 25 farmers who seemed to be a high risk group for the Coxiella burnetii infection and normal residents in a city. With use of an indirect immunofluorescent antibody test(IFA) employing the phase Ⅱ antigen of the Nine-Mile strain of Coxiella burnetii, the titer of polyvalent immunoglobulins was determined. Results:1) When IFA titer of 1:20 or above was considered seropositive, 23(39.7%) of 58 stock breeders and 12(48.0%) of 25 farmers were seropositive respectively.Fourteen(19.7%) of 71 city residents had elevated antibodies to the Coxiella burnetii phase Ⅱ antigen. 2) IFA titers ranged from 1:20 to 1:320, but the majority of the seropositive samples showed IFA titers of 1:20 or 1:40 indicating that in a majority of the seropositves C. burnetii infection progressed weakly or antibody titer decreased because of the long duration after the infection. 3) As the age increased, a positive rate of antibody to Coxiella burnetii phase Ⅱ antigen also increased. Conclusion : Our study suggests that Coxiella burnetii infection occurs in Korea more widely than expected and thus more extensive serosurvey and clinician's attentions for Q fever are required.

Non-Plague Yersiniosis 32예에 대한 임상적 고찰

홍천수,홍창호,박효진,이원영,김 응,김용범,김준명,정윤섭 대한감염학회 1987 감염 Vol.19 No.1

The case records of 32 patients infected with Yersinia enterocolitica or Yersinia psuedotuberculosis during the period of July 1979 to Jun 1986 were retrospectively analysed. The following results were obtained. 1) The age was distributed between 1 and 60 years (median age 20.5). Male to female ratio was 1.7:1. 2) The seasonal incidences were spring 43.8%, summer 15.6%, autumn 3.1%, and winter 37.5%. 3) The most common initial symptom in these patients was diarrhea (84.4%). The additional cardinal symptoms were fever (65.6%), abdominal pain (56.3%), vomiting (25.0%) and arthralgia (3.1%). 4) Twenty-nine cases of infection were caused by Y. enterocolitica and three cases by Y. pseudotuberculosis. 5) The isolated organism of 21 cases of Y. enterocolitica were grouped into two Wauters biotypes; the one group of 18 isolates was Wauters biotype 3 and the other group of 3 isolates was biotype 2. 6) In the antibiotic sensitivity test, most of isolates were sensitive to tetracycline, co-trimoxazole and aminoglycosides such as gentamicin, but resistant to ampicillin (78.1%) and cephalothin (81.3%). 7) Most of patients showed improved clinical courses within 3.5 days after taking conservative and/or antimicrobial regimen, but two septic patients with serious underlying conditions showed fatal courses.