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        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.

      • 다약물 내성기전으로서 ABC transporter와 화학감작제의 개발

        최철혁,권대승,최석민 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

        Anticancer resistance is one of the major problems in the clinical cancer chemotherapy. Of resistance mechanisms are ATP (ATP-binding cassette) transporters including P-glycoprotein. In this paper, ABC transporters with respect to the physiological functions and multidrug resistance mechanisms as well as the development of chemosensitizers for their reversal have been reviewed.

      • 鹽化物 含有梁에 따른 鐵分 腐蝕에 관한 實驗的 硏究

        최진석,조철희,신용석,고송균,손순채,김정섭 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

        As a result of separating river sand and sea sand into the corrosion increased according to the of thinnss or the coating and the Chloride Content and Corrosion of Steel Bar through the experiment, the following conclusions are obtained. 1. There was no corrosion in the case of treating the steel bar with anticorrosive among test specimens cured in the air for 60 days, corrosion was found in the test specimens not treated with anticorrosive and for 60 days of age. 2. The area of corrosion increased according to the thinnss of the coating and the chloride content wher exposed for are more than 60 days. Therefore, it was determined in general that the corrosion progressed more rapidly in water cured specimens than in air cured ones and this was due to the influence of C1_( ̄) in the sea sand.

      • KCI등재

        인천 인현동 호프집 화재 피해자 분석

        최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

        Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.

      • SCOPUSKCI등재

        양측성 누낭점액종의 치험례

        최희윤,류재만,조임철 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.1

        Lacrimal obstruction is associated with lacrimal duct injury, posttraumatic scars, infection and congenital anormaly etc. There are now available a variety of surgical methods depending on the site of obstruction. Dacryocystorhinostomy is the treatment of choice for patients with nasolacrimal duct obstruction. The various modified procedures were introduced to perform a dacryocystorhinostomy since Toti. The nasolacrimal duct obstruction is characterized by epiphora and mucopurulent material discharge from the lacrimal sac clinically. The preoperative dacryocystography combined with lacrimal scintillography provide the most comprehensive anatomic and functional assessment of the drainage system avilable. Authors have experienced one case of bilateral nasolacrimal duct obstruction associated with lacrimal mucocele and got satisfactory results using dacryocystorhinostomy. So we could report them with reviews of the relative references.

      • 黃柏에서 抽出한 多糖類의 抗癌作用에 대한 硏究

        최영철,홍희탁,홍영욱,이태균,박원환,김철호 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

        In order to investigate antitumor activities of the extracted polysaccharides from Phellodendron chinense SCHNEID, the following studies were carried out. Phellodendron chinense SCHNEID was extracted with hot water and alkali, and the extracted polysaccharides showed antitumor activities against mice Sarcoma-180 solid tumors in parameters of tumor weight, inhibition ratio, thymidilate synthetase(TS) and thymidine kinase(TK) activities. The results were as follows : 1. Delipidated extracts from Phellodendron chinense SCHNEID, were systematically fractionated, the heteropolysaccharide contains D-N-acetylglucosamine, D-galactose, D-mannose, D-glucose. The molecular weight distribution of the sample was found to be nearly homogeneous (about from 200 to 1000 kDa) in gel permeation analysis. 2. Among the polysaccharide fractions, the water extracted fractions, particularly Fr.-2, showed a potent growth-inhibitory activity against implanted in mice Sarcoma 180 solid tumor (inhibition, 95.3%, at 2 ㎎/100g), but the cold alkali extract (Fr.-4) showed a very low activity (inhibition; 4.7%). Fr.-7 and Fr.-8 showed the highest tumor inhibitory activity (inhibition; 96.4 and 98.2%, respectively). 3. TS activity in the Fr.-2 given oral administration of propolis was markedly suppresed to 73.7% of that in the control (p<0.01 by Student's t-test). However, there was little difference in TK activity with a slight decrease in Fr.-2 only.

      • SCIESCOPUSKCI등재
      • KCI등재후보

        부산, 울산, 경남지역 직업병감시체계에서 나타난 수지진동증후근의 역학적 특성

        최영희,유철인,이지호,이충렬,이헌,김영욱,채창호,고상백,김은아,이유진,김양호 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.3

        목적: 국내에서도 국소진동에 의한 수지진동증후군이 다수 있을 것으로 추정하나 최근에 이에 대한 보고가 적어 부·울·경 직업병감시체계를 통하여 수지진동증후군에 대한 환례를 수집하여 이의 역학적 특성을 밝히고자 본 연구를 실시하였다. 방법: 2001년 44월부터 2002년 12월까지 부산, 울산, 경남지역에 있는 종합병원 9곳을 통하여 특수 건강진단과 산업의학과 외래를 방문한 근로자를 대상으로 진동폭로에 대한 설문조사를 실시하고 이들중에서 수지진동으로 인한 증상을 호소하는 근로자는 이학적 검사와 Stockholm workshop scale을 이용하여 수지진동증후군이 있는지 평가하였다. 결과: 남자 188명, 여자 4명 등 총 192례의 수진진동증후군이 의심되는 환례를 수집하였으며, 업종별로는 조선업에 종사하는 근로자들이 가장 많았다. 국소진동의 주된 폭로원은 그라인더가 가장 많았으며, 혈관장해로 인한 증상보다 감각신경성 장해로 인한 증상을 많이 호소하였다. 결론: 전국적으로 조선업종의 그라인더 사용자를 중심으로 많은 수의 수지진동증후군의 환자가 있을 것으로 추정되며, 이들에 대한 예방대책을 마련하기 위하여 전국규모의 정확한 유병률 조사 및 실태파악이 필요한 것으로 판단된다. Objects: The objectives of this study were to estimate the epidemiologic characteristics of hand-arm vibration syndrome (HAVS) due to occupational exposure of hand transmitted vibration and to identify the occupations and industries where such exposures arises, and the main sources of exposure. Methods: In April 2001 the Busan, Ulsan, and Kyung-Nam Province occupational disease surveillance system was established to measure the incidence and prevalence of work-relatd HAVS and other occipational diseases in these Korean provinces. Occupational physicians of nine hospitals in Busan, Ulsan, and Kyung-nam Province were involved in this project between April 2001 and November 2002. Physicians collected information through questionnaires and interviews. Information gathered included age, occupation, types of vibration tools used and presence of subkective symptoms such as vibration-induced white finger (VWF), numbness and tingling. Results: A total 192 cases were reported with 188 males and 4 females. The shipbuilding industry was the most common type of industry and grinders were the most common source of exposire. Symptoms of neurological disorder were more common than those of vascular disprder. Conclusions: The authors concluded that exposure to hand transmitted vibration is common and that HAVS is one of the most common occupational diseases in Korea. However, the range and extent of hand transmitted vibration and the overall prevalence of HAVS in Korea is still unknown. More extensive research on this syndrome in order to priorite necessary preventive measures is required.

      • 오렌지 껍질로부터 분리된 프라보노이드의 화학요법 감작효과

        최철익,변익건,차윤정,김선필,민영돈,유진철,송재경 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

        Background and Objectives : The overexpression of P-glycoprotein (Pgp) or multidrug resistanceassociated protein (MRP) confers multidrug resistance (MDR) to cancer cells. MDR cells could be sensitized to anticancer drugs when treated concomitantly with a chemosensitizer. In this study, orange peel have been screened for the development of chemosensitizers reversing MDR. Materials and methods : Expression of Pgp in AML-2/WT and AML-2/D100 were determined using western blot analysis and RT-PCR. Candidates for chemosensitizers were isolated, purified from orange peel using sephadex LH-20 column chromatography and silica-gel column chromatography, whose structure was determined using ^1H-NMR, ^13C-NMR, ^1H-^1H-COSY, 13C-NMR, EI-Mass, IR. Chemosensitizing effect of NP-28 on AML-2/DX100 over expressing Pgp and MRP was determined by the MTT assay. Membrane toxicity was evaluated by the RBC hemolysis test. Antioxidant effects were examined by using a fluorescence probe (2’-7’-dichlorofluorescein diacetate). Results : A potent candidate, NP-28, has a flavonoid nucleus with some methoxy moiety. NP-28 is believed to have high therapeutic index, being non-transportable inhibitor and possibly, of inhibiting other efflux pumps such as MRP and antioxidant effects. NP-28 is also unlikely to be a substrate of Pgp. NP-28 did not increase Pgp levels. Conclusion : NP-28 has a Chemosensitizing effect to reverse Pgp-mediated MDR by increasing the intracellular accumulation of drugs. Furthermore, they do not increase expression of Pgp, which can allow a long term use without the concern about Pgp activation. NP-28 is anticipated as an ideal second-generation flavonoid chemosensitizer and/or possibly other therapeutic agents by further investigation.

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