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.

분산 멀티미디어 시스템의 성능 분석 기법

최항묵,성재철,김상균 인제대학교기초과학연구소 1999 자연과학 Vol.3 No.-

네트워크를 기반으로 하는 분산 시스템, 영상 회의 시스템, 병렬처리 시스템등을 대상으로 성능분석에 사용된 성능 평가 인자들과 성능평가 기법들에 대하여 고찰하고자 한다. 이는 현재 개발 중인 의료 영상 회의 시스템(MICS)의 성능을 평가하기 위하여 이와 유사한 시스템들을 고찰하고, 시스템의 성능평가를 위해 선택, 사용된 성능 평가 항목 및 평가 방법에 대하여 검토하여 적합한 성능평가 항목 및 성능평가 기법을 제시하기 위함이다. In this paper, I would like to investigate about "performance evaluation techniques" and "performance evaluation factors" used in performance analysis for systems in network based distributed system, image conference system and parallel processing systems. The aim is to propose profitable performance evaluation factors and performance evaluation techniques. For this, I went through similar systems to evaluation factors and performance evaluation techniques. For this, I went through similar systems to evaluate the performance of MICS(Medical Image Conference system)which is still being developed and worked out performance evaluation factors and evaluation methods to evaluate performance of system.

현대 무도(武道)의 지향과제에 대한 논의

최종균,장재이,홍장표,박순진,김의영 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

I would like to make the following suggestions on the basis of such problems as arguments over the philosophies and historicity of modern martial arts, a flood of groups with commercialism, the absence of true martial arts in the wake of game-oriented trends, and the stagnation of martial arts. First, the philosophy and historicity of martial arts should be established. I should like to suggest that the philosophy of martial arts should be established through the understanding of the changing aspect of the Eastern cultures and changes in the meanings of martial arts. Second, the groups of martial arts should be fostered in a synthetic fashion. Third, the methods of running martial-art games should be improved. That is, it is necessary that the games should be improved in order to activate the essence of martial arts. Fourth, martial arts should be made academic. Philosophy, science and Comtism should be organically connected so that martial arts may be academically systemized.

폐렴구균 감염에 의한 복부 대동맥류 1예

최소연,백경란,기현균,문치숙,오원섭,송재훈,신동현,위유미,고영혜 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

폐렴구균은 폐렴, 수막염, 중이염 등의 감염증을 일으키나 감염성 대동맥류를 유발하는 경우는 매우 드물다. 저자들은 고혈압, 당뇨병 등을 가지고 있으며 대동맥류가 확인되지 않았던 78세 남자 환자에서 감염증의 증상없이 대동맥류 파열로 내원하여 폐렴구균에 의한 대동맥류로 진단되었던 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Streptococcus pneumoniae has been an important etiologic agent of community-acquired pneumonia, meningitis, and otitis media. S. pneumoniae is also an important cause of bacteremia, especially in a community setting and it may cause intravascular infection. S. pneumoniae has been rarely been reparted to cause mycotic aneurysm and three is no case report on abdominal aneurysm caused by S. pneumoniae in Korea, yet. We experienced a case of abdominal aneurysm caused by S. pneumoniae infection. A 78-year old male with hypertension and diabetes mellitus was transferred to our hospital due to ruptured abdominal aortic aneurysm. Surgical intervention was done for removal of hematoma and vascular anastomosis. Ascending aorta showed atheromatous plaque with dystrophic calcification and thrombus. S. pneumoniae was isolated from the culture of the surgical specimen. After successful treatment with antibiotics for 7 weeks, he has been followed up uneventfully in outpatient clinic for 1 year.

Ciprofloxacin 제제의 생물학적 동등성에 관한 연구

최철희,신재국,신완균,유호진,이경훈,정원석,장인진,신상구 대한화학요법학회 1991 대한화학요법학회지 Vol.9 No.1

국내 시판중인 ciprofloxacin 제제인 Citopcin®(250㎎ tablet)의 동등성을 검토하기 위해 제조원인 Bayer사의 Citopcin®(250㎎ tablet)를 기준제제로 하여 18명의 건강한 남성 피험자를 대상으로 500㎎ 1회 교차 경구 투여후 약동학적 성상을 분석비교한 결과는 다음과 같다. 시험제제의 생체 이용율의 지표인 AUC, C_(mao), T_(max) 및 MRT들의 평균치는 백분율차이에 있어 모든 기준제제 지표의 ± 20% 이내였으며, 이들 생체 이용율 지표들은 분산분석 검정에서 차이를 인지할 수 없었다.생체 이용율 지표들의 기준제제에 대한 백분율 90% 대칭 신뢰구간 검토시 모든 경수들에서 ± 20% 이내의 조건을 만족하였으며 AUC의 경우에는 대칭형 신뢰구간으로 변환시 95% 신뢰구간에서도 동등성의 조건을 만족하였다, 이상의 시험결과로 시험제제인 Citopcin®은 기준제제인 Ciprobay®와 생물학적 동등한 제제로 판단되었다. The pharmacokinetics of ciprofloxacin was studied for the evaluation of the bioequivalence of the generic ciproflocacin products. Two single doses of 500㎎ each of ciprofloxacin(Ciprobay® 250㎎ tablet as a reference compound and Citopcin® 250㎎ tablet s a test compound) were administered orally to ighteen male volunteers in a balanced, randomized crossover design. Pek plasma levels of ciprofloxacin were observed about 1 hour after the doses and the peak concentrations of both products were similar(Ciprobay®, 3.18㎍/㎖; Citopcin®, 2.89㎍/㎖). The values of other pharmacokinetic parameter of ciprofloxacin computed for Ciprobay® are presented in that order: AUC=13.53:12.47㎍·h/㎖, T_(max)=1.28:1.14 hours; MRT=5.30:5.08 hours; t_(1/2)β=3.65:3.47 hours. No satistically significant, differences were detected when AUC and the other parameters were compared with the method of ANOVA. Using the criteria of 90% confidence interval for the assessment of bioequivalence al the parameters were acceptable. The products were found to be equivalent on the premise that no significant difference was detected when the relevant pharmacokinetic parameters were compared, and the confidence limit analysis showed acceptable results.

Carboxymethylcellulose(CMC)를 이용한 수용성 섬유 제조 특성에 관한 연구

최영민,정의현,박진원,신재균,Toshio, Kajiuchi,Hong, Kyung Jin 한국공업화학회 2003 응용화학 Vol.7 No.1

The manufacturing characteristics of water soluble fiber were studied using carboxymethycellulose(CMC) prepared from viscose rayon. Manufactiring process of CMC consists of mercerization and etherification stages. Experimental conditions are NaOH and MCA concentration and stop of reaction process. The former two steps of manufacturing process were reduced to one step. The solubility of CMC in one step process was compared with former process.

어유에서 요소부가법에 의한 EPA와 DHA의 농축

최원균,조재선 경희대학교 부설 식량자원개발연구소 1993 硏究論文集 Vol.14 No.-

어유에틸에스터에서 요소부가법을 이용하여 고도불포화지방산, 특히 eicosapentaenoic acid와 docosahexaenoic acid를 농축할 때 효율에 영향을 끼치는 용매의 종류와 최적 요소량과 효율적인 방법에 대해 살펴보았다. 용매는 5%수화된 아세톤을 사용한 것이 포화지방산과 단일 불포화지방산을 보다 효율적으로 제거하였다. 요소의 양은 시료의 양보다 부가물을 형성하는 포화지방산 및 단일불포화지방산의 양과 밀접한 관계가 있었으며 포화 및 단일불포화지방산양의 5배를 첨가하는 것이 EPA와 DHA를 최대로 농축할 수 있었다. 이 조건하에서 EPA와 DHA는 각각 36%와 41%로 농축되었고 증량수율은 25.1%였다. 복잡한 공정을 단축시키기 위해 요소 column을 통과시켜 실시한 결과 EPA, DHA는 각각 29%, 36%로 농축되어 농축효율은 batch식보다 떨어졌으나 공정이 간단하며 시간이 절약되었다. High yield and efficient enrichment of eicosapentanoic acid(EPA) and docosahexanoic acid(DHA) from fish oil could be obtained by urea adduct formation. The content of EPA and DHA were varied significantly depending on the amount of urea and monoenoic and saturated fatty acids in the sample. Effective organic solvent and the amount of urea are 5% hydrated acetone and 5 times of saturated and monoenoic fatty acid in the sample. With the new method the fraction in which the total content of EPA and DHA is more than 80% could be obtained. Tough the low efficiency of enrichment was showed as 29% of EPA and 36% of DHA by continuous process with urea column but the process was simple and could be saved the operation time.

중추에서 Prostaglandin계가 Renin-angiotensin System에 미치는 영향

최영태,김종승,문성호,오형균,김재훈,전제열,염철호,윤평진 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.1

Role of prostaglandins on the renin-angiotensin system in the central nervous system was examined in normotensive and 2-kidney, 1 clip (2K1C) hypertensive rats. The experiment was done under thiopental (50 ㎎/㎏, IP) anesthesia. Captopril and indomethacin were injected into the right lateral cerebral ventricle. Arterial blood pressure and heart rate were recorded from the femoral artery. Intracerebroventricular (ICV) captopril (1 ㎎) caused a decrease in mean arterial pressure in both normotensive and 2K1C hypertensive rats. The depressor response to captopril was more sensitive in hyper-tensive rats than in normotensive rats. Indomethacin treatment (ICV, 200 ㎎) altered the depressor response to captopril neither in normotensive nor in hypertensive rats. These results suggest that the cardiovascular effect of renin-angiotensin system in the central nervous system may not be mediated via prostaglandin systems in normotensive and 2KlC hypertensive rats.

HEMA와 CA 및 PVA공중합체의 막제조와 물성에 관한 연구

崔乘載,鄭皓鍾,鄭在均 단국대학교 1993 論文集 Vol.27 No.-

The grafting of 2-hydroxyethyl methacrylate(HEMA) and cellulose acetate(CA) and synthesis polymer poly(vinylalcohol) as a biocompatible material for medical application was investigated in the various condition. The structure of graft copolymer was indentified by using infrared spectroscopy.(IR) The membrane of sytnesis copolymer CA-g-p(HEMA) and PVA-g-p(HEMA) were prepared for a skin substitute and water content, tensile strength, elongation, water vapor transimmision rate(WVTR) and biodegradation the membranes was determind. And the surface structure of graft copolymer membrane characterized by SEM. The water content was about 100% and then tensile strength was 166∼661kg/㎠, 210∼88kg/㎠ at dry condition, 60∼328kg/㎠, 54∼23kg/㎠ at wet condition in the PVA-g-p(HEMA) and CA-g-p(HEMA) membrane respectively. Water vapor transimmision rate(WVTR) was 123.59∼128.54kg/㎠/day like that of the normal skin. From the result of the biodegradation by protein hydrolysis pepsin the biodegradation rate was that at the 4∼5day and accessed to the equilibrium state. From the results obtained in this study, syntheis membrane was found to satisfy most of the basic properties of a skin substitute.

농산물의 풀질인증 단계별 소비자가치 측정

최태길,김태균,조재환 한국농업정책학회, 한국축산경영학회 2000 농업경영정책연구 Vol.27 No.1

This study used a dichotomous-choice contingent valuation method to measure consumer's value of quality certificated lettuce. Consumers were willing to pay more than the current price of regular lettuce for quality certificated lettuce. This value is attributed to the safety of quality certificated lettuce in comparison with regular lettuce. Findings suggest that the consumers put substantially high value on safe food, such as high quality certificated lettuce.