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.

Nonlinear Cardiac Dynamics and Morning Dip : 위험한 일중리듬 An Unsound Circadian Rhythm

염명걸,김남수,오재원,김창렬,이재웅,김순길,이철범,노정일,최정연,윤용수 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.3

Original Article : Geographic difference of epidemiological features of HCV infection in Korea

( Kyung Ah Kim ),( Sook Hyang Jeong ),( Eun Sun Jang ),( Young Seok Kim3 ),( Youn Jae Lee ),( Eun Uk Jung ),( In Hee Kim ),( Sung Bum Cho ),( Mee Kyung Kee ),( Chun Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Background/Aims: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. Methods: In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. Results: The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. Conclusions: There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection. (Clin Mol Hepatol 2014;20:361-367)

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

방과후 체육활동과 여가활동과의 관계

김현준,변재경,김창범,고영민 忠北大學校 平生體育硏究所 1999 平生體育硏究所 論文集 Vol.11 No.-

In this study, the researcher analyzed the difference between the participation in after-school physical exercise activities and the leisure satisfaction to examine the relationship between the leisure satisfaction before and after the participation in after-school physical exercise activities. The researcher sampled two groups. One group is the 450 students of a middle school (W. Middle School in Daejon, appointed as a middle school of the school physical education case study by Ministry of Education), who participated in the after-school physical exercise activities by using the sports facilities in a community, more than three times and four hours in a week. The other group is the 435 students of a middle school (B, Middle School near W. Middle School), who didn't participated in the afterschool physical exercises activities. The questionnaire about leisure satisfaction was based on the scale of domestic previous studies translated by Lee, Jong-Kil from Beard and Ragheb's Satisfaction Scale(1980). The statistics to be employed to analyze the data collected through the questionnaire was 'One-way ANOVA'. On the basis of the results by the above research methods, the conclusions were drawn as follows: First, study1 showed that Participating in the after-school physical exercises activities significantly influenced on all the factors of leisure satisfaction through the specific period, excepting for the factor of relaxing satisfaction. Second, study2 indicated that the experimental group(physical activities) showed higher scores on the general leisure satisfaction than control group(non-physical activities) did. But there was not difference between the experimental group and control group on the factor scores of environmental satisfaction. Therefore, from above results, this study could say that the middle school students' participation of the after-school physical activities influences positively on the physiological, social, educational, and psychological leisure satisfaction, but not on the relaxing or environmental leisure satisfaction.

유방암에서 PCR을 이용한 p53 유전자의 Codon 175에서의 점돌연변이에 관한 연구

김영철,김종석,김선한,목영재,최상용,문홍영,구범환 고려대학교 의과대학 1993 고려대 의대 잡지 Vol.30 No.2

The p53 gene, which is located in the short arm of chromosome 17, has been a constant source of fascination since its discovery at 1979. Allelic deletion coupled with mutation of the remaining allele is a theoretical hallmark of functional inactivation of tumor suppressor gene, and mutation and/or deletion of p53 gene is to be the most frequently observed genetic changes in breast cancer related to a single gene. In the present report, we have attempted to determine a point mutation at codon 175 which is known as one of four hot spots within highly conserved regions of the p53 gene where almost all of the reported mutations cluster A 304-bp fragment of exon 5 of p53 gene in fresh tissue of breast carcinoma was amplified by polymerase chain reaction (PCR), digested with Hha I restriction endonuclease, and electrophoresed. A point mutation was studied by observation of polymorphism with ethidium bromide staining under ultraviolet transillumination. The result revealed all of 14 carcinomas had wild-type p53 gene.

조기 대장암

이재범,박영진,박군주,김선회,박재갑,이건욱,박용현,최국진,김진복 대한대장항문학회 1998 Annals of Coloproctolgy Vol.14 No.3

스포츠 집단 수준에 따른 응집력 및 성원만족도와 팀성공의 관계 : 대내경기 집단과 대교경기 집단을 중심으로

김범식,유재충 경희대학교 사회체육연구소 1996 體育科學論叢 Vol.- No.9

The purpose of this study was to investigate the relationship between group cohesiveness, member satisfaction and team success. In order to meet this purpose, the following four subsequent research questions were explored : 1) the difference of group cohesion in the intramural and interscholastic group 2) the difference of member's satisfaction in the intramural and interscholastic group 3) the relationship group cohesion and member's satisfaction according to the level of sport group 4) the relationship group cohesion, member satisfaction and team success bared on level of sport group. The subjects of this study were sampled 94 students and 88 athletic students(total 182 persons) using the random sampling. The data collected questionnaire designed for this study were considered of response to items constructed to represent each variable. Statistics employed in this study was t-test and multiple regression. The findings of this study were as follows: First, friendship, influence, sense of belonging, teamwork, closeness, and value of membership were singnificantly different. Second, the level of sport group showed that a significant difference of member's satisfaction. Member's play satisfaction, member's position satisfaction, and member's belonging satisfaction were significantly different. Third, group cohesion influenced on member's satisfaction. Group cohesion influenced member's play satisfaction, member's position satisfaction, and member's belonging satisfaction among the sub-factors of member's satisfaction in intramural group. Group cohesion influenced member's position satisfaction and member's belonging satisfaction in interscholastic group. Fourth, group cohesion and member's satisfaction influenced team success in intramural and interscholastic group.

Zoledronic acid가 골육종 세포에서 Matrix Metalloproteinase-2와 -14의 발현과 폐전이에 미치는 영향

김용백,김상범,권영호,김재도 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Purpose : Gelatinase A (MMP-2) and membrane-type metalloproteinase (MT1-MMP, MMP-14) play a critical role in metastasis. It was known that bisphosphonate acts not only to protect bone absorption but also to inhibit tumor invasion and metastasis. The aim of this study is to investigate the inhibition of MMP-2 and 14 in osteosarcoma by zoledronic acid, whether it can prevent lung metastasis in nude mouse. Material and Method : Protein synthesis and mRNA expression of MMP-2 and MMP-14 cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines with zoledronic acids were measured. In vivo test, it was observed that the inhibitory effect of zoledronic acid on lung metastasis of osteosarcoma with nude mouse model. Result : Zoledronic acid inhibited mRNA expression of MMP-14 and MMP-2 in cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines. Zoledronic acid decreased the intensity of activated 62KD MMP-2 in human MG-63 osteosarcoma and HOS osteosarcoma cell lines on gelatine zymography. Number of metastatic lung nodule decreased from 9.4 to 1.2 in MG-63 osteosarcoma cell line and from 8 to 1.6 in HOS osteosarcoma cell line with nude mouse model. Conclusion : In vitro, zoledronic acid had an inhibitory effect on the MMP-14 and MMp-2, which also prevents lung metastasis of osteosarcoma in vivo. So, zoledronic acid could be used as one of good chemotherapeutic agents against metastasis of osteosarcoma.

여자중학생 배드민턴 하이클리어 동작의 운동학적 분석

김창범,유재광 한국운동역학회 2002 한국운동역학회지 Vol.12 No.2

이 연구는 배드민턴 경기기술 중 클리어에 대한 연구 대부분 경기분석 및 타법사용에 대한 연구에 국한되어 있어 여자중학생 배드민턴 선수를 대상으로 하이클리어 동작을 운동학적 변인으로 측정 · 분석하였다. 이 연구의 대상자는 충청북도에 위치한 C여자중학교 배드민턴 선수 4명이었으며, 동작의 분석 범위는 준비자세에서 동작의 시작순간, 라켓이 최대로 백 스윙 된 순간, 라켓과 셔틀콕이 임팩트 되는 순간, 임팩트 이후의 마무리 스윙동작까지로 단계별 동작을 설정하였다. 여자중학생 하이클리어 동작을 운동학적으로 분석한 결과 다음과 같은 결론을 얻었다. 피험자 대부분 백 스윙 단계에서 어깨 및 팔꿈치 관절을 충분히 회전하지 못한 것으로 나타났고, 특정 관절 부분에만 좋은 동작을 나타내 관절의 협웅동작이 떨어지는 것으로 보였다. 피험자 S1과 S2가 임팩트 단계에서 어깨 및 팔꿈치 관절은 크게 천천히 스윙하다가 오른 손목관절 및 라켓헤드의 속도는 빠르게 나타나 다른 피험자 보다 관절의 협웅동작이 잘 이루어진 것으로 나타났다. 피험자 모두 성장기에 있는 학생으로서 관절의 유연성에 기인하여 오른 어깨각도 변화는 큰 각도를 보였고 각속도는 피험자 S3이 다른 피험자 보다 기술적 차이를 보여 개선될 점으로 나타났다. 피험자 모두 오른 팔꿈치 각도 변화는 비슷한 양상을 보였고 각속도에서 피험자 S2는 백 스윙단계부터 임팩트 시 심한 굴곡의 형태를 보여 힘을 효과적으로 사용하지 못한 것으로 나타났다. 피험자 모두 오른 손목각도의 변화는 백 스윙 직후 큰 각도를 이루지 못하고 임팩트 직후 손목의 빠른 굴곡이 형성되지 못하여 셔틀콕의 속도가 감속될 것으로 나타났다. 그러나 각속도는 피험자 S1과 S4는 임팩트 시 무릎각도의 크기는 큰 각도를 이룬 반면 고관절 각도는 작은 각도를 보여 무릎관절과 고관절과의 합성동작인 강한 허리힘을 이용하지 못한 것으로 나타났다. This research got the following conclusion as result that analyzed high clear action kinematically to 4 C girls' junior high school badminton players who are situated in Chungchong-bukdo. 1. Most of the subject didn't rotate their right shoulder and elbow joint at back swing and moved speedy to shuttle cock. And an cooperation action of joint decreases displaying only a good action on both subject's specification joint part. 2. When the subject S1 and S2 swing slowly and largely the joint of shoulder and elbow and then the speed of right wrist and racket head is fast, the cooperation action of joint is better than other subject. 3. An angle change of right shoulder showed angle that all subjects are great being caused in softness of joint and angular velocity was exposed that load enough Impact force and increase the speed of racket head as angular velocity decreases rapidly in Impact except subject S3. 4. All subjects of right elbow angle change showed similar form and was exposed that subject S2 sees form of impact stage serious bends from back swing and do not use force effectively in angular velocity. 5. Angle of right wrist appeared that the speed of shuttle cock is decelerated because fast bends of wrist is not formed shortly after Impact because all subject do not accomplish big angle shortly after back swing. Angular velocity cal assume that the subject S1 and S4 are using and move fast strong snap shot offering angular velocity value of Impact stage sound (-). 6. While size of Impact stage knee angle accomplishes angle that is big both subject, hip joint angles sees small angle and is playing swing that do on upper body and arm without using strong waist force that is composition action with knee and hip joint.