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.

트레드밀 운동시 흡기근 테이핑이 폐활량에 미치는 영향

김민지,신수영,송월섭,조수진,최동락,황미진,황진규,박진현,김경,Dennis W. Fell 대구대학교 특수교육재활과학연구소 2011 再活科學硏究 Vol.29 No.1

이 연구는 트레드밀 운동과 키네시오 테이핑의 효과에 따른 폐활량의 변화를 알아보기 위해 26명의 비흡연자가 참가하였으며 키네시오 테이핑을 적용하지 않은 그룹과 키네시오 테이핑을 적용한 두 그룹으로 무작위로 배정하고 각 군들을 주 3회 6주간의 트레드밀 훈련을 실시하였다. 실험 전과 후, 스파이로미터를 사용하여 키네시오 테이핑의 적용 따른 폐활량 변화 효과를 측정하였다. 이 연구의 결과를 종합해보면 키네시오 테이핑을 적용 그룹에서 적용하지 않은 그룹에 비해 FVC, FEV1에서 유의한 증가를 보였다. 이러한 결과는 건강한 성인에서 키네시오 테이핑을 적용한 경우 키네시오 테이핑을 적용하지 않고 트레드밀 운동을 한 경우보다 폐활량의 향상에 효과적이라고 생각되어진다. The purpose of this study was to investigate the variation of vital capacity(VC) according to the effects of kinesio taping with treadmill exercise. Twenty-six non-smokers were participated in this research and these subjects were randomly assigned into two groups. To measure the VC variation effects of kinesio taping, spirometer was used. The collected data were analyzed statistically by using a paired Mauchly test and repeated measure ANOVA. The results of this study were as follows; A group: treadmill with kinesio taping B group: treadmill without kinesio taping. Between A and B, there were significant differences. In the case of A group, there was 11.66% increase of VC, during 3 weeks experiment(p<.01). In the case of B group, there were significant differences, 3.35% increase of VC, during 3 weeks taping intervention(p<.01). After 6 weeks experiment, the improvement of VC shown a significant difference with intergroup (p<.05). From this result, it was revealed that treadmill exercise with kinesio taping was effective to improve VC to healthy adult than treadmill exercise without kinesio taping.

만대천 유역의 강우량에 의한 비점오염물질 유출특성에 관한 연구

최한규,이진태,박수진 강원대학교 산업기술연구소 2005 産業技術硏究 Vol.25 No.B

Non-point source pollution, which is found in soil, urban area, and agricultural area, is difficult to have its amount to be estimated. Moreover, it is hard to come up with a counterplan to cope with this pollutant. Hence, the watershed of Mandae-cheon located at the upstream of Soyang Lake was chosen as our site of study. We analyzed the relationship between precipatation level of each month and pollution load in the watershed by using statistical methods: measuring BOD, T-N and T-P - which are the causes of eutrophication - in the water; and analyzing the changes in water quality caused by precipitation level of nth.

유통업체의 경쟁력 강화를 위한 POS 활용방안에 관한 연구

최상래,김영민,최진수 한국유통정보학회 2003 유통정보학회지 Vol.6 No.2

The purpose of this study is to suggest the application strategies of POS for the competitiveness improvement of the small and medium retailers. It is studied POS system, the survey of the application degree of POS data and application strategies in the small and medium retailers. In the results of survey most of the small and medium retailers don't use POS data strategically in the side of promotion, item management, inventory management and ABC analysis, etc. To use effectively POS data, we suggest the preception of the importance of distribution information, the education of information, strategic application of POS data. Specially, it is needed to use positively POS data like as promotion management, item management, inventory management, lay-out management, distribution decision makings, etc. When the small and medium retailers use distribution information strategically, they are able to get competitiveness and survive in the distribution competitions.

횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예

최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.

다방성 낭성 신종 1예

최수정,김진국,황승덕 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multilocular cystic nephroma is a rare and non-inherited benign renal neoplasm occuring in the both children and adults. It is necessary to make a differential diagnosis from all renal diseases with a cystic component, such as simple cyst, metastatic renal tumor, cystic adenoma or angiomyolipoma in adults. We report a case of multilocular cystic nephroma presented with painful abdominal mass treated with laparoscopic nephrectomy and confirmed with pathology.

대구지역 실내 외 공기중 주요 대기오염물질의 농도조사에 관한 연구

최진수,백성옥,김영민,박상곤,정점희,황승만 嶺南大學校 環境問題硏究所 1995 環境硏究 Vol.15 No.1

최근 현대인의 실내거주시간이 일상생활시간의 80% 이상을 차지할 정도로 크게 증가하면서 보건·위생학적 측면에서 실내공기질은 매우 중요한 관심사로 등장하게 되었다. 본 연구는 1994년 8월의 여름철과 1994년 12월 ∼1995년 1월의 겨울철에 대구를 중심으로 가정집, 사무실, 식당과 같은 3가지 유형의 일반주거환경 중 실내·외 공기를 대상으로 실행되었다. 측정항목으로는 RSP, CO, CO₂, NO₂등의 주요 기준성 오염물질과 Bioaerosol을 선정하였다. 본 연구의 결과, 각 성분대상물질의 실내·외 농도는 실내거주환경 및 여름과 겨울, 두 계절에 따라 영향을 받는 것으로 나타났으며 실내·외 농도비교에서 RSP, CO, CO₂의 실내농도는 대부분의 지역에서 실외에 비하여 높은 농도를 나타냈다. 각 실내거주환경에 따른 실내·외의 농도는 가정, 사무실에 비하여 식당에서 상대적으로 높은 농도를 나타냈으며 실내·외 농도비 또한 식당에서 상대적으로 큰 값을 나타냈다. 여름과 겨울의 두 계절에 따른 RSP, CO, CO₂의 실내·외 농도는 여름철에 비하여 겨울철에 더욱 높은 농도를 나타냈으나 Bioaerosol의 실내·외 colony/plate는 여름철에 더욱 높은 수치를 나타냈다. The study was carried out to investigate the concentrations of indoor air pollutants such as respirable suspended particulate (RSP), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂) and bioaerosol at homes, offices and restaurants in Taegu city. Indoor and outdoor concentrations of these pollutants were observed simultaneously from August 1994 for summer to January 1995 for winter. The results were summarized as follows : 1. Both in summer and in winter, the indoor concentrations of RSP, CO, and CO₂; were higher than the outdoor concentrations, the indoor concentrations of major air pollutants (RSP, CO, CO₂, NO₂) in restaurants were higher than those in homes and offices. 2. The indoor and outdoor concentrations of RSP, CO, and CO₂; in winter were significantly higher than those in summer, on the other hand. The CFU/plate of bioaerosol in winter was lower than that in summer. These results suggested that indoor levels of air pollutants were affected by various indoor characteristics such as smoking, cooking, ventilation rate, winter heating systems, and behavioral activity of occupants.

Hurdle Technology방법에 의한 식품저장

최수진,노봉수 서울여자대학교 자연과학연구소 1995 자연과학연구논문집 Vol.6 No.-

Hurdle technology에 의한 방법으로 식품을 저장하는 방법이 논의되었다. 이 방법은 다른 처리방법과 함께 사영하거나하여 미생물이 성장하는데 장애가되는 저해 요인들을 유도하여 한 가지 방법이 아니라 여러방법에 의해 가공 처리하는 방법이다. 이 방법은 냉장이나 냉동 없이도 안정하게 유지되며 가벼운 처리 가공방법이 적용되므로 관능면이나 영양가면에서도 매우 우수한 것으로 나타났다. 이에 기초를 둔 대표적인 식품으로는 F-SSP, A-SSP, pH-SSP, Combl-SSP, IMF 그리고 방사선조사 식품에 다른 처리를 한 것등이 있다. 이 기술방법은 주로 육류제품, 유가공제품, 해산물등에 응용되고 있으나 이를 다른 분야에 적용하는 방안을 앞으로 모색하여 나아가야할 것이다. The concept of hurdle technology is reviewed. This technique is the intelligent use of combinations of different preservation factors or technique in order to achieve multitarget, mild but reliable preservation effect. Hurdle-preserved foods are F-SSP, A_wSSP. pH-SSP, combi-SSP,IMF and irradiated foods with other treatments. This technology is mainly applied meat products, fish, and dairy products. Recently qualities of irradiated foods have been improved by combination of irradiation with other treatments such as cryogenic temperature or heating. The future work for application to various foods is discussed.

魚油함유 飼料에 첨가한 α- 토코페롤의 含量이 흰쥐 血液의 肢質過酸化反應에 미치는 影響

崔鎭浩,金一星,金在一,金東右,朴泉洙,尹泰憲 부경대학교 기초과학연구소 1993 기초과학연구논문집 Vol.4 No.-

어유와 돈지의 혼합지질(3 : 1, wt/wt: P/S : 1.6)에 α-토코페롤을 용량별(0, 50, 100, 200, 400, 800mg/kg diet)로 첨가하여 조제한 어유 함유 사료로써 7주간 사육하여 이 사료에 혼합한 α-토코페롤의 첨가량이 혈청 중의 지질대사에 미치는 영향을 검토하였다. 중성지질(TG)과 인지질의 함량은 α-토코페롤 200mg 이상의 첨가군은 대조군에 비하여 유의적으로 감소하였고, 또한 총콜레스테롤의 함량은 α-토코페롤의 첨가에 따라 감소하는 경향이었지만 낮은 첨가농도에서만 유의성이 인정되었다. HDL-콜레스테롤의 함량은 100mg 이상의 α-토코페롤 첨가군에서 총콜레스테롤에 대한 HDL-콜레스테롤의 비(HDL-chol/T. chol)도 α-토코페롤의 모든 첨가군에서 유의적으로 증가효과가 인정되었다. 따라서 동맥경화 지표가 α-토코페롤 첨가군에서 유의적으로 감소하였다. 중성지질에 대한 과산화지질(TBA value/TG)의 비는 10mg 이상의 α-토코페롤의 첨가군에서 유의적으로 억제되???고, 중성지질에 대한 α-토코페롤(α-tocopherol/TG)의 비는 100mg 이상의 α-토코페롤 첨가군에서 유의적으로 증가되었다(p<0.001). 어유 함유 사료에 α-토코페롤을 첨가함으로써 C20 : 5/C20 : 4의 비를 효과적으로 억제할수 있었다. 따라서 혈액 중의 적절한 지질대사를 위해서는 이들 어유 함유 사료에 100mg 이상의 α-토코페롤이 첨가되어야 할것으로 생각된다. To evaluate the vitamin E requirement, Fischer 344 male rats were fed diets containing the fish oil-lard (3 : I, wt/wt: P/S ratio : 1.6) supplemented with 0, 50, 100, 200. 400 and 800 mg/kg diet of a-tocopherol for 7 weeks. The effects of a-tocopherol levels supplemented to fish oil rich diets on the lipid metabolism in serum were investigated. Triglyceride (TG) and total cholesterol significantly decreased by supplementation of a-tocopherol. The a-tocopherol supplementation of abme 100 mg diet caused an incressis in HDL-cholesterol. and HDL-cholesterol : T. chol ratio, and a decrease in the atherogenic index. The lipid peroxide : TG ratio significantly inhibited by a-tocopherol supplementation of above 100 mg. The ratios of α-tocopherol/TG or n-3 fatty acid (EPA+ DHA) significantly increased in all α-tocopherol supplemented groups. The ratio of eicosapentaenoic acid : arachidonic acid effectively inhibited by a-tocopherol supplementation of above 100 mg. The results suggest that a-tocopherol supplementation of above 100 mg to fish oil-rich diets map be requisite for adequate lipid metabolism.

Ethephon 및 Aminoethoxyvinylglycine 처리가 ‘원황’ 배 모의 수출 환경에서의 품질 및 생리장해 발생에 미치는 영향

최진호,이욱용,안영직,황용수,천종필 충남대학교 농업과학연구소 2013 농업과학연구 Vol.40 No.2

We investigate the effect of preharvest spray of aminoethoxyvinylglycine (AVG), an inhibitor of ACC synthase activity, on fruit quality of ‘Wonhwang’ pear (Pyrus pyrifolia Nakai). And the effects were compared with ethephon which releasing ethylene to elucidate treatment efficacy of ethylene biosynthesis inhibitor on Asian pears. Chemicals were sprayed on 30 days before harvest with AVG (75 and 150 mg/L) and ethephon (100 mg/L), respectively. Highest flesh firmness during 21 days of shelf-life at 25℃ after 30 days of cold storage was attained in the fruit treated with 150 mg/L AVG (26.5N) when compared with untreated control (16.7N), while the fruits treated with 100 mg/L ethephon completely lost their marketability within 14 days of shelf-life by mass drop of firmness down to 11.6N. Low incidence of physiological disorders including pithiness and core browning were attained at the fruits treated with 150 mg/L AVG when we compared with untreated control. No occurrence of mealiness found in the fruits treated with AVG but ethephon treated fruits showed 36.4% during 14 days of shelf-life. Consequently, AVG spray at the concentration of 150mg/L on Asian pear ‘Wonhwang’ fruit regarded as useful preharvest management approach for keeping quality during marketing period after simulated exportation.