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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.

      • 기하학적 방법을 이용한 초기 박판형상 추정

        정동원,안현길 제주대학교 공과대학 첨단기술연구소 2005 尖端技術硏究所論文集 Vol.16 No.2

        A method is described for mapping a three-dimensional computer modelled surface into the two-dimensional plane. The technique is referred to as geometric modelling and provides in the computer a transformation between the flat sheet and the final surface. The initial blank shape represents an approximate development of the final formed three dimensional surface. It was used the initial constant area mapping hypothesis in this paper. This technique is intended to be developed as the basis of an interactive computer design capable of dealing with typical stamping process, including deep parts and complex shapes.

      • One-Step 이론을 이용한 Roof 판넬 해석에 관한 1차 연구

        정동원,안현길 濟州大學校 海洋硏究所 2004 해양과환경연구소 연구논문집 Vol.28 No.1

        The static implicit finite element method and the dynamic explicit finite element method are applied effectively to analyze total auto-body panel stamping processes, which include the forming stage. Analyzed complicated and abnormal Large size auto-body panel using common use program called AutoForm. Analysis results examining possibility and validity of the formulation and the factor study are presented. Further, the simulated results for the total auto-body panel stamping Processes are shown and discussed. Its application is being increased especially in the automotive industrial area for the cost reduction. weight saving, and improvement of strength.

      • 스템핑 금형개발을 위한 SPCC소재와 SPCEN소재의 비교연구

        정동원,안현길,문원섭 제주대학교 공과대학 첨단기술연구소 2005 尖端技術硏究所論文集 Vol.16 No.2

        The static implicit finite element method is applied effectively to analyze total panel stamping processes, which include the forming stage. Complicated and abnormal large size panel was analyzed by using commercial program called Auto-Form. Analysis results examining possibility and validity of the Auto-Form software and the factor study are presented. Further, the simulated results for the total panel stamping processes are shown and discussed. Its application is being increased especially in the automotive industrial area for the cost reduction, weight saving, and improvement of strength.

      • 정적-내연적 이론을 이용한 Cowl Top Otr 판넬 해석에 관한 연구

        정동원,안현길,고형훈,문원섭 제주대학교 공과대학 첨단기술연구소 2005 尖端技術硏究所論文集 Vol.16 No.1

        The static implicit finite element method has been effectively applied to analyze total cowl top otr panel stamping processes, which include the forming stage. Complicated and abnormal large size cowl top otr panel was analyzed by using commercial program called AutoForm. Analysis results examining possibility and validity of the AutoForm software and the factor study are presented. Furthermore, the simulated results for the total cowl top otr panel stamping processes are shown and discussed. Its application is being increased especially in the automotive industry for the cost reduction, weight saving, and improvement of strength.

      • KCI등재

        양 하지의 근력저하를 주소로 응급실로 내원한 원발성 알도스테로증 1예

        안력,김원,조규종,홍정석,이미우,장성은,오세현,임경수 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

        A primary central nervous system lymphoma(PCNSL) is defined as a lymphoma limited to the cranial-spinal axis without systemic involvement. PCNSLs were formerly very rare, only 0.5∼ 1.2% of all intracranial neoplasms, and were usually associated with acquired immuno-deficiency syndrome(AIDS) and other immune-compromised states. Recently, there has been a clear rise in the incidence of this disease among normal individuals. We describe a 77-year-old female with hyponatremia who presented with a confused mental state. Computed tomography(CT) of the brain demonstrated a suprasellar mass with enhancement. We evaluated the basic hormonal studies and the magnetic resonance imaging(MRI). A ventricular biopsy was done, and the result was a diffuse, large, B-cell-type malignant lymphoma. She presented panhypopituitarism and partial central diabetes insipidus. She received chemotheraphy and was discharged in an improved condition. We report a case of panhypopituitarism due to PCNSL and give a review of the literature.

      • 소뇌출혈후 신경인성방광으로 배뇨장애를 주소로 한 환자 치험 1例

        안정조,최영,조현경,임승민,김민상,오병렬,유병찬,설인찬 대전대학교 한방병원 2002 惠和醫學 Vol.11 No.1

        In patients with Cerebral vascular accident, Voiding Dysfunction is very usual, but if with no improvement for a long time, it can cause many complexed-problems as urinarytract injury, infection or inflamation and patients suffering from pain, inconvenience and anxiety. In this case 58-year-old female with Voiding Dysfunction with Neurogenic Bladder after Cerebellum Hemorrhage, for 6 monts there was no interval change on symptom, We prescribed appropeiate herbal medication, and perform acupuncture and moxa. 5 days later after admission in Taejeon Oriental Hospital, The patien was able to have self-voiding and gradually improved. So we report it for the better treatment.

      • REF SILL OTR-R/L 차체판넬 스템핑공정에서의 금형개발에 관한 초기 연구

        정동원,황재신,안현길 濟州大學校 海洋硏究所 2004 해양과환경연구소 연구논문집 Vol.28 No.1

        Finite element method is very effective method to simulate the forming Processes with good prediction of the deformation behaviour. For the finite element modeling of sheet mental forming the accurate tool model is required. Due to the geometrical complexity of real-size Part stamping tools it is hard to make FE model for real-size auto-body stamping parts. In this paper, it was focussed on the drawability factors on auto-body panel stamping by AUTOFORM with using tool planing alloy to reduce law price as well as high precision from Design Optimization of die. According to this study. the results of simulation will give engineers good information to access the Design Optimization of die.

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