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.

브루셀라균에 노출된 미생물 검사실 직원들에 대한 예방적 항생제 요법과 혈청학적 추적검사

이창섭,이혜수,이재현,박진희,최영실,황규잠,이흥범 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

The aerozolization is one of possible Brucella transmission mechanisms, particularly in air-borne exposed laboratory workers. In this study, seven laboratory workers were potentially exposed to B. abortus via aerosols. Two laboratory workers who sniffed an agar plate several times were considered to be at high risk for acquiring the disease, 5 workers who did not work directly with the strain were be considered at low risk of infection. Prophylactic antibiotics of doxycycline 200 mg/day and rifampin 600 mg/day were offered for 6 weeks in high risk workers and 3 weeks for low risk workers respectively. Enrolled workers were advised to check for serological testing of Brucella species every 3 weeks during a total period of 12 weeks. Compliance with taking medicine was 57.1% (4/7) and compliance for completing the serological tests was 85.7% (6/7). None of the laboratory workers developed clinical disease or tested positive serologically during 3 months of seroloaical testing and 1 year of clinical follow-up.

고량강의 항염증 작용에 대한 연구

박히준,이제현,김수영,심범상,구헌종,강전모,최일환,이재동,김남재,이지숙,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The use of herbal therapy is becoming an increasingly attractive approach for the treatment of various inflammatory disorders. The Alpiniae officinari Rhizoma is popular in Aisa as a traditional herbal medicine. Alpiniae officinari Rhizoma is a species of the ginger family(Zingiberacease). Method : This study was performed to investigate the anti-inflammatory effect of Alpiniae officinari Rhizoma extract by the methods of "carrageenan induced paw edema" and "Lipopolysaccharide-induced inflammatory mediators in mouse macrophage RAW 264.7 cells". Result : We suggest that Alpiniae officinari Rhizoma extract decreased paw volume induced by plantar injection of carrageenan. Also Alpiniae officinari Rhizoma extract inhibited nitric oxide, prostaglandin E₂production and induced nitric oxide synthase, cyclooxygenase-2 protein expression in Mouse macrophage RAW 264.7 cells stimulated with lipopolysaccharide. Conclusion : This study shows that Alpiniae officinari Rhizoma extract seems to have anti-inflammatory effect by inhibition of nitric oxide, prostaglandin E_(2) production and nitric oxide synthase, cyclooxygenase-2 protein expression.

계지의 항염 효과에 관한 연구

박히준,이지숙,이재동,김남재,표지희,강전모,최일환,김수영,심범상,이제헌,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : Cinnamomi Ramulus (CR), the young twing of Cinnamomi loureirii nees, has been used for treating symptoms related to pain. rheumatic arthritis and inflammation in Korean herb medicine. This study was carried out to investigate the anti-inflammatory effect of CR in vivo and in vitro. Methods : Extracts of CR were prepared and the chemical components of the extracts were examined by gas chromatography-mass spectrometry (GC-MS). The extracts were administrated to the rat paw edema model induced by carrageenan to evaluate the anti-inflammatory effect of CR. The expressions of nitric oxide (NO). prostaglandin E2(PGE2), inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were also quantified in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages to survey the effect of CR in vitro. The main components were cinnamaldechyde and coumarin. Results : We examined the anti-inflammatory activity of the 80% ethanol extract of Cinnamomi Ramulus in vivo by using carrageenan-induced rat paw edema model. Maximum inhibition of 54.9% was noted at the dose of 1000㎎/㎏ after 2 hours of drug administration in carrageenan-induced rat paw edema and this showed a potent anti-inflammatory effect. Conclusions : The results showed that Cinnamomi Ramulus suppressed dose-dependently LPS-induced NO production in RAW 264.7 macrophages and also decreased iNOS protein expression. Cinnamomi Ramulus also showed a significant inhibitory effect in LPS-induced PGE2 production and COX-2 expression.

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.

유전알고리즘을 이용한 분산 데이터베이스 시스템에서의 컴퓨터 기종 선택과 데이터 분석

이재욱,조정복,고석범 東西大學校 1999 동서논문집 Vol.5 No.-

본 논문에서의 최적 분산 데이터베이스 구축에 관한 문제는 두 개의 결정을 나타낸다. 즉, 1) 각 사이트로의 적합한 컴퓨터 선택 2) 단편화된 파일의 할당이다. 또한, 제안된 모델에서는 1)waited response time 과 2) 투자비용 두 개의 목적함수를 고려한다. 각 컴퓨터와 파일의 할당의 영향에 따라 두 목적함수의 상관관계를 고찰한다. 제안된 수학적 모델은 경험적 탐색법 중의 하나의 유전적 알고리즘의 설계를 통해 효율적인 해의 탐색을 시도한다. 유전적 알고리즘(GA :Genetic Algorithm)의 설계에 있어서 요구 메모리의 최소화와 최적해 탐색시간의 최소화를 목적으로 한다. 끝으로, 수학적 모델과 해 알고리즘의 성능 검토를 위해 수치 예를 든다. Recently,DDS (Distributed Database System) has been often implemented on VAN (Value Added Network) as we know the amazing expansion of information network. DDS can yield significant cost and response time advantages over centralized systems for geographically distributed organizations. However, inappropriate design can result in high cost and poor response time. In a DDS design, the main problem is 1) how to select proper computer, and 2) how to allocate data fragment into poper nodes. This paper addresses DDS design problem of selecting a proper class of processor and allocating data files on VAN. Also, the formulated model includes two objectives, waited response time and investrment cost. GA (Genetic Algorithm) is developed to solve this mathematical formulation. A numerical experiment shows that the proposed method arrives at a good solution.

한라산 경사면의 일사량 및 기온 추정 모형

이종범,이민영,최재천 江原大學校 附設 環境硏究所 1991 環境硏究 Vol.8 No.-

A prototype air temperature and solar irradiance simulation model was developed to predict the distribution pattern over the slope of Mt. Halla in Chejudo. The model is based on potential effects of major topo-geographical factors on hourly air temperature derived from principal component analysjs multiple regression analysis. Although the model outputs were not validated yet, the precision based on 1km by 1km grid and small RMS error show a feasibility for practical applications to diverse economic activities in Cheju Island.

한국에 도해하는 검은머리갈매기(Larus saundersi)의 월동 현황

이기섭,박진영,이재범,김학진,유정칠 경희대학교 한국조류연구소 1999 연구보고 Vol.7 No.1

검은머리갈매기(Larus saundersi)는 그 동안 생존집단이 약 3,000개체로 추정되어온 멸종위기의 종이나, 한국에서의 월동 개체수에 대해선 현재까지 알려진 바가 없다. 본 조사는 1994년에서 1997년까지 동계기간에 실시되었다. 조사기간 동안 1994/95년 겨울에는 548개체, 1995/96년 겨울에는 1,159개체, 1996/97년에는 2,140개체가 관찰되었다. 해마다 증가하는 것으로 되어 있으나 실제는 조사면적이 확대된 데 그 원인이 있는 것 같다. 1994/97년 동계기간 동안에는 8개 조사지역에서 최대 2,425개체가 관찰되었다. 남해안에서는 조사가 광범위하게 이루어지지 않았기 때문에 월동 개체수는 이 보다 더 많을 것으로 추정되며, 종합적인 조사가 이루어진다면 전 세계의 생존집단은 6,000개체 이상이 될 것으로 사료된다. 조사지역 8곳 중에서는 순천만과 금강하구, 만경강하구에 각각 최대 500개체 이상이 도래하여 이 지역이 검은머리갈매기의 중요한 월동지임이 밝혀졌다. 성조에 대한 유조의 비율을 보면 평균 14.8%이었으나, 조사시기에 따라 변동이 있었다. 중국 리아오닝(Liaoning) 지방에서 적색 표식한 2개체가 아산만에서 관찰되었다. 최근 한국에서 새로 3개의 번식지가 발견되었으나 한국에서의 간척사업으로 인해 본 종이 계속 감소할 위기에 처해 있어 보존대책이 시급하다. Saunders's Gulls Larus saundersi are the endangered species and the world populations of the species were estimated about 3,000 individuals. The breeding sites were known at several sites in China, and the wintering areas were known in southern China, Hong Kong, Vietnam, Taiwan, Japan and Korea. Recently, the number of Saunders's Gulls was rapidly increased in Kyushu province of Japan: about 1,000 birds wintering there. One of factors affecting on the increasing population of Saunders's Gulls in Japan may be due to the destruction of the wintering habitats of Saunders's Gulls in Korea. But the wintering population of Saunders's Gulls in Korea has not been reported by now. We surveyed during the winter season of 1994~1997, and counted 548 individuals in 1994~95, 1,159 in 1995~96, and 2,140 in 1996~97. The increasing population each year may be due to the increase of survey areas each year in Korea. The peak count obtained from 8 sites was 2,425 individuals during the winter season of 1994~97. The real wintering population of Saunders's Gulls would be more than 2,425 individuals, because we did not survey many parts of southern coast although most areas of west coast were surveyed. If we estimate the world populations of Saunders's Gulls on the basis of this study and a Japanese report made in 1996(4,387 individuals), the world populations of the species may be more than 6,000 individuals. Sunchon bay, Kum river estuary, and Mankyung river estuary are major habitats supporting over 500 individuls of the wintering Saunders's Gulls every year in Korea. The ratio of juveniles to adults was averaged on 14.8% in the wintering population of Saunders's Gulls in Korea. Two individuals tagged with red colour flags were found in Asan bay, indicating that some birds wintering in Korea bred in Liaoning province of China. Breeding sites were newly found in the three reclaimed salt marshes. The major habitats of Saunders's Gulls should be set aside for nature reserves for effective protection and management, and should be turned into Ramsar sites to protect Saunders's Gulls in Korea.

한국과 일본의 체육계 학과 교육과정 비교

이범제 師範大學 體育硏究所 1995 서울大學校 體育硏究所論集 Vol.16 No.2

The purpose of this study was to provide a comparative analysis of the Physical Education programs within the Department of Physical Education, Leisure, and/or Department of Sport-For-All in Korea and Japan. The 68 Departments that were investigated were within College of Education, general colleges, and college of sport science. This analysis was done through the examination of requirements of coursework or elective subjects, credit requirements and academic classes with laboratory hours according to countries, types of Department, and contents of curriculum. Contents of curriculum was divided into theoretical and practical field. Further, nine majoring courses of specialty were classified into detailed areas of specialty. The differences by country, contents of curriculum and coursework to be taken were noted and following results were obtained. 1. The difference found in the contents of curriculum were: 1) In Korea the percentage of credit units of practical field were higher than those of theoretical field, but the percentage of credit units of theoretical field were higher than those of practical field in Japan. 2) Korea had more numbers of optional subjects in practical field, but Japan had more numbers of that in theoretical field. 3) In the hour(s) allotted to each subject, the percentage of 2 and 4 hours of both theoretical and practical subjects in Japan were higher than any other hours allotted to each subject in both of theoretical and practical field. 4) Japan attached more importance to courses that included laboratory classes than those in Korea. 2. The differences found in the majoring courses of specialty were: 1) Majoring courses of specialty in Korea and Japan showed a tendency to emphasize sport-related area. 2) The Departments in Japan tended to provide more natural science and methodology courses than those in Korea. 3. In a specific contents of specialty, Noted differences were observed: 1) Departments in Korea and Japan put an emphasis on such theoretical fields as exercise physiology and health area. 2) Departments in Korea and Japan put an emphasis on such practical fields as track & fields, gymnastics, ball games and martial arts area.

주상복합건물의 구조형식에 따른 환경영향 비교연구

이강희,김상범,양재혁 대한건축학회 2004 대한건축학회논문집 Vol.20 No.7

The further building industries are required to include the economic aspects and the environmental aspects simultaneously, where the assessment of these two areas make it possible to select the proper alternative at planning stage. In various assessment ideas in planning process, the estimation of the energy consumption, CO₂ emission and SO_x emission could be effectively utilized to compare and analyze the environmental influence within various alternatives. In this paper, it aimed at providing the unit of energy consumption, CO₂ emission and SO_x emission as an assessment item in according to the structural type of the residential complex building and comparing the environmental impacts at the Steel Reinforced Concrete and Reinforced Concrete. This study found that Steel Reinforced Concrete is better than the RC type building in energy consumption. But SRC is a little unfavorable than the RC type building in CO₂ emission and SO_x emission.