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.

Distribution of Aquaporins (Water Channels) in the Rat Salivary Glands

정지연(Ji-Yeon Jung),한창룡(Chang-Ryoung Han),정연진(Yeon-Jin Jeong),오원만(Won-Mann Oh),김미원(Mi-Won Kim1),김선헌(Sun-Hun Kim),김옥준(Ok-Joon Kim),김현진(Huyn-Jin Kim),고정태(Jeong-Tae Koh),최홍란(Hong-Ran Choi),김원재(Won-Jae Kim) 대한해부학회 2002 Anatomy & Cell Biology Vol.35 No.3

침샘은 하루 1.5 l의 침을 분비하며, 일반적으로 침샘에서 수분이동은 능동적 염분 이동에 따른 삼투현상에 의해 일어난다. 따라서 침샘에서 높은 수분투과성으로 인해 수분통로 단백인 aquaporin (AQP)들이 풍부하게 존재할 수 있다. 지금까지침샘에 4가지 형태의 AQP이 존재한다고 알려져 있지만 침샘에서 정확한 위치와 수분 이동에 대한 각 AQP들의 역할은 아직 확실치 않다. 본 연구는 300 g 정도의 흰쥐를 pentobarbital sodium (50 mg/kg, IP) 마취하에서 carbarchol (10 μg/kg)을 복강 내 투여한 후 AQP들의 역할과 분포를 면역조직화학방법으로 조사하였다. AQP1은 침샘의 미세혈관의 내피세포와 샘세포와 샘관 주위에 존재하는 근육상피세포에 존재하였다. AQP4는 침샘관의 마지막 부위인 배출관에 존재하였다. AQP5는 주로 장액세포의 바닥가쪽과 세포사이 분비소관을 포함한 세포꼭대기쪽막 에 존재하였으며 콜린성 분비 자극으로 세포꼭대기쪽막으로 이동되어 밀집되었다. AQP5는 모든 침샘의 사이관과 줄무늬 관에도 존재하였으며 점액세포는 약하게 존재하였다. AQP8은 AQP5처럼 장액세포의 바닥쪽막과 세포사이 분비소관을 포함한 세포꼭대기쪽막에 존재하였으며 콜린성 침분비 자극으로 세포꼭대기쪽막쪽으로 이동되어 밀집되었다. 이상의 실험결과는 AQP5와 AQP8이 장액세포에서 일차 침 형성시 일어나는 수분이동의 주된 통로임을 시사하였다. The salivary glands produce 1.5 l of fluid per day. As in other organs, the general paradigm in the salivary glands is that water movement occurs secondary to osmotic driving forces created by active salt transport. Therefore, high water permeability in salivary glands is expected to need a variety of aquaporin (AQP), a water channel. Although four AQPs have been known to reside in salivary glands, the precise location and roles of AQPs have been not well examined. This study is aimed to investigate the distribution of AQPs in 3 major salivary glands and their changes after cholinergic stimulation using immunohistochemical study in Sprague Dawley rats weighing 300 g under pentobarbital sodium anesthesia. AQP1 was localized in the endothelial cells of all salivary capillary vessels and the myoepithelial cells. AQP4 was demonstrated in the epithelium of the excretory ductal cells of all salivary glands. AQP5 and 8 were abundantly present in the basolateral membrane and apical membranes of the serous acini including intercellular secretory canaliculi, whereas AQP5 was weakly present in mucous acini. In addition, AQP5 was found in the epithelium of the intercalated and striated ducts. Upon stimulation of carbachol (10 μg/kg, I.P). AQP5 and 8 tended to translocate from basolateral membrane to the apical membrane, appearing as clusters of dots. These results suggest that AQP5 and 8 are the candidate molecules responsible for the water movement in salivary acinar cells.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Inoue Balloon을 이용한 PMV의 장·단기 결과 분석

진은선,이연아,전숙,김현숙,정승묵,박상선,최락경,임달수,홍석근,황흥곤 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.11

졸참나무 수피의 추출성분

김진규,이상극,함연호,배영수 江原大學校 森林科學硏究所 2002 Journal of Forest Science Vol.18 No.-

졸참나무 수피를 채취하여 아세톤:물(7:3, v/v) 혼합용액으로 추출하고 유기용매를 제거한 후 hexane, CH₂Cl₂, EtOAc 및 수용성으로 분획하여 등결건조하였다. 그 중에서 EtOAc용성 분획물을 MeOH 수용액 및 EtOH-hexane 혼합용액을 사용하여 Sephadex LH-20 칼럼크로마토그래피를 수행하여 (+)-catechin, ellagic acid, taxifolin, taxifolin-3-O-β-D-glucopyranoside를 단리하였다. 단리된 화합물의 구조는 ¹H, ^(13)C-NMR spectrum으로 구조를 구명하였다. The bark of Quercus serrata Thunb were collected, extracted with acetone-H~O(7: 3, v/v), fractionated with hexane, methylene chloride and ethylacetate, and freeze dried to give some dark brown powder. The ethylacetate soluble mixture was chromatographed on a Sephadex LH-20 column using a series of aqueous methanol and ethanol-hexane mixture as eluents. The isolated compounds from &. serrata were (1- 1-catechin, ellagic acid taxifolin and taxifoiin-3-O-ll-D-glucop~anos~de. The structures of isolated compounds were characterized by ¹H, ^(13) C-NMR spectroscopy.

폐쇄성 황달의 초음파 촬영 소견

김연진 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Ultrasonographic findings of obstructive jaundice in 27 patients are presented. The results are as follows; 1. The diameter of common duct was 1. 9cm in stone and 1. 7cm in carcinoma. 2. In patients with common duct stone, strong echogenic mass with acoustic shadowing was seen in 9 patients (56%) ani multiplicity was noted in 3 patients(19%). In patients with carcinoma, moderately echogenic mass without acoustic shadowing was seen in 6 patients(55%) and multiplicity was not noted. 3. The margin of obstruction of common duct was meniscus-shaped in 9 patients(56%) with stone, and nipple and tapering appearance in 5 patients(46%) with carcinoma. 4. Diagnostic accuracy of ultrasonography was 56% in stone and 54% in carcinoma.

마찰이 있는 진동계의 Stick/slip 현상

김현진,최연선 成均館大學校 科學技術硏究所 1990 論文集 Vol.41 No.1

Friction exists on any relatively moving parts in mechanical systems, which results in the reduction of energy, wear, inaccurate position control. Since the friction force is discontinuous near the stop region, the stick/slip phenomenon, occurs in some specific parameters. The stick/slip phenomenon is analyzed using the stop region concept and the nondimensionalized system parameters in which the stick/slip occurs are found.

내후성 폴리머 콘크리트의 제조 및 특성연구

연규석,김기성,이기원,황진하 강원대학교 석재복합신소재제품연구센터 2001 석재연 논문집 Vol.6 No.-

본 연구에서는 불포화 폴리에스터 수지비율을 변수로 하는 자외선 흡수제 첨가유ㆍ무 시편에 대한 Xenon lamp, 52±3℃, 실내습도 50±5%, 시험체 걸이 직경 20inches의 조건의 내후성 시험기로 각각 100, 200, 400, 800, 1600 시간 인공촉진열화 시킨 시편의 색차변화를 측정하여 불포화 폴리에서터 수지량 및 자외선 흡수제의 첨가에 의한 열화특성을 고찰하였다. 그 결과 100% 불포화 폴리에스터 수지량 및 자외선 흡수제의 첨가에 의한 열화특성을 고찰하였다. 그 결과 100% 불포화 폴리에스터 수지 시편과 상대적으로 수지비율이 큰 폴리머 페이스트에서는 자외선 조사시간에 따른 큰 색차변화 및 자외선 첨가에 의한 열화방지 효과를 확인 할 수 있었고 불포화 폴리에스터 수지비율이 상대적으로 작은 폴리머 모르타르에서는 자외선 조사에 의한 색차변화 및 자외선 흡수제 첨가에 의한 열화방지가 그리 크지 않음을 확인할 수 있었다. 이러한 것은 야외에 설치되는 폴리머 모르타르(콘크리트) 제품은 자외선에 의한 열화가 그리 크지 않음을 보여주는 결과이기도 하다. This study was to investigate the characteristics of deterioration of polymer concrete due to wethering Two sets of specimens with a various mixing ratio of unsaturated polyester resin, UV absorber added and not-added, were artificially exposed by the weathering test machine to ultraviolet (UV) radiation 100, 200, 400, 800 and 1600 hours under the conditions that the temperature was set by Xenon lamp at 52±3℃, the chamber humidity at 50±5%, and specimen rack diameter 20 inches to measure the color change to examine the characteristics of deterioration. Color difference increased as the exposure time to UV radiation increased, but decreased 20-30%, comparing to the case of non-absorber added, as the ultraviolet absorber was added. On the other hand, the effect of addition of ultraviolet absorber decreased as addition of aggregate increase. Thus, the effect of addition of ultraviolet absorber was a little on the polymer concrete containing aggregate, Especially, increment of color difference in polymer mortar specimen was lower than that of polymer resin and polymer paste specimen, when the resin volume for specimen mixture proportion was below 30%, as fine aggregate increased. As a result, outdoor-installed polymer concrete product is believed to be hardly affected by ultraviolet radiation.

임부의 연령에 따른 보완대체요법에 관한 인식 태도 경험 비교 연구

김연진,김지연,노경민,신혜리,유예지,이지민,장희조,정아인,최소정,강숙정,이향연,민혜영 이화여자대학교 간호과학대학 2016 이화간호학회지 Vol.- No.50

Purpose: This study aims to test if the age of pregnant women affects the perception, experience, and attitude towards complementary alternative therapy (CAT), by investigating the perception, experience, and attitude of pregnant women under the age of 35, and above 35 (Advanced Maternal Age). The study will 1) find the general characteristics of pregnant women under and over the age of 35 2) compare the perception, behavior, and experience of pregnant women under and over the age of 35, and 3) find the comparison of the perception, behavior, and experience according to the general characteristics of pregnant women under and over the age of 35. Method: The subjects of this study are composed of 44 women under the age of 35 and 44 women above the age of 35, totaling 88 pregnant women visiting midwiferies, obstetrics and gynecology, and baby fairs in Seoul and Gyeong-Gi area. Data for this study was collected from November 28, 2015 to January 6, 2016 for 40 days. The collected data analyzed mean, standard deviation, t test, ANOVA, and chi-square by using SPSS 23.0. Result Results show that there is a significant difference in the perception, attitude, and experience of the two-sample groups in the use of CAT. The question of “what is most necessary when applying CAT in a hospital clinical environment” for the perception criteria came out with the results of t=9.980, p<.05. For the attitude, results showed that the answers of pregnant women under the age of 35 displayed a more positive attitude towards CAT. (t=2.421, p<.05) Lastly, in the experience section, pregnant women under the age of 35 showed more CAT use than the other sample group. Conclusion Results have shown that there is a difference in the perception, behavior, and experience between the two sample groups. Therefore further research on the efficacy and the adverse effects of CAT needs to be done.

우리나라 호텔의 교육훈련 전이에 대한 내ㆍ외부 교육간 비교연구 : A focus on the comparison of the internal graiining and external training

김민주,장연진 문화관광연구학회 2001 문화관광연구 Vol.3 No.1

The purpose of this study were to find the relationship between trainging components and transfer of training and to verify the moderating effect of superior' support and fellow of officals's support and continuous study culture. This study especally focused on the comparison of internal training and external training. The sample were consisted in the employee of hotel in korea. Actually, 262 of 320 samples were used to verify hypotheses of this study. The result from empirical tests showed that the satisfation of the training component were correlated to the transfer of training positively. Specially, the higher that satisfation of trainer's teaching ability, trainee's needs for achievement, and the training contents were related in the internal training and external training. The training components were more correlated to external training than internal trainging. The moderating effect of superior's support and companion's support and continuous study culture were accepted partially in the internal training. But the moderating effect of superior's support and continuous study culture between the training components and training transfer was found in the internal training. but companion's support between the training components and training transfer was not founded. In the external training the moderating effect of three fator between the training components and traing transfer was not founded.