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.

혼합유화제 비율에 따른 인계난연제 캡슐의 제조 및 특성 연구

백경현,이준영,홍상현,김중현 한국공업화학회 2004 응용화학 Vol.8 No.1

The microcapsules containing triphenyl phosphate (TPP) flame retardant have been prepared by using the epoxy resin (Novolac Type) with good physical properties and network structure. The reactants including TPP, epoxy resin and mixed surfactants were emulsified to oil in water (O/W) by the phase inversion technology and then conducted on the crosslinking of epoxy resin by In-situ polymerization. The capsule size and size distribution of TPP microcapsules was controlled by mixed surfactant ratio. The thermal property of TPP capsules were measured by the TGA. The morphology and capsule size were also investigated by the SEM respectively. TPP capsules with 1 : 1 of mixed surfactant (F127 : SDBS) ratio were more spherical and uniform than it with others. The TPP capsule size was 12~17㎛ and TGA results shows that TPP capsule efficiency was about 73%.

노화가 인체 중간엽 줄기세포로부터 조골세포로의 증식 및 분화에 미치는 영향

백기현,태현정,오기원,이원영,조정기,권순용,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3

연구배경: 일반적으로 골다공증과 연관된 위험인자로는 연령, 폐경, 약물, 불충분한 칼슘섭취, 만성질환 및 운동부족 등이 있는데, 특히 노화가 진행할수록 골밀도가 감소하는 것은 잘 알려져 있다. 노화와 관련하여 진행되는 골소실은 조골세포 및 전구조골세포의 기능적 결핍에 의한 골형성의 감소가 주요한 요인으로 여겨지고 있다. 그 동안 연령이 조골모 세포의 양과 조골모 세포로부터 성숙조골세포로의 분화 및 증식에 미치는 영향에 대한 일부 보고들이 있었으나 아직 일치된 견해는 없는 형편이다. 방법: 다양한 연령의 사람으로부터 골수를 채취, 중간엽 줄기세포가 포함된 단핵세포를 분리한 후 조골세포로 분화하기 좋은 조건하에서 배양하였다. 대상군은다시 젊은군과 노령군으로 구분하여 다양한 변수를 비교 분석하였다. 일차배양에서는 CFU-F를 계수하여 골수내 중간엽 줄기세포의 수를 추산하였고, 칼슘측정을 통하여 기질의 무기화 정도를 비교하였다. 계대배양후 이차배양에서는 시기별로 알카리성 포스파타제 활성도를 측정하고 오스테오칼신 mRNA의 발현을 관찰하여 젊은군과 노령군 사이의 증식능 차이를 비교하였다. 또한 이차배양 시기별로 MTT 측정을 하여 양군간에 증식능 차이가 있는지 알아보았다. 결과: 1. 일차배양 15일째에 평균 CFU-F의 수는 젊은군에서 유의하게 많았다(젊은군 148.3±28.9, 노령군 54.3±9.1, p=0.02). CFU-F의 평균면적은 젊은군에서 넓은 경향을 보였으나 통계적으로 유의하지는 않았다. 2. 일차배양 17일 경과 후 양군간에 기질 칼슘 침착정도는 유의한 차이를 보이지 않았다(젊은군 103.6±50.6, 노령군: 114.0±56.5, p=NS). 3. 이차배양 10일째에 젊은군에서 알카리성 포스파타제 활성도가 고령군에 비해 유의하게 높았다(젊은군: 935.5±115.0 U/mg, 노령군: 578.4±115.7U/mg,p.0.05). 고령군에서는 시간 경과에 따른 변화가 미약했으며 전반적으로 알카리성 포스파타제의 활성도가 젊은군에 비해 낮았다. 4. 이차배양도중 오스테오칼신 mRNA의 발현은 배양시기별로 젊은군에 비해 고령군에서 더 낮은 경향을 관찰할 수 있었다. 5. 이차배양 10일과 15일에 젊은군에서 노령군보다세포증식이 유의하게 증가된 양상을 보였다(10앓 젊은군 0.73±0.05, 노령군 0.58±0.04, p=0.05, 15일; 젊은군 0.80±0.05, 노령군 0.70±0.03, p=0.05).결론: 이상의 연구에서 저자들은 노령군에서 젊은군보다 골수 내 중간엽줄기세포의 수가 적고, 노령군에서 유래한 전구조골세포의 성숙조골세포로의 증식 및 분화가 젊은군 보다 감소해 있는 것을 관찰할 수 있었다. Background: Osteoblasts originate from osteoprogenitor cells in bone marrow stroma, termed mesenchymal stem cells (MSCs) or bone marrow stromal cells. Each MSC forms colonies (colony forming units-fibroblasts [CFL-Fs]) when cultured ex vivo. There are some reports about the age-related changes of the number and osteogenic potential of osteoprogenitor cells, but any relationship has not been clearly established in humans. In this study, we counted MSCs using CFU-Fs count and examined the proliferative capacity and differentiation potential of osteoprogenitor cells. Finally, we analyzed how these parameters varied with donor age. Methods: Bone marrow was obtained from the iliac crest of young (n=6, 27.2±8.6 years old) and old (n= 10, 57.4k6.7 years old) healthy donors. Mononuclear cells, including MSCs, were isolated and cultured in osteogenic medium. In primary culture, we compared the colony-forming efficiency of MSCs between the two groups and determined the matrix calcification. When primary culture showed near confluence, the cells were subcultured. Alkaline phosphatase activity, osteocalcin expression by RT-PCR and proliferative potential by MTT assay were examined by the time course of secondary culture. Results: At the 15th day of primary culture, the mean number of CFU-Fs was significantly higher in the younger donors (young: 148.3±28.9, old: 54.3±9.1, p=0.02) and the mean size of CFL-Fs was also larger in the younger donors than the older donors. However, matrix calcification was not different between the two groups (young: 103.6±50.6, old: 114.0±56.5, p=NS). In secondary culture, alkaline phosphatase activities were significantly lower in the older donors. The younger donors showed peak alkaline phosphatase activity at day 10, while the older donors didn't showed a remarkable peak (young: 935.5±115.OU/mg, old: 578.4±115.7U/mg, p<0.05). Total cell number as a proliferative index increased progressively during the secondary culture and a significantly greater cell number was noted in the younger donors. Osteocalcin expression was generally upregulated in the younger donors, but this was not statistically significant. Conclusion: Our study shows that the number of osteoprogenitor cells is decreased during aging and that the proliferative capacity and differentiation potential of osteoprogenitor cells seem to be reduced during aging (J Kor SOC Endocrinol 18:296-305, 2003).

수증기메탄개질반응에서 발생된 이산화탄소 분리특성

백일현,윤여일,김종기,박정훈 한국공업화학회 2005 응용화학 Vol.9 No.1

Based on the results coming from the methane steam reforming and the CO₂ breakthrough experiments, the basic design of the hybrid reaction process was set up. Hybrid reaction test using the device of the lab and bench size revealed high hydrogen and low CO₂ composition compared with the equilibrium composition of the methane steam reforming. In particular, an examination of the average composition through the repeated experiments of the hybrid reactions at the maximum adsorption temperature of the adsorbent of 750℃ found that hydrogen had 12 to 14% higher composition in the hybrid reaction compared with the methane steam reforming whereas the composition of CO₂ was 6-8% lower.

응급통신소생술 도착전지시 프로토콜 기본설계 방안

백홍석,김정현,오용교,조현 한국응급구조학회 2000 한국응급구조학회지 Vol.4 No.1

As technology advances rapidly, emergency medical dispatching systems must also advance. Optimal emergency medical dispatching requires the courage to practice medicine at dispatch. Modern emergency medical dispatch provides appropriate resource responses with the use of an (Advanced Medical priority Dispatch System(AMPDS) in U.S.A. The AMPDS is a systematic protocol for all aspects of the dispatch process. Based on the AMPDS chief complaint list, we initiated a basic design on pre-arrival instruction protocol and completed the scripted pre-arrival instruction protocol, using Cardiopulmonary resuscitation(CPR) protocol. Implementation of this study creates computerized emergency medical dispatching system for future enhancements, such as the AMPDS.

반하(Pinellia ternata)가 랫드의 수컷 생식기계에서 3β-HSD,SGP-2 및 AR 유전자 발현에 미치는 영향

연정민, 백인정, 김윤배, 노재섭, 황방연, 김순선, 조대현, 이범준, 윤영원, 남상윤 충북대학교 동물의학연구소 2005 Journal of Biomedical and Translational Research Vol.6 No.2

본문참조

이산화탄소 분리용 세라믹 흡수제 제조

백일현,윤여일,김종기,박정훈 한국공업화학회 2005 응용화학 Vol.9 No.1

A pelletized absorbent was developed in order to separation the CO₂ generated during methane steam reforming reaction. The best adsorbent manufactured using the organic and inorganic binder showed the best plasticity when CaCO₃, feldspar and bentonite are mixed at the rate of 90:5:5% with the hardness of 95%. The CO₂ breakthrough test on the adsorbent using the fixed bed reactor found that the amount of adsorption was very high at the reaction temperature of 750>700>800℃ in the descending order.

안면골 골절에 관한 임상적 연구

김현수,이상한,장현중,백상흠,차두원 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

To investigate epidermiologic trend in maxillofacial fractures, We retrospectively studied 934 patients with maxillofacial fractures between 1981∼1987 and 1995∼1999. The results were compared in the previous group (Group A, patients treated between 1981∼1987) with those in the recent group (Group B, 1995∼1999). Also, we studied 516 patient between 1995∼1999 for occupation, associated injuries, treatment and complications. The sex ratio of men to women decreased (5.6 : 1 in Group A vs. 3.5 : 1 in Group B), and the largest age group was 20 to 29 years. There was the highest incidence in September and Fall. The most frequent cause of maxillofacial fracture in both Group A and B was traffic accidents. The distribution of fracture site did not change appreciably, but the frequency of midfacial fracture increased. In the recent group, the largest occupational group was salaried men, and the largest associated injuries of maxillofacial fracture was head and neck injury. Open reduction was used in 91% of the cases, and post-operation complications were infection, neurologic problem, malocclusion, and mouth opening limitation etc. Our results suggest that the clinical features of patients with maxillofacial fractures have changed during the past decade.

Triamcinolone Acetonide가 배양 켈로이드 섬유아세포의 G1 세포주기 관련 유전자 발현에 미치는 영향

설정현,우상현,백원기,서성일,서민호 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.2

The effect of triamcinolone acetonide(TA) on the expression of Gl related genes was investigated the cultured keloid fibroblast. The addition of TA to the culture medium resulted in growth inhibition of keloid fibroblast. TA reduced the expression of cyclin A, B, E and cyclin dependent kinase(CDK) 2 mRNA, but unexpectedly, the expression of cyclin C, Dl and CDK4 mRAN was not affected significantly as compared with those of normal fibroblast. Expressions of p16, p21 and p27, the wellestabilished CDK-inhibitors, were also investigated. The level of p16 was not detected in both normal and keloid fibroblasts and the expression of p27 was significantly decreased in keloid fibroblast. The expression of p21 was dramatically increased in keloid fibroblast but not significantly changed in normal fibroblast. Also the expressions of p53 and pRb, the well known tumor suppressor genes, were increased by the addition of TA. These data suggested that the observed growth inhibitory effect of TA may be related to transcriptional inactivation of cyclin A, B, E and CDK2 and to the transcriptional activation of p21, but the mechanisms of unchanged expression of cyclin C, Dl and CDK4 mRNA remain to be elucidated.

시간영역 적분방정식에 의한 도체의 산란 근접장 산출

이창현,정백호 湖西大學校 工業技術硏究所 2005 工業技術硏究所論文集 Vol.24 No.-

In this paper, we present a stable computation of the transient near-field scattered from the conducting objects. We solve the time-domain integral equation by expressing the transient behavior of the induced current in terms of weighted Laguerre polynomials. By using this basis functions for the temporal variation, the time derivative in the integral equation cam be handled analytically. Since these temporal basis functions converge to zero as time progresses, the transient response of the induced current does not have a late time oscillation. To show the validity of the proposed method, we solve a time-domain combined field integral equation and compare the results with the inverse discrete Fourier transform (IDFT) of the solution obtained in the frequency domain.