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.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

개에서 발생한 신우신염 증례

유건우,이선희,임수정,박형진,김태신,송은식,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 6 years old Schunauzer dog (7.2kg, intact female) with history of hematuria for two days was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Complete blood cell count showed no significant abnormalities and serum chemistry profile showed increased phosphate profile. On urinanalysis, there was evidence of bacterial infection. On ultrasonographic evaluation, irregular renal contour and increased echogenecity, pelvic and uretral dilation, and thickening of urinary bladder wall were observed. Based on these finding, the dog was diagnosed as pyelonephritis. The dog was treated with antibiotics based on antimicrobial susceptibility test results, then successfully resolved after 8 weeks of treatment.

혼합형 자가면역성용혈성빈혈과 동반된 Evans 증후군 1례

선길홍,윤찬영,박상곤,박경희,우정주,한경택,김진화,김영훈,정춘해,박치영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Evans syndrome is defined as a simultaneous or sequential occurrence of autoimmune hemolytic anemia and autoimmune thrombocytopenia. Autoimmune hemolytic anemia (AIHA) is usually induced by IgG warm autoantibody or cold-active IgM antibodies reacting specifically with antigens associated with a patient's RBC. AIHA is a fairly uncommon disorder, with estimates of the incidence at 1 to 3 cases per 100,000 per year. Mixed-type AIHA is a relatively uncommon form of AIHA, with studies noting the incidence of 7-8% among cases of AIHA. We experienced a patient, 46-year-old woman who was diagnosed having a very rare clinical presentation of mixed warm and cold antibody mediated Evans syndrome. She was treated with corticosteroid therapy only and has been maintaining a complete response for 15 weeks. 저자들은 혼합형의 자가면역성 용혈성 빈혈과 자가면역성 혈소판 감소증이 동시에 발생한 혼합형 Evans 증후군으로 진단하고 스테로이드 요법 후 혈액학적으로 회복된 상태로 15주가 지난 현재 steroid 5 mg/일 까지 감량한 상태에서 추적 관찰 치료중인 46세 여자 환자를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

악성 점막하 종양과의 구별이 어려웠던 Gastritis Cystica Profunda 1예

선제형,박진석,한민석,김수항,김우진,박인형,이숭,유종선,박찬국 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Gastritis cystica profunda (GCP) is a rare disease characterized by gastric foveolae elongation along with hyperplasia and cystic dilatation of the gastric glands extending into the tissue beneath the submucosa. GCP mainly develops at the gastroenterostomy stoma but can arise in a stomach that has not undergone surgery. The proposed pathogenesis is related to chronic inflammation, ischemia and the presence of a foreign body. GCP may present as a submucosal tumor, Polyp or a giant gastric mucosal fold. Endoscopic ultrasonography (EUS) is an effective diagnostic method for differentiating GCP from protruding and elevated gastric lesions. We report a case of GCP along with the endoscopic and EUS findings that were indistinguishable from a malignant submucosal tumor.

좋은 예후를 보인 품행장애 환자에 대한 정신의학적 고찰

진혁희,한선호,한상우 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

The following results were gathered from the extensive research done on the conduct disorder of patients improving and relative conditions. 1. All were good students in elementary school and showed no disobedience. 2. The majority of them had many strong relationships and were very outgoing. 3. Their parents showed much affection toward them in their childhood. Also, they were either the youngest or the oldest in their families consisting of 2 or more. 4. Five out of the 6 patients belonged to upper-middle or just upper class parts of society. 5. Fathers occupied professional occupations and the mothers occupations were domestic housekeeping. 6. They all had parents who were both well educated. 7. The patients attitude toward their parents changed from assertiveness ot obedience and respectfullness. 8. The degree of educational interest by their parents was very high ; 4 out of 6 9. Parents attitudes toward their children changed from traditional to democracy. The family relationship situation was deterioration. Then overtime, the situation inproved dramatically. 10. Parents method of punishing children seems to have changed from the tendency of tough punishment and patients respectful attitude toward their parents has changed from assertive to obedient. 11. There was no history of mental disorders in the family. 12. Most patients had jobs or continued their studies. 13. Conduct disorders occurred in these patients in their late teens. 14. They have never been imprisoned or placed in a mental hospital before.

USB 메모리 장치 정보 및 암호를 기반으로 한 사용자 인증정보 관리 방안

이진해, 김선주, 이진우, 조인준 배재대학교 공학연구소 2016 공학논문집 Vol.18 No.1

Presently, one of user authentication methods is ID/PW that we use. This one has some advantages that are low cost in terms of building and easy to use. But, authentication information consisted of only possible ID and password is always exposed to security attack such as password guessing attack, replay attack. In order to compensate the defect, There are some authentication methods such as security card, OTP, certificate and fingerprint verification. Those are method that we use at least two ways to pass user authentication. Password only accessible to user, medium which user already have and their own biometrics are used to confirm in user authentication. In this thesis, we suggest scheme that is useful to user authentication information for safety by combining USB device information with user’s password, creating user authentication information and then storing in USB memory, in case of user authentication, using user authentication information that is stored in it. Although user authentication information stored in USB memory is exposed to hacker, it can’t be used because of not agreeing USB device information. Even if password is exposed to someone as well, it can’t be used due to not agreeing USB memory information. That is why USB memory device information and user password is combined. Our proposal system has low cost of building infrastructure(ID/PW method) and high convenience. Thus, proposed system which is cheap, convenient and has high security enables existing ID/PW method to build without additory expense. We expect all companies to use this one. 현재 우리가 사용하고 있는 사용자 인증방법 중에 ID/PW방식이 있다. ID/PW방식은 구축비용이 저렴하고 사용이 편리한 장점이 있다. 하지만 ID와 패스워드로만 구성된 인증정보들은 Password guessing attack, Reply attack 등 다양한 보안공격에 노출되어 있다. 이를 보완하기 위해 보안카드, OTP, 인증서 지문인식 등의 인증방법 들이 있다. 이러한 인증방법들은 두 가지 이상의 인증수단을 이용하여 사용자를 인증한다. 사용자만 알고 있는 비밀번호 이외 사용자가 가지고 있는 매체나 사용자의 고유한 생체 정보를 이용하여 사용자 인증에 사용한다. 하지만 앞에서 언급했던 인증 시스템들은 새로운 인증요소를 추가함으로써 인증에 필요한 새로운 인프라 구축비용 및 인증에 편리성이 저하되는 단점을 가지고 있다. 본 논문에서는 USB 디바이스 정보와 사용자의 비밀번호를 조합하여 사용자의 인증정보를 생성하여 USB 메모리에 저장하고, 사용자 인증이 필요한 경우 USB 메모리에 저장된 사용자 인증정보를 불러와 사용함으로써 사용자 인증정보를 안전하게 관리 할 수 있는 방안을 제안하였다. 이를 통해 해커에 의해 USB 메모리에 저장된 사용자의 인증정보가 노출되어도 USB 메모리 디바이스 기기 정보가 일치하지 않기 때문에 사용자 인증정보를 사용할 수 없다. 또한 비밀번호가 노출되어도 USB 메모리 정보가 일치하기 않기 때문에 사용자 인증정보를 사용할 수 없다. 또한 비밀번호가 노출되어도 USB 메모리 디바이스 정보와 사용자 패스워드가 조합된 인증정보로 인해 사용이 불가능하다. 또한 제안 시스템은 ID/PW 방식의 저렴한 구축비용과 편리성을 높인 장점을 가지고 있다. 따라서 저렴하고 편리하고, 보안성까지 높인 제안 시스템은 기존의 ID/PW방식에 추가적인 비용 없이 구축이 가능하다. 향후 모든 기업에서 사용할 수 있을 것으로 기대한다.

열전대(thermocouple)를 이용한 Buchanan Plugger 표면의 온도상승 분석

조진숙,황윤찬,김선호,황인남,최보영,정영진,정우남,오원만 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.4

This study was performed to evaluate the actual temperature rise on the surface of Buchanan plugger using thermocouple. The heat carrier system 'System B Heatsource'(Model 1005, Analytic Technologies, Redmond, WA, USA) and the Buchanan pluggers of F, FM, M and ML sizes are used for this study. The temperature was set to 200℃ on digital display and the power level on it was set to 10. Five thermocouples were placed in direct contact with the surface of each size of Buchanan's pluggers at 1 mm increments from the tip to the 4 mm length of shank. The heat control spring was touched for 5 seconds, and temperature rise on the surface of the pluggers were measured at 1 sec intervals for more than 5 seconds with an accuracy of 0.01 using Data Logger. The data were statistically analyzed by one-way ANOVA. The results were as follows. 1. The position at which the temperature peaked was approximately at 1~2 mm far from the tip of Buchanan plugger (p<0.01). 2. The peak temperature was 215.25±2.28℃ in F plugger, 185.94±2.19℃ in FM plugger, 169.51±9.12℃ in M plugger, and 160.79±1.27℃ in ML plugger and the peak temperature was highest in F plugger and followed by, in descending order, FM plugger, M plugger. ML plugger showed the lowest peak temperature (p<0.01). 3. The temperature on the pluggers was decreased with the increase of touching time. This results suggest that the actual temperature on the surface of the pluggers dose not correlate well with the temperature set on digital display. Heat concentrates around the up. The larger plugger reveals lower temperature rise relatively.

개질 아스팔트 혼합물의 변형강도 측정 연구

김광우,도영수,이기호,조문진,최선주 강원대학교 부설 석재복합신소재 제품연구센터 2004 석재연 논문집 Vol.9 No.-

본 논문은 아스팔트 혼합물의 소성변형 저항성과 상관성이 높은 특성치를 찾고자 Kim test를 개발하여 현재 적용성 연구결과를 다루고 있다. 이 논문은 새로운 강도특성치인 변형강도(S_(D))를 개발하는 Kim, test 연구의 4단계 연구 결과이다. 13 mm 골재(편마암, 화강암)와 입도(밀입도, 갭입도) 5가지 폴리머로 제조한 8가지 바인더로 두 가지 입도에서 소성변형 저항성이 다른 32가지 혼합물을 만들었다. 슬래브(305㎜×305㎜×62㎜)공시체를 제조하여 한쪽은 Kim, test를 수행하기 위하여 18 cm정도로 잘라서 코어를 3개 채취하고 다른 한쪽은 12cm크기로 하여 반복주행시험을 실시하였다. Kim, test는 하중봉 3(0.75), 4(1.0)을 사용하였다. W/T시험으로부터 최종 침하 깊이와 동적안정도의 두 가지 소성변형 계수를 각 혼합물별로 구했다. 각 하중봉과 골재별, 입도별로 S_(D)와 소성변형 계수간의 통계적 상관관계 분석을 수행한 결과 S_(D)와 소성변형 계수와의 결정계수가 매우 높게 (R²>0.95) 나타났다. 하중봉 4(1.0)이 3(0.75)보다 다소 높은 상관성을 보였다. 향후 Kim test실험에서 하중봉 4(1.0)을 사용하고 4단계 방법을 이용한다면 소성변형 특성치인 침하깊이(DR)와 동적안정도(DS)와의 상관성이 매우 큰 시험법이 될 것이다. 또한 변형강도의 파괴 메커니즘은 콘크리트의 펀칭파괴와 유사하여 콘크리트의 전단강도 추정식을 근거로 아스팔트 콘크리트의 재료 특성에 적합한 추정식 계수 ◁ 원문 수식 참조 ▷ 를 얻었다. 이 식을 이용한다면 아스팔트 콘크리트가 견딜 수 있는 임계하중을 변형강도에 근거하여 추정할 수 있을 것이다. This study shows predictability of rut parameters of modified and unmodified asphalt concretes based on the deformation strength (S_(D)) which is calculated from the maximum load, deformation and size variables of loading head under simple static loading. This paper is the result of latest studies, phase 4 which is a part of Kim, Test studies for developing a new strength property for asphalt concrete. Two aggregates, gneiss and granite, two gradations, dense-graded, gap-graded, with maximum, size of 13mm and eight binders using different contents of five polymers (RLDPE, RHDPE, LDPE, SBS, SBR) were used to produce 32 different mixtures. A slab (305㎜×305㎜×62㎜) was cut into two pieces(18cm and 12cm width) and three 10cm cores were taken for S_(D) test from the larger piece and wheel tracking test was performed on the smaller piece. Kim test was performed using loading head 4(1.0), 3(0.75). Two rut parameters, depth of rut and dynamic stability, from the rut depth-cycle curve from a WT test were obtained for each mixture. Statistical analysis were performed for each loading head, aggregate, and gradation to find out correlation between S_(D) values and each rut parameter. The analysis results showed that S_(D) had high R² (over 0.95) on the average with rut parameters. The loading head 4(1.0) showed R² better than 3(0.75). It is concluded that S_(D) is the property that has excellent predictability for rut parameter of asphalt concretes. An equation, ◁ 원문 수식 참조 ▷ was obtained based on the equation of concrete shear load creating punching failure and current test data, because the failure mechanism of S_(D) is similar to punching failure of concrete. In the equation, P is shearing force creating punching effect, b is length of perimeter of punching area and d is depth of specimen. If this formula is used, a critical load for deformation failure will be predicted based on the S_(D).

과학 교육의 의미 분석

윤선진,우종옥,김범기 한국교원대학교 과학교육연구소 1995 청람과학교육연구논총 Vol.5 No.1

The purpose of this study is to find out the answer to the question as "What is the meaning of the Science Education?". Semantic analyses were done according to each situations and contexts in science, education and science education. The following result was drawn: It is concluded that science education is the practtical behavior for the human as the purpose, through the science and education as the means and methods.