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.

제주도 지하수 질산염 농도의 시·공간적 변화 특성: 장기(1993-2015) 모니터링 자료의 평가

김호림(Ho-Rim Kim),오준섭(Junseop Oh),도현권(Hyun-Kwon Do),이경진(Kyung-Jin Lee),현익현(Ik-Hyun Hyun),오상실(Sang-Sil Oh),감상규(Sang-Kyu Kam),윤성택(Seong-Taek Yun) 대한자원환경지질학회 2018 자원환경지질 Vol.51 No.1

1993년부터 2015년까지 관측된 제주도 지하수 장기모니터링 관측정(N = 4,835)에서 수집된 지하수 수질자료(N = 21,568)를 기반으로 질산성질소의 시공간적 변동 특성을 평가하였다. 제주도 지하수의 질산성질소 농도의 중앙값은 2.5 mg/L로서 다른 국가나 대륙의 조사 결과에 비해 다소 높거나 유사한 것으로 나타났다. 또한 지하수 용도, 행정구역 및 고도 별로 유의한 차이를 보였다. 특히, 산간 지역에 비해 저지대 해안가에 위치한 농업 및 주거지역에서 농도가 높음을 확인하였다. Mann-Kendall 및 Sen’s slope 분석을 활용한 질산성질소 농도의 추세 분석 결과, 하류 저지 대에 비해 중산간지역에서의 질산성질소 농도 증가 경향이 뚜렷하였다. 제주도 내 토지 피복의 시계열 변화 특성과 결부 지어 보면, 중산간지역의 오염 증가 추세는 농업지역의 확장 등 인위적 활동 증가에 기인한 결과로 판단된다. 반면,기지정된 지하수자원특별관리구역에서는 전반적으로 질산성질소 농도의 감소 경향이 나타났는데, 이는 지하수 관리 측면에서 수질관리를 위한 적극적인 정책이 유효함을 시사한다. 본 연구에서는 제주도 지하수의 질산성질소 오염관리를 위한 적정 방안을 제안한다. The spatio-temporal variations of nitrate concentrations in groundwater of Jeju Island were evaluated by an analysis of time series groundwater quality data (N = 21,568) that were collected from regional groundwater monitoring (number of wells = 4,835) for up to 20 years between 1993 and 2015. The median concentration of NO 3 -N is 2.5 mg/L, which is slightly higher than those reported from regional surveys in other countries. Nitrate concentrations of groundwater in wells tend to significantly vary according to different water usage (of the well), administrative districts, and topographic elevations: nitrate level is higher in low-lying agricultural and residential areas than those in high mountainous areas. The Mann-Kendall trend test and Sen’s slope analysis show that nitrate concentration in mid-mountainous areas tends to increase, possibly due to the expansion of agricultural areas toward highland. On the other hand, nitrate concentrations in the Specially Designated Groundwater Quality Protection Zones show the temporally decreasing trend, which implies the efficiency of groundwater management actions in Jeju. Proper measures for sustainable groundwater quality management are suggested in this study.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

페디그리 사료 섭취에 의한 급성신부전증의 치료 1례

김영실,신영지,박정희,김명철,신상태,조종기,김덕환 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 4 years old male poodle dog with gastro-intestinal distress was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. The patient was presented with history of vomiting, hemorrhagic diarrhea and inappetence. Laboratory evaluation revealed that WBC (23.8 x 10^(3)/㎕). BUN (87.9 ㎎/㎗), creatinine (7.3 ㎎/㎗) and phosphate (9.6 ㎎/㎗) was elevated, and proteinuria, hematuria and bilirubinuria were detected on urinalysis. Increased renal cortical echogenicity and parenchymal calcification of kidney were observed by ultrasonography. Based on the findings of history, clinical signs, laboratory assessment and ultrasonography, it was diagnosed as acute renal failure. The present patient showed favorable therapeutic response by fluid therapy. diuretics, peritoneal dialysis and blood transfusion.

농업의 특성을 고려한 자유무역 일반균형효과 분석모형의 체계

김충실,이상호 한국농업정책학회, 한국축산경영학회 2000 농업경영정책연구 Vol.27 No.3

The main purpose of this study is to construct Multiregional General Equilibrium Model which is generally used to analyze general equilibrium effects of trade liberalization and changes in various international or national economic variables like as Free Trade Agreement, WTO new Round, and changes of price, exchange rate, and tariff rate. This multiregional general equilibrium model handles the multilateral trade liberalization and various kinds of policy shocks. Especially, this model emphasizes the speciality of agricultural demand and production system. Key words : 아밍턴 함수(Armington Function), 불변전환탄력성 함수(CET Function), 다국간 일반균형모형(Multiregional General Equilibrium), 소비체계(Demand System), 생산체계(Production System)

GIS를 이용한 지역농업 특성 분석과 정책방향

김충실,이상호 韓國農業政策學會 1999 농업경영정책연구 Vol.26 No.1

Guar gum의 섭취 수준과 기간이 흰쥐의 영양소 흡수율에 미치는 영향

김상연,선영실,장유경 漢陽大學校 韓國生活科學硏究所 1993 韓國 生活 科學 硏究 Vol.- No.11

This study was performed to investigate apparent absorption of nutrients according to level and duration of guar gum intake. Eighteen male rats of Sparague-Dawley strain weighing 50g were blocked into three groups : FF, 5G, 10G(Fiber Free, 5% Guar gam, 10% Guar gum). Balance studies were conducted at 2nd week, 4th week and 8th week. Feed in-take body weight gains, apparent absorption of protein, fat, Ca and P were measured. The results obtained in this study were summarized as follows : (1) Feed intake was not significantly different among the groups during each balance studies. Weiht gain was decreased according to level of guar gum intake during each balance studies. (2) Protein apparent absorption of 5G were not significantly different with that of 10G at 2nd week and 4th week but at 8th week protein apparent absorption of 10G was singificantly lower than that of 5G According to duration of guar gum intake, protein apparent absorption of FF and 5G were not significantly different. Wherease protein apparent absorption of 10G was significantly decreased at 8th week. (3) Fat and Ca apparent absorption were not significantly different among groups at 2nd week. Fat apparent absorption of 10G was not significantly lower than that of 5G at 4th week and 8th week. According to duration of guar gum intake, fat and Ca apparent absorption of FF and 5G were not significant different. But fat and Ca apparent absorption of 10G was significantly decreased according to duration of fur gum intake. (4) Phosphorus apparent absorption were not significantly different among groups at 2, 4th week. But phosphorus apparent absorption of 10G were significantly higher than that of 5G at 8th week. According to duration of guar gum intake, phosphorus apparent absorption of FF and 10G were not influenced. But Phosphorus apparent absorption of 5G was significantly decreased according to duration of guar gum intake. From the results of this study, we could recommend 5% guar gum in diet of obese man and di abetics.

이산형 판별분석하의 새로운 변수선택기준에 관한 연구

김혜중,한성실,김희수 동국대학교 자연과학연구원 1994 자연과학연구 논문집 Vol.14 No.-

A new variables selection criterion for two-group discriminant analysis is derived under full multinomial model. It is obtained by use of Havrada-Charvat measure of directed divergence. The criterion is named as Havrada-Charvat divergence measure statistic, and it is shown that the criterion is approximately distributed as a central Chi-square distribution. Unlike others, the suggested criterion has a merit that it serves not only as a variables selection criterion but also as a criterion for conditional discriminant analysis. This is demonstrated by use of an empirical data set.

치간 삭제 후 불소 및 수산화인회석 도포 시 법랑질 표면의 함량 및 결정구조 변화에 관한 연구

김상철,홍현실,황영철 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.6

본 연구의 목적은 치간삭제 후 불소 및 수산화인회석 페이스트의 치면 도포에 대한 법랑질 표면의 결정구조 및 재광화를 평가하고자 하였다. 치간삭제 후 1.23% 인산화 불소 및 10% 수산화인회석 페이스트를 치면에 도포한 후 법랑질 표면의 결정구조 변화를 주사전자현미경으로 관찰하고, 법랑질 표면의 칼슘, 인, 불소 함량 등의 변화를 energy dispersive X-ray spectroscopy (ESD)로 분석하였다. 실험결과 10% 수산화인회석 페이스트 도포한 군에서 칼슘 함량이 증가하였고 (p < 0.01), 치간 삭제 후 거칠었던 법랑질 표면이 매끄럽고 부드러워졌으며 법랑질 결정구조가 작고 치밀해짐을 관찰할 수 있었다. 이상의 결과는 치간삭제 후 불소 및 수산화인회석 도포가 치면 결정구조 및 재광화에 유리하다는 것을 의미한다. The aim of this study was to evaluate the remineralization of interdentally stripped teeth after fluoride gel or hydroxyapatite paste application. Methods: After interdental stripping, 1.23% fluoride gel or 10% hydroxyapatite paste was applied three times a day, with a duration of four minutes, for a week. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to compare the change of surface contents and crystal structures before and after the application of fluoride gel or hydroxyapatite paste. Results: EDS analysis indicated that calcium contents were increased after 10% HAp paste application on stripped enamel (p < 0.01). SEM view showed that enamel surfaces in groups of 1.23% APF gel or 10% HAp paste application were smoother than those of control group, which was regarded as filling of the pore structure. And pores between crystal structures in groups treated with 1.23% APF gel or 10% HAp paste were smaller than those of control group. Conclusions: Application of APF or HAp on stripped enamel could positively influence on the surface contents or crystal structure.

사과 환경농업의 실태와 정책과제

김충실,이상호 韓國農業政策學會 1997 농업경영정책연구 Vol.24 No.2