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.

근막 결손의 복원과 자궁천골인대 고정을 통한 전자궁적출술 후 질탈출의 성공적 교정

문화숙(Hwa Sook Moon),최진국(Jin Koo Choi),김경서(Kyung Seo Kim),박근식(Kyun Sik Park),황지영(Ji Young Hwang),문성은(Sung Eun Moon),한지원(Ji Won Han),김상국(Sang Gook Kim),김상갑(Sang Gap Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

목적 : 본 연구는 전자궁적출술 후 질탈출을 부위-특이적인 결함의 개념에 입각하여 치골경부 근막과 직장질 격막의 연결을 통한 골반내 근막의 복원과 자궁천골인대 고정술을 이용한 질탈출의 성공적인 수술적 교정의 방법과 결과를 보고하고자 한다. 연구 방법 : 1999년부터 2001년 8월까지 자궁적출술 후 질궁탈출 증상으로 문화병원 산부인과를 내원, 탈출된 질의 근막을 재건시킨 다음, 이를 자궁천골인대에 고정시킴으로써 질의 부위-특이적인 교정술을 받은 3명의 환자를 대상으로 하였다. 3명중 1명은 개복술을 하였고 2명은 내시경 수술을 하였다. 결과 : 환자의 연령 분포는 49-67세였으며, 수술시간은 평균 113분 (105-125)이었다. 세 환자 모두 수술 후 질의 상태가 해부학 및 기능적으로 정상이었으며, 9일째 특이사항 없이 퇴원하였다. 수술 후 HRT를 시행한 1명을 포함한 3명 모두 각각 24개월, 12개월, 7개월간의 추적 검사에서도 특이한 합병증이나 재발 없이 좋은 경과를 보였다. 결론 : 골반 근막 결손의 복원과 자궁천골인대 고정술은 전자궁적출술 후 질탈출의 교정에 매우 안전하고 효과적이며, 기능적인 방법으로 사료되며, 자궁천골인대를 질탈출 교정에 이용한 연구는 본 연구가 국내에서 처음이다. Objective : To report the method and efficacy of the site specific-defects repair in the endopelvic fascia and uterosacral ligament suspension for the correction of posthysterectomy vaginal vault prolapse. Methods : This study was performed in 3 patients with posthyterectomy vaginal vault prolapse who underwent the surgery for the reconstruction of endopelvic fascia and the correction of vault prolapsed vagina by using uterosacral ligament suspension at the department of Obstetrics and Gynecology in Moon-Hwa Hospital. Among them, 1 patient was treated by laparotomy, and 2 patients were treated by laparoscope. Results : The age of patients ranged from 49 to 67 years. The mean operation time was 111 minutes (105-120 minutes). The status of postoperative vagina was normal in all 3 patients, who were discharged 9 days after operation without symptoms. No complication or recurrence were found in them despite long-term follow-up for 24 months, 12 months, 7 months, respectively after operation. One patient has been treated with HRT therapy. Conclusion : The reconstruction of the defect of endopelvic fascia and uterosacral ligament fixation may be very safe, effective, and functional in the correction of vaginal vault prolapse. This study reports the treatment of vaginal vault prolapse using uterosacral ligament within Korea for the first time.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

影島産 昆蟲群의 醫昆蟲學 및 保全生物學, Ⅲ. 송장벌레科 (딱정벌레目)

文太暎,李星珍 고신대학교보건과학연구소 1999 보건과학연구소보 Vol.9 No.-

영동에서 기록된 송장벌레들은 2아과 4속 4종으로 부산 전체에서 기록된 2아과 5속 5종의 대부분을 차지한다. 이는 면적상 넓지 않고 생태적 질이 높지 않은 녹지를 유지하는 상황에서도 남아있는 녹지에 대하여 큰 간섭이 없는 것이 송장벌레의 당양성을 유지하게 해주는 요인임을 시사하고있다. 분포지역에서도 봉래산과 공원족지를 중심으로 기록되므로 자연생태계의 유기물 분해를 촉진시키고 노양의 질소 순환을 촉진시키는 중요한역할을 담당하는 셈이다. 그러므로 생태적 건강성과 보건위생을 유지하는 자연적인 분해자로서의 역할을 고려하여 생물자원으로서 활용할 가치가 있다. Four species belonging to 4 genera and 2 subfamilies in Silphidae were recorded at the Islit Youngdo. It covers the major component of taxonomic diversity recorded in Pusan that are representer as 5 species belonging to 5 genera and 2 subfamilies. The beetles were recorded largely at the Mt. Bongrae and the linked woody parks. It may imply that the less-disturbed green areas support the more diversity of Silphidae at the Iselet Yongdo where Mt. bongrae has taken the role of a biological source, although neither the ecological quality nor the size of the green areas is enough to support a broad spectrum of biodiversity in overall. Therefore, they are of value and of use to be conserved as a biological resource maintaining ecological equality and public health as a natural decomposer, in terms that they facilitate to resolve organic materials and to supply nitrogen to soils.

모체 Thyroxine 투여가 태아알코올효과를 가진 흰쥐 대뇌겉질 및 해마에서 NPY함유 신경세포의 생후 발달에 미치는 영향

김복,박상기,박영란,김종중,문정석,김주수,문영민,현영식,천관영,정윤영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: Maternal alcohol abuse is considered to be one of the most prominent cause of neurobiological malformations in the postnatal and adult life of the offspring. In this study, we investigated the effects of maternal alcohol drinking on the postnatal development of NPY-containing neuron, and, the influence of thyroxine treatment on the cerebral cortex and hippocampus of pups of alcohol abused mother. Materials and Method: Time-pregnant rats were divided into three groups. Alcohol-fed group A received 35 calories of liquid alcohol diet daily from gestation day 6; control pair-fed group B was fed a liquid diet in dextrin replaced alcohol isocalorically: alcohol + T4 group C received 35 calories liquid alcohol diet and exogenous thyroxine subcutaneously. Results: Group C showed prominent NPY immunoreactivity in the cerebral cortex compared to group A and B at P7. In group C, NPY-containing neurons were widely distributed in the all layers of cerebral cortex after P14. Besides, numerical decrease of NPY-containing neuron as age increases was not found in group C. However, the decrease of NPY-containing neuron was clearly observed in group A compared to group C after P14. In hippocampus, group Band C were appeared similar patterns after P7. Additionally, in group C, NPY immunoreactivity was prominently appeared in CA2 and CA3 at P14 as compared to group B. Conclusions: The present results showed the increase of intensity and number of NPY-containing neurons in cerebral cortex and hippocampus of pups of exogenous T₄ supplemented alcohol-exposed dams as compared to control pair-fed and alcohol-exposed pups at P7. It presumably suggest that NPY-containing neurons might be regulated by the early postnatal growth stimulatory effect of the exogenously supplemented T₄. Therefore, the increase of NPY synthesis caused by maternal administration of exogenous thyroxine may ameliorate fetal alcohol effect, one of the ill effects as a result of the dysthyroid state following maternal alcohol abuse.

Lactobacillus plantarum을 接種한 옥수수와 수수 Silage 製造 試驗

文勝式,朴成振,鄭錫龍,宋瑛敏 진주산업대학교 농업기술연구소 1989 農業技術硏究所報 Vol.2 No.-

유산균 접종이 옥수수와 수수silage의 품질에 미치는 영향을 조사할 목적으로 L. plantarum을 대조구는 접종하지 않았고 처리구는 2×10 exp(8), 4×10 exp(8) 및 6×10 exp(8)cfu, kg^-1(fresh forage) 수준으로 접종하여 조제한 silage의 일반성분, pH 및 유기산 함량을 비교한 결과는 다음과 같다. 1. crude protein, crude ash, NDF, ADF 및 hemicellulose 함량은 접종수준이 증가할수록 높았고 moisture 및 NFE 함량은 낮았다. 2. 접종수준이 증가할수록 lactic acid와 total acid 함량은 증가한 반면 acetic acid함량과 pH는 낮았다. 3. 옥수수 silage에 비하여 수수silage에서 L. plantarum의 접종효과가 높았다. The objective of this thesis is to investigate the effects of lactic acid bacterium inoculation on the qualities of corn and sorghum silages. The control group was not inoculated : the treated group was inoculated with Lactobacillus plantarum of the levels of 2×10 exp (8), 4×10 exp(8) and 6×10 exp(8) cfu. Kg^-1(fresh forage). The chemical components, pH and organic acid contents of the developed silages were measured and compared. The results obtained are as follows : 1. As the level of inoculation was higher, the contents of crude protein, crude ash, NDF, ADF and hemicellulose became larger, but the contents of moisture and NFE became smaller. 2. As the level of inoculation was higher, the contents of lactic acid and total acid became larger, but the acetic acid content and the pH became smaller. 3. The inoculation effect of L. plantarum was greater in the sorghum silage than in the corn silage.

경추 후종인대 골화증 : 증예 보고 Report of 2 cases

문명상,김진영,최용삼 최신의학사 1985 最新醫學 Vol.28 No.3

密陽 얼음골의 夏季結氷 現象에 關한 硏究

文勝義,黃水鎭 釜山大學校 師範大學 1977 교사교육연구 Vol.4 No.2

There are f reezing phenonena in summer at so called "Ice-valley" in the south-eastern part of the Korean peninsula. The purpose of this paper is to examine the causes of this ice-forming phenomena which can be explained by following causes. (1) As the valley is very deep and is toward the North, the insolations to the "Ice-valley" are very little through the year. Therefore, the under ground (15m from the surface) temperatures maintain about 6°C in summer. (2) The upper capillary zone is considered as a adiabatic situation because this zone is insulated from the solar radiation by the Talus having very large boulders(50-20G<* in dia.) (3) As the defferences of saturated vapor pressure between upper capillary zone and outside of the Talus are very high, the evaporization will be occur on the upper capillary zone. (4) Consequently, water is frozen by the loss of evaporization heat due to the evaporation at the upper capillary zone.

알칼리형 연료전지에서의 산소극 제조

문세기,김형진,공성호,조장호,김영채 한양대학교 에너지·환경기술연구소 1997 에너지·環境技術論文集 Vol.3 No.-

알칼리형 연료전지(Alkaline fuel Cell, 이하 AFC)의 산소극에 사용되는 촉매를 은 염의 화학적 환원법으로 제조하였다. 그리고 최적의 전극 제조 조건을 찾기 위해 촉매의 loading량, 전극 소결 온도, PTFE함량 및 촉매 입자 크기 등이 전극의 분극특성에 미치는 영향들이 조사되었다. 연구결과에 의하면, 최적 조건은 전극 소결 온도 350℃, PTFE 함량 9wt%, 촉매의 입자크기 68㎛ 이하이었다. 한편 촉매 loading량이 증가함에 따라 전극 성능이 향상되었다. 최적의 제조 조건에서 제작된 전극은 개회로 전위 1.11V(vs. RHE),200㎷ 분극(전극전위 0.91V vs. RHE)시 전류밀도 약 0.4A/㎠,300㎷ 분극 (전극전위 0.81V vs. RHE)시 전류밀도 1.0A/㎠의 성능을 나타내었다. Doped silver catalyst used for oxygen electrode in alkaline fuel cells was prepared by reduction method of silver salt. And the effects of the silver catalyst loading, electrode sintering temperature, content of PTFE and particle size of the catalyst on the polarization characteristics of the oxygen electrodes were investigated to find the optimum preparation conditions of the electrodes. According to the results of this work, the optimum conditions were sintering temperature of 350℃, PTFE content of 9 wt% and below catalyst particle size of 68 ㎛. On the other hand, with increasing the catalyst loading, the electrode performance was improved. The electrode prepared at the optimum conditions showed open circuit potential of 1.11V(vs.RHE), current density of 0.4A/㎠ at a overpotential of 200㎷ and 1.0A/㎠ at a overpotential of 300㎷.

액체막법에 의한 중금속이온의 분리 및 회수

曺文換,丁學鎭,이상인,金振浩,金始中 江原大學校 附設 環境硏究所 1994 環境硏究 Vol.11 No.-

거대고리 리간드는 금속이온과 선택적으로 결합하는데, 이를 이용하여 에멀젼 액체막을 통한 금속이온의 이동에 관하여 연구를 수행하였다. 금속이온은 유기층에 있는 운반체에 의하여 source phase에서 receiving phase으로 이동한다. 운반체로는 거대고리 리간드인 DBN_(3)O_(3)를 사용하였다. 여기에서 에멀젼 액체막을 통한 금속이온의 이동에 관한 요인과 어떤 금속이온의 선택적 분리에 관하여 검토하였다. 금속이온과 거대고리 리간드 그리고 금속이온과 receiving phase내에 있는 음이온에 대한 안정도 상수를 금속이온의 선택적 이동에 대한 척도로 조사하였다. 납이온이 혼합 용액에서 다른 금속이온보다 높은 이동속도를 나타내었다. Receiving phase내의 음이온이 금속이온의 이동에 중요한 역할을 한다. Receiving phase내에 있는 NO_(3)^(-)을 S_(2)O_(3)^(2-) 대치하면 이동량이 증가함을 보였는데 이는 Pb^(2-)-S_(2)O_(3)^(2-) 상호작용이 Pb^(2+)-NO_(3)^(-) 상호작용보다 크기 때문이다. Macrocyclic ligand has been know to selectively bind with metal ions so that ability applied for the transport of metal ions across the emulsion liquid membrane in this study. The metal ions are transproted from the source phase to the receiving phase by the carrier of the organic phase. Several factors involved in the transport of metal ions acrose the emulsion membrane we reported here and these factors proveided the informations for the selective seperation of some metal ion. Stability constants for cation-macrocyclic ligand and metal ion-anion receiving phase interaction are examined as parameters for the prediction of metal ion transport selectivities Pb^(2+) was transported higher rates than the other metal ions in the mixture solution. The interaction of metal ion to anion in receiving phase is important. S_(2)O_(3)^(2-) in replacement of NO_(3)^(-) in the receiving phase enhances the transport of pb^(2-) since Pb^(2-)-S_(2)O_(3)^(2-) interaction is greater than Pb^(2+)-NO_(3)^(+) interaction.