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.

Inconel 718 상향 엔드밀링시 절삭력에 미치는 공구형상오차의 영향

이영문,양승한,장승일,백승기,김선일,이동식 한국공작기계학회 2002 한국생산제조학회지 Vol.11 No.5

In an end milling process, the undeformed chip section and cutting forces vary periodically with the phase change of the tool. However, the real undeformed chip section area deviates from the geometrically ideal one owing to the cutter runout and tool shape error. In the current study, a method of estimating the real undeformed chip section area which reflects the cutter runout and tool shape error is presented during up-end milling processes of Inconel 718. The specific cutting forces, K_r and K_t are defined as the radial and tangential cutting forces divided by the modified chip section area, respectively. Both of the K_r and K_t values become smaller as the helix angle increases from 30˚ to 40˚. Whereas they become larger as the helix angle increases from 40˚ to 50˚. The K_r and K_t values show a tendency to decrease with increase of the modified chip section area.

봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

후방 십자 인대 급성 손상에서 일차 복원술의 결과

이동철,백승희 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. Materials and Methods: Twenty two patients who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability Lysholm knee score was used for knee function. Results: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (p〈0.05). Posterior displacement of the posterior stress test showed 17.2 min at initial injury and 8.6 mm at last follow up in femoral detachment group, 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group. There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. Conclusion: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.

Moclobemide의 항우울 효과에 대한 평가

이귀행,박민철,노승호,백영석,이상열,김재현 圓光大學校 醫科學硏究所 1996 圓光醫科學 Vol.12 No.2

Eighteen patients took Moclobemide for 6 weeks, who had been diagnosed as major depression based on DSM-Ⅲ-R and had had more than 16 points on the Hamilton Depression Rating Scale. After medication of Moclobemide, they were evaluated by the Hamilton Depression Rating Scale and in terms of sleep, vigilance, performance, social interactions and drive. The results were as follows ; 1. The average dosage of Moclobemide was 400±89 ㎎. 2. Antidepressant effect were checked on the all items of the Hamilton Depression Rating Scale and prominent on the items of work and activities, insomnia, suicide, somatic symptoms. 3 There were obvious changes of the antidepressive effect by the evaluation of the doctors and patients at 4 weeks after the medication of Moclobemide. 4. In the patients, 61% had positive effects on the sleep. 94% no negative effects on the vigilance. Nobody has negative effects on the social interactions and drive. 5. Side effects or physical disturbances induced by Moclobemide were not found. According to these results, it seemed that Moclobemide had clear antidepressant effects, few negative effects on the life of day time, positive effects on the sleep and somatic symptoms.

제4경추의 형태와 초경을 통한 성숙지표에 관한 연구

이규홍,황용인,김윤지,박양호,백승학,차경석 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.1

본 연구는 측모 두부 규격 방사선사진을 이용하여 성장 중인 아동의 제4경추 형태를 경추 몸체부 하연의 만곡 정도에 따라 분류하고 초경의 시기와 수완부 골 성숙 단계를 평가하여, 성장 중인 아동의 골격적 부정교합의 진단 및 악정형 치료를 위한 성장 시기 평가에 제4경추의 형태 변화가 진단의 참고자료로 활용될 수 있는지를 연구하였다. 11-14세 여자 환자 중, 같은 날짜에 촬영된 측모 두부 규격 방사선사진과 수완부 방사선사진이 모두 있는 81명을 대상으로 환자의 측모 두부 규격 방사선사진상 제4경추 몸체부 하연의 만곡 정도에 따라 세 그룹으로 분류하였다. (Group A - 제4경추 몸체부 하연의 만곡 정도가 1.05 mm 이하, Group B -제4경추 몸체부 하연의 만곡 정도가 1.05- 2.07 mm 사이, Group C -제4경추 몸체부 하연의 만곡 정도가 2.07 mm 이상)세 그룹에서 각각 제4경추 몸체부의 수직 길이, 수평 길이, 수직/수평 비율, 초경의 시기, 수완부 골 성숙 단계를 측정한 결과 다음과 같은 결론을 얻었다. 평균 수완부 골 성숙 단계는 Group A가 SMI 5.67 ± 2.57단계, Group B는 SMI 8,73 ± 2.41 단계, Group C는 SMI 10.00 ± 1.47단계로 나타났다. GroupA에서 Group B, Group C로 갈수록 제4경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 각각 유의하게 더 큰 값을 보였다. 본 연구대상 아동의 평균 초경 시기는 11.64 ± 0.92세를 보였다. 제4경추 몸체부 하연의 만곡 정도, 수직 길이, 수평 길이, 수직/수평 비율은 수완부 골 성숙 단계와 각각 서로 유의한 양의 상관관계를 나타냈다. 초경을 경험한 그룹이 초경을 경험하지 않은 그룹에 비해 제4경추의 수직 길이, 수평 길이, 수직/수평 비율, 수완부 골 성숙 단계에 있어서 유의하게 큰 값을 보였다. 연구 결과 측모 두부 규격 방사선사진상 제4경추 하연의 만곡 깊이가 2.07 mm 이상인 경우 성장의 완료 단계에 가까운 시기로 나타나 이 시기의 악정형적 치료는 큰 효과를 얻을 수 없을 것으로 사료된다. Objective: This study analyzed the morphologic changes of the fourth cervical vertebra body to determine the skeletal age of orthodontic patients during growth. Methods: Eighty-one female patients aged from 11 to 14 who had cephalograms taken on the same day were examined. The subjects were divided into three groups depending on the depth of the concavity of the lower border of the fourth cervical vertebra (Group A: less than 1.05 mm, Group B: 1.05 - 2.07 mm, Group C: greater than 2.07 mm). Menarcheal timing, SMI stage, length, width and ratio of length and width of the fourth cervical vertebra body were analyzed and the following results were obtained. Results: The average SMI stage of group A,B and C were 5.67 ± 2.57, 8.73 ± 2.41, and 10.00 ± 1.47, respectively. Length, width, ratio of length and width, and SMI stage were greater in group B than group A and in group C than group B. Mean menarcheal timing was 11.64 ± 0.92 years. Concavity depth, length, width, ratio of length and width showed a significant positive correlation with SMI stage, especially with the concavity depth. Conclusion: The results of this study propose a simple method for determining the timing of orthopedic treatment by measuring the concavity depth of the fourth cervical vertebra on the cephalogram.

Expansin 유전자를 이용한 담배의 형질전환과 형질전환체 선발

백승준, 김보미, 장종오, 엄유리, 석영선, 이이 충북대학교 연초연구소 2008 煙草硏究 Vol.21 No.-

-본문참고-

직장암 절제 수술 후에 발생하는 문합부 누출의 위험 인자

이승현,안병권,배승언 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: Anastomotic leakages are one of the most serious complications after rectal cancer resection. The aim of this study was to identify the relevant risk factors of anastomotic leakage after low anterior resection for rectal cancer. Methods: We reviewed retrospectively the medical records of 251 patients, who underwent low anterior resection for rectal cancers between January, 2001 and December, 2004. All patients underwent a tumor-specific mesorectal excision. We excluded the patients underwent emergent surgery, protective stoma formation and used pelvic drainage. Results: The mean distance of the tumor from the anal verge was 8.0 cm (3-16 cm). Lower anterior resection was performed in 214 patients and ultra-low anterior resection in 37 patients. Fifteen patients had preoperativechemoradiation for rectal cancer. The anastomotic leakage was identified in 10 patients (4.0%). Seven patients with anastomotic leakage underwent corrective surgery.Other postoperative complications included 5 rectovaginal fistula (2.0%) and 4 intra-abdominal abscess (1.6%). The incidences of anastomotic leakage were significantly different according to preoperative chemoradiation (13.3% vs. 3.4%, p=0.05) and rectal obstruction (33.3% vs. 3.3%, p=0.00). Conclusions: In patients with history of preoperative chemoradiation and rectal obstruction, the careful management for anastomotic leakage is necessary

한국 미생물 자원의 개발연구 : 특히 유용 미생물주(균주)의 분리와 응용에 관한 연구 The Research on the Isolation and Application of Utilizable Microorganisms Related to Jeonju Materials

이주식,백승화,이오형 Natural Science Research Institute JEONJU UNIVERSI 1987 전주대학교 자연과학연구소 학술논문집 Vol.2 No.2

The isolated strains of microbes from some hay, water of lake, marketing milk and Tachju brewing in Jeonju area. Were as follows Isolated 10 strains of Bacillus group, 2 strainins of Chlorella group, 2 strains of Lactobacillus group, 2 strains of Saccharomyces grpup and other microbes and determinated 4 strains in the 20 strains and application of utlizable microorganisms studies on the strains or pure cultual materials. Microbiological and biochemical examined for each organism. Its Bacillus species, Lactobacillus species, Chlorella species and Saccharomyces species were as follows. Bacillus species in Bacillus subtilis natto like strain. In addition, some of these strains were prepared to show different responses to the biotin added medium. Therefore our primary purpose was to examine the possible effects of glutamic acid, biotin and boiling soybean extract on the growth or sporulation of one these strains. It is a novel finding that biothin and soybean extrat affects on its sporulation. Glulamic acid was required for both its growth and sporulation. Chlorella species is Chlorella ellipsoidea like strain. The optimum cultural conditions and composition of the medium for wild Chlorella ellipsoidea were studies as follow. The addition than in control in concentration of the nitrogen sources high presented the effective result in the increasing order of meat extract, peptone amino, acid. Lactobacillus species is Lactobacillus casei like. Lactobacillus casei was isolated relatively high temperature and high salt contend and mesothermophilic condition. In addition, among, J-1, J-2, J-3 strains isolated together from above samples, J-2 was prominant in producing typical curd within 20 hours. Saccharomyces species is Saccharomyces cerevisiae like. When Sacchromyces cerevisiae like was used as a sole yeast source, this was dominated soon after it. But in this case Hansennula, Candida, Pichia, Torulopsis etc. were alse found out. This fact indicates that many kinds of yeast species were related with the alcohol fermentation. Biochemical studies on Cell-bound a-amylase in Bacillus subtilis like. Extracelluiar and Cell-bound a-amylase were purified separately and some of their biochemical properties examined. The amount of extracellular a-amylase produced by bacteria is known to very greatly with growth conditions. Extracellular a-amylase activity was more inhibited than cell bound a-amylase by metal ions tested.

궤적 정보를 이용한 냉동 컨테이너 모니터링 시스템

이명진,이응재,하덕천,류근호,백승재 한국지리정보학회 2005 한국지리정보학회지 Vol.8 No.1

위성 통신 기술의 발달로 국부적으로 수행리던 위치 추적의 범위가 선 세계로 3~4간되었다 하지만 기존의 물류 관제 시스템들은 관제 서버와 물류간의 통신을 위하여 휴대폰 통신망을 이용하기 때문에 일부 지역 내에서 이동하는 물류에 대해서만 관제가 가능하다. 이 논문에서는 위성 통신을 이용하여 전 세계를 이동하는 물류 매체인 냉동 컨테이너의 위치 및 상태 정보를 관리하기 위한시스템을 제안하였다. 제안 시스템은 냉동 컨테이너의 상태를 직절 관제하는 데이터 수집부, 관제서버와의 통신을 담당하는 위성 통신부, 냉동 컨테이너 정보를 판리하는 관제부로 구성된다. 시스템의 관제부에서는 냉동 컨테이너의 위치 주적 및 관제를 효과적으로 수행하기 위하여 기존의 TB 트리를 기반으로 하는 다중 버전 이동 객체 색인을 사용하였다. 제안된 냉동 컨테이너 관제시스템은 화주, 운송회사 등 육해상 물류관련 기관에서 냉동컨테이너 및 선박 위치추적, 컨테이너 통제, 컨테이너 통계 등 다양한 용도로 사용될 수 있어 화주에게는 컨테이너 운송에 대한 서비스를 제공하며, 선사에게는 선박안전경보시스템, 선박 관리, 냉동컨테이너를 효율적인 관리 기능을 제공하게 한다. As developing satellite communication, the tracking range of the moving objects which move in local area is expanded to the whole world. However previous logistics management system is able to monitor freight which transporting in local area using mobile communication system. In this paper, we propose the reefer container management system that manages the location information and other related information such as temperature, humidity of container using the satellite system. The proposed system consists of three parts; data collector, satellite communication manager, reefer container information manager. And the proposed system uses the moving object index for managing the trajectory of container and tracing the location of container or vessel that is transporting the container, and supports various services such as reefer container and vessel tracking, container control and container statistics to logistic companies like shipper and forwarding agent. And the system can be increasing the quality of container transportation service to the shipper, and it makes the efficient management of reefer container to the shipping company.