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.

급식소에서 제공되는 돼지고기 장조림과 햄,오이샐러드의 조리 후 보관방법 및 시간이 살모넬라(Salmonella typhimurium) 식중독균의 생존에 미치는 영향

고성희,김지영 한국조리과학회 2004 한국식품조리과학회지 Vol.20 No.4

This study was performed to predict the multiplication growth patterns of Salmonella typhimurium according to the holding methods and times in cooked foods served at foodservice institutions. When simmered pork in soy sauce and ham and cucumber salad were inoculated with S. typhimurium (7.00 logCFU/g) and tested according to holding methods and times, room temperature holding showed a continuous increase in S. typhimurium count as time passed, whereas 80℃ heating table sharply reduced the count to 4.00 (logCFU/g) after 2hrs of holding and to zero after 6hrs, which suggested that all S. typhimurium were destroyed. However, 5t refrigerator holding showed a count increase, although it wasis still lower than that at room temperature and at 10℃ cold table holding, which suggested that S. typhimurium is comparatively resistive to low temperature.

폐결핵 환자 혈청에서 수용성 Interleukin 2 수용체 및 Adenosine Deaminase 활성도에 관한 연구

고정희,박성규,백상현,박찬권,박병수,안진영,최우석,박정규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Interleukin-2 (IL-2) induces T cell proliferation in an autocrine manner and provides a means by which antigen triggered T cells can be clonally expanded in vitro. During the following activation, the activity of IL-2 is mediated by specific high affinity IL-2 binding membrane receptors which are expressed shortly after activation. In this process, a 42 KD-fragment (soluble IL-2R) is continuously cleaved off and circulates as a soluble marker of T lymphocyte activation. Elevated level of soluble IL-2R has been identified in the serum of patients with malignant autoimmune and allergic disorders, systemic parasitic infection, undergoing graft versus host disease, acute or chronic lymphocytic leukemia and HIV-infection. ADA (adenosine deaminase) completes the process of differentiation of T cell and is essential for progression of T cell maturation. Therefore level of ADA is to correlated with magnitude of T cell immune response. The fact that expression of sIL-2R and ADA activity increases in peripheral blood T-lymphocytes of patients with active pulmonary tuberculosis suggests that T cell activation might have a major role in the pathogenesis of pulmonary tuberculosis. In order to evaluate the T cell immune response in pulmonary tuberculosis, we measured the serum concentration of sIL-2R and ADA activity in 17 patients with current pulmonary tuberculosis, 10 chronic inactive pulmonary tuberculosis, 10 as normal controls. (1) Current pulmonary tuberculosis had significantly higher levels of sIL-2R (237.24±95.47)when compared with those of inactive tuberculosis (78.6±11.06). and the control (68.17±15.4) group. (2) ADA activity in current pulmonary tuberculosis was significantly increased (34.41±20.63) when compared with those of inactive tuberculosis (24.7±14.36) and control (17.65± 5.94) group. (3) There was good correlation between sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group. (4) sIL-2R concentration and ADA activity was decreased significantly 6 months after anti-tuberculosis drug medication. In conclusion, sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group was increased when compared with those of inactive pulmonary tuberculosis and the control group. By the way, T cell mediated immune response was enhanced in current pulmonary tuberculosis, but in inactive chronic pulmonary tuberculosis who had treated by antituberculosis drug medication, the concentration of sIL-2R and ADA activity was nearly normal.

법랑질 접착에 대한 습윤 효과

고근호,조영곤,진철희,유상훈,김종욱,박병철,기영재,최희영,김종진 大韓齒科保存學會 2004 Restorative Dentistry & Endodontics Vol.29 No.3

This study evaluated the microleakage and interfacial gap between enamel and composite resin under the dry and wet condition of the enamel surface, V shaped class 5 cavities were prepared on the occlusal portion of extracted human molars. Samples were divided into three groups: D group (air dry for 10-15s), BD group (blot dry with moist cotton pellet), and DR group (air dry for 10-15s and rewet with Aqua-Prep F for 20s). Cavities were filled using Aelitefil composite resin after applied One-Step. Microleakage was tested by 2% methylene blue dye solution and the data were statistically analysed by Kruskal-Wallis test and Mann-Whitney test. Also Enamel-resin interface was observed under SEM. Group BD showed statistically lower microleakage than group D (p〈0.05). but there was no statistically significant difference between group BD and DR (p)0.05). At the enamel-resin interface, group D showed the gap of 2 ㎛ thickness, but group BD and DR showed close adaptation. In conclusion, the use of blot dry and rewetting agent (Aqua-Prep F) resulted in decreased microleakage and improved adhesion between enamel and resin when using One-Step.

Swivel joint를 이용한 비대칭 발치증례의 교정적 공간폐쇄

고창희,임성훈,김광원,정동기,김도영,박선주,양용근 조선대학교 구강생물학연구소 2003 口腔生物學硏究 Vol.27 No.1

Extraction therapy is popular treatment protocol in orthodontics. Generally, symmetric premolar extraction is performed. But, in some cases, asymmetric extraction is required to solve asymmetric dental alignment. But asymmetric extraction treatment has side effects and disadvantages like a) collapse of dental arch form. b) canting of occlusal plane, c) extended treatment duration. For a good treatment result, we applied the orthodontic space closing arch wire with swivel joint to allow rotational movement of arch wire segments during space closure, Now we present a case treated with orthodontic space closing arch wire with swivel joint.

치수및 치근단병소에서 interleukin-1α, interleukin-1β, tumor necrosis factor-α의 분포에 관한 연구

고현정,정관희,임성삼 大韓齒科保存學會 1998 Restorative Dentistry & Endodontics Vol.23 No.1

This study was designed to examine the tissue levels of interleukin-1α(IL-1α), interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) in inflamed human dental pulps and periapical lesions, and to determine the relationship between each cytokine and pulpal and periapical pathosis. The pulps used in this experiment, were obtained in routine endodontic treatment and the periapical lesions in periapical surgery after clinical diagnoses were performed. These specimens were divided into four groups as normal pulp group(control group, n=9), acute pulpitis group(n=9), chronic pulpitis group(n=10) and periapical lesion group(n=18) and stored in liquid N_2. For extract preparation, tissues were finely minced with a scalpel, and the fragments were incubated in 0.5㎖ homogenizing buffer (0.1 mol/L potassium chloride, 0.02 mol/L TRIS; pH=7.6) for two hours and grinded with glass homogenizer. Debris was removed by centrifugation and supernatants were immediately tested with enzymelinked immunosorbent assay(ELISA, R&D Co., Minneapolis, USA). Following results were obtained ; 1. The concentrations of IL-1α in all experimental groups were significantly higher than in control group(p<0.05). And the concentrations of IL-1α in periapical lesion group were somewhat higher than in two pulpitis groups, but the differences among those groups were not stastically significant(p>0.05). 2. The concentrations of IL-1β in all experimental groups were significantly higher than in control group(p<0.05), and all the experimental groups expressed similar concentrations. 3. The concentrations of TNT-α in all experimental groups were higher than in control group but only the differences between chronic pulpitis group and control group were statistically significant(p<0.05). And the concentrations of TNT-α in acute and chronic pulpitis groups were higher than in periapical lesion group but only the differences between chronic pulpitis group and periapical lesion group were statistically significant(p<0.05). 4. There was significant correlation only between IL-1α and IL-1β in periapical lesion group(p<0.05).

쪽파[Allium ascalonicum L.] 재배기간 중 Diazinon, Iprodione 및 Chlorfenapyr의 잔류랑 변화

고광용,나은식,김성헌,김상준,장영희,이규승 충남대학교 농업과학연구소 2005 농업과학연구 Vol.32 No.2

In order to know the residual pattern of pesticides and predict to the degradation period until below MRL, we experimented diazinon, iprodinon and chlorfenapyr for shallot. They were the most detected pesticide in shallot by NAQS (National Agricultural product Quality management Service) survey. In this experiment, we sprayed those pesticides 15days before harvest and analyzed 0, 1, 2, 3, 5, 7, 10, 14 day sample to establish logical equation and to calculate DT_(50). During the cultivating period, the residue amount of diazinon was changed from 1.02 mg/kg (0 day) to 0.01 mg/kg (14 day), DT_(50) was 2.19 days, and iprodione was changed from 1.45 mg/kg (0 day) to 0.14 mg/kg (14 day), DT_(50) was 4.15 days, and chlorfenapyr was changed from 1.5 mg/kg (0 day) to 0.01 mg/kg (14 day), DT_(50) was 1.97 days. The DT_(50) of double amount in those pesticides, diazinon was 2.24 days, iprodione was 4.82 days, and chlorfenapyr was 2.24 days, respectively.

四種 鹿茸의 免疫學的 效能에 關한 實驗的 硏究

고병희,소경순,김성수,김달래,김광호,송일병 慶熙大學校 1990 論文集 Vol.19 No.-

In order to investigate the effect of 4 kinds of antlers of Cervus elaphus xanthophgus(CEX), Cervus Elaphus dyboskii(CED), Rangifer tartandus articus(RTA) and Cervus nippon manthohurcus(CNM) on immune response and natural killer cell activity(NKCA), the author performed this experimental study. Delayed type hypersensitivity(DTH) and Rosette forming cells(RFC) for cell-mediated immune response, hemagglutin(HA) titers, hemolysin(HL) titers for humoral immune response, carbon clearance for phagocytic function of MPS(mononeuclear phagocyte system), and splenic natural killer cell activity(NKCA) were measured in ICR mice. The results were summarized as follows ; 1. DTH in all of the treated group was increased, as compared with the control group, with statistical significance. 2. RFC in all oof the treated group was increased, as compared with the control group, with statistical significance except for CEX and CED treated group. 3. HA titers increased in all of the treated group as compared with the control group, with statistical significance except for CEX and CNM treated group. 4. HL titers increased in all of the treated group as compared with the control group, but the statistical significance was showed only in case of CNM treated group. 5. Carbon clearance was increased in all of the treated group with the statistical significance. 6. NKCA was increased in all of the treated group with statistical significance except RTA treated group. 7. Through this experimental study in ICR mice, these findings suggest that CEX, CED, RRA and CNM generally enhence both cell-mediated and humoral immune response, phagocytic function of MPS andNKCA except CEX in humoral immune response and RTA in NKCA.

정신분열병 환자의 간호진단 분석

고성희 대한간호학회정신간호학회 1995 정신간호학회지 Vol.4 No.2

This study is to analyze nursing diagnoses used in students' psychiatric clinical practice, and ultimately to provide basic data for efficient clinical teaching. The subjects for this study are 30 cases reported by nursing students. Data collection is done from Aug. 21 to Sep. 11 in 1994, from April 4 to June 22, and from July 3 to Sep. 16 in 1995. The findings of this study are as follows : Nursing diagnoses stated by students' nurses were 27 titles of nursing diagnosis, and 2.9 titles per patient. The frequency order of nursing diagnoses by student's nurses were 'coping, ineffective individual' 'thought process, altered' 'sensory-perceptual alterations' 'social isolation' 'social interaction, impaired' 'communication, impaired verbal' 'self-esteem, chronic low' 'self-care deficit, bathing/hygiene' 'anxiety'. In the classfication, according to 9 human response patterns, the frequency orders were 'perceiving' 'choosing' 'relating', but 'valuing' was not used. Titles and defining characteristics on the NANDA list of approved diagnoses were most frequently used by students' nurses. But many of the related factors used by students' nurses were not on the NANDA approved list. These results suggest that titles and defining characteristics on the NANDA list of approved diagnoses are very useful in psychiatric clinical practice, but the related factors are not highly of use. Further study and research are needed to develope the NANDA list in psychiatric field.

도앗섭프로그램을 활용한 학생상담 자원봉사자의 훈련연구

성희자,고유나 위덕대학교아시아태평양연구소 2004 아태연구 Vol.3 No.-

사회복지 서비스 자원이 열악한 농어촌 소도시에서 학생상담 자원봉사활동은 청소년문제와 욕구를 해결하기 위한 청소년복지 서비스자원으로서 중요한 역할을 담당한다. 이에 본 연구에서는 농어촌 지역의 청소년들에게 양질의 상담 서비스를 제공하기 위한 토대를 마련하기 위해 동사섭 소집단 훈련을 통한 학생상담 자원봉사자의 자아존중감과 내외통제력의 변화를 살펴보았다. 분석결과 학생상담 자원봉사 참여자들의 자아존중감과 내적 통제성은 대체로 높은 편이었으며 동사섭 소집단 활동을 실시한 후 이들의 자아존중감과 내적 통제성은 유의미한 수준은 아니지만 전반적으로 향상된 것을 관찰할 수 있었다. 동사섭 소집단 활동을 통한 상담훈련은 학생상담 자원봉사자들에게 상담자로서 자긍심을 향상시키고, 내적 통제성을 향상시켜 자신의 삶에 발생하는 사건에 대해 스스로 책임지고, 삶의 문제에 대한 통제력을 향상시키는데 효과가 있었다. 본 연구결과를 통해 학생상담 자원봉사자들을 상담자로서의 자질을 향상시키고, 양질의 상담 서비스를 제공할 수 있는 복지자원으로 지속적으로 활용하기 위한 방안으로 동사섭 소집단 활동의 활용가능성을 확인하였다.