한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

Tonsillectomy as prevention and treatment of sleep-disordered breathing: a report of 23 cases

Woo, Jae-Man,Choi, Jin-Young Korean Association of Maxillofacial Plastic and Re 2016 Maxillofacial Plastic Reconstructive Surgery Vol.38 No.-

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

Analysis of eco-corridor usage status of mammals in Odaesan National Park

Sang Jin Lim,Ki Yoon Kim,TaeJun Lee,Woo Chan Lim,Ji Hong Min,Hyeong Woo Ji,Baek Soon Choi,Tae Il Kim,Hyo Nam Kim,Hee Bok Park,Yung Chul Park 강원대학교 산림과학연구소 2017 강원대학교 산림과학연구소 학술대회 Vol.2017 No.11

We investigated species, ecological pathway type, and mammal size using two eco-tunnels from trail-camera data. The analyses of the camera data showed that 12 mammalian species from 8 families of 5 orders used Jin-gogae eco-corridor (bridge type) and 14 mammalian species from 9 family 5 orders were found at Odaesan eco-corridor (tunnel type). At both eco-corridors, water deer used eco-corridor most frequently, and then secondly racoon dog did. The analyses by mammal size (small, medium, and large) showed that large-sized mammals were found in high ratio at the bridge type of the eco-corridors. In case of medium-sized mammals, utilization ratio of the tunnel-typed corridor was 42%, whereas that of the bridge-typed corridor was 24%, showing 1.8 times higher usage.

Analysis of monitoring Road-kill in Odaesan National Park

Sang Jin Lim,Ki Yoon Kim,Woo Chan Lim,Hyeong Woo Ji,Baek Soon Choi,Tae Il Kim,Hyo Nam Kim,Ji Hong Min,Hey Ri Kim,Eui Kyeong Kim,Yung Chul Park 강원대학교 산림과학연구소 2017 강원대학교 산림과학연구소 학술대회 Vol.2017 No.11

We surveyed mammalian roadkill at the National Route 6 (Jin-gogae to Songcheon, 18㎞) and a local road 446 (Odaesan National Park office to Sangwon-temple, 12㎞) in Odaesan National Park. Data of the surveys were analyzed by year, month, and species. Roadkills of 226 individuals were found at the survey areas. Of them, the road-killed 131 mammal individuals, 44 bird individuals, 40 reptile individual and 11 amphibian individuals were found during the survey period. High ratio of the road-kills was observed in mammals than the other animals. Among mammalian species, high ratio of the road-kills was observed in squirrels. There were road-kills of three endangered species, containing otters, yellow-throated marten and leopard cats. According to the analyses of annual road-kills, roadkills of 104 cases were occurred and highly frequent in 2014, following by roadkills of 81 cases in 2015, and then those of 41 cases in 2016. Most ases of the roadkills occurred in summer (June to September). The results will contribute to establishing management for reduction of roadkill in Odaesan National Park.

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.

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

곰소만에 있어 바지락포자충, Perkinsus sp.의 출현에 관하여

박경일,최광식,최진우,PARK Kyung-Il,CHOI Kwang-Sik,CHOI Jin-Woo 한국수산과학회 1999 한국수산과학회지 Vol.32 No.3

이 연구를 통하여 바지락 대량 폐사가 발생한 전라북도 곰소만에 서식하고 있는 패류, 바지락, R. philipinarium, 굴 C. gigas, 피조개, S. broughtonii, 피뿔고둥, R. venosa, 등을 대상으로 바지락포자충, Perkinsus sp. 감염 여부 및 정량적인 분석을 수행하였다. 바지락포자충의 감염 진단은 Ray(1952)의 방법에 따라 혐기성배양액인 FTM(Fluid Thioglycollate Media)을 이용하여 배양하였으며, Rugol's iodine으로 염색한 후 해부현미경 하에서 검사하였다. 바지락포자충의 감염 정도는 Mackin (1961)의 기준을 따랐으며 일부 시료는 Choi et al. (1989)의 정량적인 방법에 따라 NaOH로 처리한 후 혈구 계수기로 계수하였다. FTM 분석 결과 곰소만에서 채집된 모든 바지락 개체들은 바지락포자충에 감염된 것으로 나타나 감염율 (prevalence)은 $100\%$였다. Mackin의 기준에 따른 감염 정도 판정에서 평균 2.87로 나타나 중간 정도의 감염 정도를 나타냈다. 바지락 육중량 1g 당 바지락포자충의 개체수는 평균 709,028 개체였으며, 바지락 1개체당 최고 4,091,667 개체의 바지락포자충이 발견되었다. 곰소만에서 채집된 패류를 대상으로한 FTM 검사 결과, 굴에서는 바지락 포자충이 전혀 발견되지 않았으며, 새로막과 피뿔고둥에 대한 조사에서는 피조개 2 개체에서만 각 각 6, 10 개의 바지락 포자충이 발견되었고 피뿔고둥에서는 전혀 발견되지 않았다. 조직병리학적 관찰결과 바지락 아가미의 연결조직에서 무정형의 결절에 쌓여있는 직경 $6\~10\;\mu$m의 tropozoites를 발견하였다. 바지락의 비만도는 개체의 각장이 클수록 낮게 나타나는 경향을 보였으며, 바지락 포자충의 감염정도는 각장이 클수록 높게 나타났다. 바지락포자충은 개체에서 개체로 감염되는 관계로 바지락밀도가 높은 지역에서는 그 전염 속도가 높은 것으로 알려져 대량폐사의 원인 중 하나는 밀식으로 판단되었다. Mass mortality of the Manila clam, Ruditapes philippinarum has been reported all along the west and south coast of Korea for the past several years. As a pathogenic agent, Perkinsus sp., an endoparasitic protozoan has been identified in this study and believed to be responsible for the mass mortalities. Prevalence and infection intensity of Perkinsus sp. was investigated from a Manila clam population inhabiting at Komsoe Bay in the west coast where mass mortality of the clam has been reported. A total of 142 Manila clam, 50 oyster, Crassostrea gigas, 10 ark shell, Scapharca broughtonii, and 5 predatory gastropada, Rapana venosa were examined for the presence and the quantity of Perkinsus sp. Ray's fluid thioglycollate medium method (FTM method) with modified Mackin's infection intensity scale and Choi's quantitative method were used in detecting and quantifying the parasite. All individuals of R. philippinarum examined in this study were infected with Perkinsus sp., indicating $100\%$ prevalence while none of the oysters and the gastropods exhibited the parasite. Six to ten individual hypnospores of Perkinsus sp. were counted from the ark shells. The number of hypnospores in the clam tissues varied from 16,667 to 4,091,667, with a mean number of 1,077,628. Average infection intensity according to Mackin's was 2.87, indicating a moderate infection. A negative correlation was observed between the number of Perkinsus sp. in the tissue and the condition index, a ratio tissue wet weight to shell cavity volume. The clam size and the infection intensity in terms of total number of parasites were positively correlated; the bigger clam, the heavier infection. Such high number of Perkinsus sp. counted in the clams could be enough to cause physiological disturbance of clams, such as retarded growth and reproduction. It is also believed that such a high infection leads mortality of the clam via continuous draining of the energy by metabolic activities and reproduction of the parasites. Correlation between the condition index and the infection intensity observed in this study supports this hypothesis.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.

冬蟲夏草의 抗轉移와 免疫增進에 關한 硏究

최우진,유화승,이용연,서상훈,조정효,이연월,손창규,조종관 대전대학교 한방병원 2000 惠和醫學 Vol.9 No.2

This experimental study was carried out to evaluate the effects of Cordiceps sinensis on the antimetastasis and immune activity. In order to investigate the effect of Cordiceps sinensis, the followings were performed; Cytotoxicity, inhibition of MMP-2 & MMP-9 gene expression, fraction of CD4+, CD8+, CD19+ in splenic cell, the moprphological change of splenic cells, gene expression of IL-12(p35), IL-12(p40), IFN-?? and splenic cell proliferation by CS-E. The results were obtained as follows. 1. CS-E did not present cytotoxic effect on L+14, B16-F10 melanoma cells and HMCB. 2. CS-E inhibited MMP-2 and MMP-9 gene expression more effectively compared with control group. 3. CS-E inhibited invasion of B16-F10 melanoma cells more effectively compared with control group. 4. CS-E helped CD4+, CD8+, CD19+ expression more effectively compared with control group. 5. CS-E activated phagocytic cells in spleen more effectively compared with control group. 6. CS-E helped IL-12(p35), IL-12(p40), IFN-?? gene expression in splenic cell more effectively compared with control group. 7. CS-E activated splenic cell proliferation more effectively compared with control group. From above findings, it is suggested that CS-E is able to inhibit metastasis of cancer and activate immune response system.