판막 질환에서의 심근 섬유화 : 심근 조직을 이용한 형태학적 연구 및 혈청 생화학적 지표의 분석

강수진,박덕우,송재관,박경민,송종민,강덕현,한기훈,송현,이재원,주석중,송명근,김정선 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

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.

감귤류의 Ascorbate 및 Phenolic 획분이 N-nitrosodimethylamine의 생성에 미치는 영향

송미향,이수정,신정혜,최선영,성낙주 한국식품영양학회 2002 韓國食品營養學會誌 Vol.15 No.2

감귤류 (자몽, 레몬, 금귤, 밀감 및 오렌지)를 착즙하여 얻은 쥬스를 sep-pak C_18 cartridge를 사용하여 ascorbate 및 phenolic 획분으로 분리한 다음 pH를 달리한 in vitro 반응계에서 아질산염 소거 및 N-nitrosodimenthylamine(NDMA) 생성억제 효과를 분석하였다. 감귤류 쥬스 ascorbate 획분의 아질산염 소거능은 5ml 첨가시 pH 2.5 에서 79.9 ~ 98.6%, pH 4.2에서 48.5 ~ 86.3%였으나, pH6.0에서는 35.2% 이하였다. Phenolic 획분은 ascorbate 획분에 비해 높은 소거능을 보였으며 특히 pH6.0 에서는 ascorbate 획분에 비해 2배 이상의 높은 소거능을 나타내었다. NDMA 생성억제 효과는 phenolic 획분의 첨가시에 월등히 뛰어나 pH 2.5의 반응용액에 금귤, 밀감 및 오렌지쥬스의 phenolic 획분을 첨가했을 때 92.8% 이상이었으나, ascorbate 획분이 첨가된 경우에는 NDMA 생성 억제 효과를 거의 나타내지 못하였다. 따라서 감귤류 쥬스의 NDMA 생성억제와 관련된 주된 인자는 phenol 화합물인 것으로 사료된다. Five citrus juices were separated into a ascorbate and phenolic portion using sep-pak C_18 catridge, respectively, in order to elucidate the nitrite scavenging effect and N-nitrosodimethylamine (NDMA) formation in model system. the nitrite scavenging effect of ascorbate portion from citrus juices, in the different pH, when added with 5ml were 79.9 ~ 98.6% under the condition of pH 2.5, 48.5 ~ 86.3% at pH 4.2 and lower than 35.2% at pH 6.0. The nitrite scavenging effect was excellent phenolic portion rather than ascorbate portion. Particularly, the effect was more 2 times than ascorbate portion under the reaction condition of pH 6.0. When added the phenolic portion in the reaction mixture, NDMA formation was inhibited 92.8% or more in kum quat, mandarin orange and sweet orange juices. But the ascorbate portion was a negative response of the inhibition of NDMA formation. The inhibition on NDMA formation in citrus juice may be due to phenolic compounds were reacted.

API 기준에 근거한 RBI 절차 개발 및 소프트웨어의 구현 (Ⅱ) : 준정량적 접근법 Semi-Quantitative Approach

송정수,심상훈,권정락,윤기봉 한국산업안전학회 2002 한국안전학회지 Vol.17 No.4

During the last then years, the need has been increased for reducing maintenance cost for aged equipments and ensuring safety, efficiency and profitability of petrochemical and refinery plants. American Petroleum institute(API) developed a code, API 581 for proposing standard procedures of risk based inspection. Even though the API 581 code covers general RBI procedures, there must be some limitations. In this study, a semi-quantitative assessment algorithm for RBI based on the API 581 code was reconstructed for developing an RBI software. The user-friendly realRBI software is developed with a module for evaluating semi-quantitative risk category using the potential consequence factor and the likelihood factor. Also, inspection planning module for inspection time and inspection method for equipments are included.

경동맥 내막 절제술 후 발생한 과관류 증후군 1예

송희정,박광열,정진상,조수진,이순정,허승,김동익,이광호,이병붕 대한신경과학회 1999 대한신경과학회지 Vol.17 No.2

고속액체크로마토그래피를 이용한 혈장중 로바스타틴산의 분석 : 시료전처리로서 단백침전법 및 고상추출법의 비교 Comparison of Protein Precipitation Method and Solid Phase Extraction Method for Sample Pretreatment

송우헌,장정수,박은우,이상길,최영욱 중앙대학교 약학연구소 1997 약학 논총 Vol.11 No.-

Lovastatin(LV), one of the potent cholesterol-lowering agents, is an inactive lactone prodrug which is metabolized to its active open acid (Lovastatin acid. LVA). In order to optimize the assay procedure of LVA by high performance liquid chromatography(HPLC). solid phase extraction(SPE) method and protein precipitation method were employed for the pretreatment of plasma sample containing LV and LVA, and plasma sample was hydrolyzed under alkaline condition to transform all LV to LVA. Following pretreatment of plasma sample. 100ul of sample was injected onto a reversed-phase C_18 column and eluted with a acetonitrile-pH 3.0 phosphate buffer mixture(45:55 v/v) at a flow rate of 2.0ml/min. Ultraviolet detection was carried out at 238nm. It has been shown that all of LV in plasma was converted to LVA in vitro under alkaline condition. On SPE method, elution with acetonitrile-methanol mixture(75:25 v/v) indicated the highest recovery of LVA, but acid treatment of plasma sample before loading on SPE cartridge revealed little effect on recovery of LVA. Compared with two different pretreatment of plasma sample, SPE indicated better sensitivity and recovery.

뇌동맥류의 진단에 대한 전산화단층촬영 뇌혈관조영술과 고식적 뇌혈관조영술의 비교

송상현,윤수한,안영환,안영민,조기홍,조경기,김선용,서정호 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

Cerebral angiography has been essential for the diagnosis of the intracranial aneurysms but. is sometimes accompanied by serious complications. Resolution of CT angiography was up-graded greatly to represent the three-demensional structure of vesseles since helical CT had been introduced. We have compared 26 cases of CT angiography and 28 cases of conventional angiography in terms of specificity and sensitivity for the diagnosis detectable aneurysm diameter. configurational diagnosis and diagnostic confidency. All results showed no statistical difference between CT angiography and conventional angiography. These should suggest that CT angiography could be replaced with conventional angiography for the diagnosis of ruptured aneurysms and even of unruptured aneurysms. resulting in the introduction of first screening modality of unruptured aneurysms.

明 建國初 國家權力과 鄕村支配體制의 形成

宋正洙 전북대사학회 1991 전북사학 Vol.14 No.-

社會體育施設 實態調査 硏究 : 行政地域을 中心으로 Focus on Administrative Districts

宋錫英,鄭東求,李相哲,全海變,李正秀 한국체육대학교 부속 체육연구소 1986 체육연구소논문집 Vol.4 No.-

In modern societies, there are trends for people to engage in more positive and creative physical activities in their leisure time, which Leads to rather participant sports than spectator sports. This study was undertaken to explore the actual state of " Sports for all" facilities in Korea. The implications of the study are as follows: 1. The total numbers of "Sport for all" facilities in Korea is 20,080 ; there are 328 public facilities, 14,696 school facilities, 1,386 job-site facilities and 3,596 civil vacilitles, which indicates that Korea has got smaller number of those facilitles than the other developed countries. 2. The actual state of the facilities by each citles and counties shows the fact that Seoul has got 2,869 facilities, Incheon 434, facilities and Jeja 290 facilities. 3. The square measure for each Korean People is 0.795㎡. 4. The facilities have been set up in servral particalar events and districts. In conclusion, it is requested that all the facilities should be opened to the publics in order to anltivate the healthy mental and physical condition of peoples and to host various types of competitions, thereby promoting the sports, sport-for-all sports in particular, by means of civil-directed activities.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.