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.

癩의 免疫에 關한 硏究 : 癩患者의 末梢血液 T 및 B 淋巴球 測定에 關한 硏究

殷熙哲,金原錫,金洪植,金道一 大韓癩學會 1981 癩學 會誌 Vol.14 No.1

치수유래 구심성 신경섬유의 삼차신경 감각핵군에서의 연접특성

배용철,이은희,최민기,홍수형,김현정,남순현,김영진 대한소아치과학회 2001 大韓小兒齒科學會誌 Vol.28 No.2

일차연접부위에서 악안면 영역에서 유래하는 유해자극의 전달 및 처리기전을 이해하고자 horseradish pe개xidase를 치수지배 구심성 신경섬유를 표식한 후 연수후각에서 미세구조 및 연절 양상을 분석하여 다음과 같은 결과를 얻었다. 표식종말은 소수의 큰 치밀소포가 관찰되는 종말 (S형) 및 다수의 치밀소포를 함유하는 종말 (LDCV형)등 2종류로 분류할 수 있었다. S형 및 LDCV형 표식종말의 연접양식은 유사하였으며, 다수의 표식종말이 1개 혹은 2개의 neurofile과 연접을 이루어 대단히 단순한 연접양상을 보였다. 표식종말은 가지돌기체 보다는 다수의 가지돌기가시와 연접을 이루는 빈도가 높았다. 표식종말이 세포체 및 이에 인접한 근심부 가지돌기와 연접하는 경우는 드물었으며, 소수의 표식종말에서 p-ending과 연접하는 경우를 보였다. 표식종말의 체적, 표면적, 사립체의 체적, neurofile과 접하는 면적, 활성부위의 면적, 단위표식종말당 연접소포의 수 및 연접소포의 밀도등은 넓은 범위의 계측치를 나타내었으며, 이는 5명 및 LDCV형 표식종말 사이에 유의한 차이가 없었다. 이상의 결과로 미루어보아 연수후각에서 치수유래 구심성 신경섬유 종말의 연접양식은 고유의 특징을 보이며 이는 신경회로의 기능과 밀접한 상관관계를 가지는 것으로 판단되었다. Little is known about processing mechanism of pain sensation of the oral cavity at the 1st synapse of trigeminal sensory nuclei. Serial ultrathin sections of tooth pulp afferent terminals, identified by the transganglionic transport of 1% wheatgerm agglutinin conjugated horseradish peroxidase, were investigated wih electron microscope. Quantitative ultrastructural analysis was performed on digitizing tablet connected to Macintoshi personal computer (software: NIH Image 1.60, NIH, Bethesda, MD). Labeled boutons could be classified into two types by the shapes of containing vesicles : S bouton which contained mainly spherical vesicles (Dia. 45-55 nm) and few large dense cored vesicles (Dia. 80-120nm), and LDCV bouton, which contained spherical vesicles as well as large number of large dense coredd vesicles. Most of the parameters on the ultrastruotural characteristic and synaptic organization of labeled boutons were similar between S and LDCV boutons, except shapes of containing vesicles. Majority of the labeled boutons showed simple synaptic arrangement. The labeled bouton were frequency presynaptic to dendritic spine, and to a lesser extent, dendritic shaft. They rarely synapsed with soma and adjacent proximal dendrite. A small proportion of labeled boutons made synaptic contacts with presynaptic pleomorphic vesicless containing endings and synaptic triad. Morphometric parameters of labeled boutons including volume and surface area, total apposed area, mitochondrial volume, active zone area, vesicle number and density showed wide variation and theme were not significantly different between S and LDCV boutons. The present study revealed characteristic features on ultrastructure and synaptic connection of pulpal afferents which may involved in transmission of oral pain sensation.

과민성 장증후군 환자에서 베타 아드레날린 수용체 기능의 활성도와 불안 수준

강은호,이풍렬,이준행,김현서,이종철,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.1

미용사들의 이직욕구에 관한 연구 : 직무스트레스, 근골격계 증상을 중심으로 Focusing on Musculoskeletal Symptoms and Occupational Stress

서은경,문덕환,박명희,김정원,황용식,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted to prepare the fundamental data on desire of job transfer in hairdresser and prevent the health impairment of hairdresser due to occupational stress and musculosketetal symptoms. Methods and Material : The author surveyed the desire of job transfer and muscurlosketetal symptoms and occupational stress with self-reported questionnaire to 105 hairdresser who were working in beautyshop of Busan area and also 121 student in department of cosmestology as control group. Results : The results were as follows: 1. The rates of self reported symptom were 81.0% for shoulder, 72.4% for back, 67.6% for knee, 58.1% for hand in hairdresser, and 79.3% for shoulder, 71.9% for back, 66.9% for neck, 64.5% for hand and knee in student. 2. The rate of musculoskeletal symptom by NIOSH criteria was 36.2% in hairdresser, it was higher than student group(24.8%)(p<0.1). Occupational stress of the groups by occupational stress category was high as decision latitude, skill discretion, psycological job demand, decision authority in order. 3. The results of logistic regression of related varibles with desire of quitting job by logistic regression were statistical bordline significance between desire of quilting and social support(p<0.1). Conclusion : As above results, the author suggest to prepare the preventive program an musculoskeletal symptoms in hairdresser, especially shoulder, and also to control the occupational stress to hairdresser in beauty shop because occupational stress can be a factor of desire of quitting job.

한국어 문장분석을 위한 의미사전의 설계 및 구현

김은희,양기철 木浦大學校 情報産業硏究所 1995 情報産業硏究誌 Vol.3 No.-

Preexisting lexicon for korean parsing has been built mainly based on syntactic information. However, Precise parsing of Korean sentence is difficult only with syntactic information, since korean is a partially free word-order which has frequent elimination of necessary constituents. Hence, including semantic information in the lexicon is essential in order to increase the quality of parsing. In this thesis, a prototype semantic lexicon for korean parsing is implemented. The components of the semantic lexicon are set of concepts, conceptual catalogues, conceptual relation, and a type hierarchy.

UASB 공정에 의한 고농도 축산폐수 처리시 유기물 제거와 메탄생성에 관한 연구

원철희,김승호,박은영,임재명 江原大學校 産業技術硏究所 2002 産業技術硏究 Vol.22 No.B

This research was performed to investigate the COD removal efficiency and methane production in slurry-typed swine wastes using UASB(upflow anaerobic sludge blanket)reactor. The USAB reactor was operated from 0.8 through 3.3days of HRT in a range of 3 to 15 kg TCOD/m³/day of volumetric organic loading rate. The removal rate of TCOD was increased with the increase of the HRT. The removal rate of TCOD at an HRT over 2days, became greater than 68% with the methane contents being from 70 to 80%. Methane production rates were increased from 0.27 to 0.36 m³CH₄/kg CODrem. as HRTs were increased from 0.8 to 3.3days.

Naltrexone으로 전처치된 사회적 음주자에서 음주 유발 후 음주 갈망과 혈장 β-endorphin의 변화

김은희,손인기,이영식,나철 대한신경정신의학회 2000 신경정신의학 Vol.39 No.4

연구목적: Opioid 길항제인 날트렉손은 알코올리즘 환자와 정상인의 음주행위에 영향을 준다는 보고가 있다. 그러나 날트렉손의 임상효과에 대한 기전은 아직 명확하지 않다. 이에 저자들은 사회적 음주자에서 날트렉 손의 임상효과 여부와 그 작용기전을 규명하고자 하였다. 방법: 사회적 음주자 15명을 대상으로 날트렉손을 이중맹검, 교차, 위약대조법으로 1주일간 전처치한 후, 음주 유발 검사를 통하여 알코올의 정신신테반응, 음주에 대한 갈망욕구와 혈장 β-endorphin과 ACTH, 혈청 cortisol 농도의 변화를 비교하였다. 결과: 1) NTX 전처치시 위약 전처치시보다 두통, 어지러움, 예민해짐, 피곤함, 주간 중 졸리움, 오심, 식욕감소 등의 부작용을 더 많이 경험하였으며(p<0.05), 혈청 GOT/GPT에 대한 영향은 차이가 없었다. 2) NTX 전처치시 음주갈망은 위약 전처치시와 비교하여 음주 전에는 차이가 없었으나, 음주 후 20분과 60분에서는 NTX 전처치시 음주갈망이 위약 전처치시 음주갈망 보다 유의하게 낮았다(p<0.05). 3) NTX 전처치시 어지러움증은 음주후 20분 뒤에는 두드러지지 않지만, 음주후 60분이 경과시에는 유의하게 높았고(p<0.05), NTX 전처치시에 음주 후 기타 신체적 불편감을 더 많이 호소하였으나 통계적인 의미는 없었다. 위약 전처치시 NTX 전처치시보다 기분이 상승되는 경향을 보였지만 통계적 의의는 없었다. 4) 음주 직전을 기준으로 한 음주 후 20분에서 혈장 β-endorphin 농도 변화율은 NTX 전처치시에 위약 전처치시보다 유의하게 증가하였다(p<0.05). 그러나 음주 직적을 기준으로 한 음주 후 60분에서 혈장 β-endorphin 농도변화율은 차이를 보이지 않았다. 5) 음주 직전을 기준으로 한 음주 후 20분에서 혈장 ACTH 농도 변화율은 NTX 전처치시에 위약 전처치시보다 유의하게 적은 감소율을 보였다(p<0.05). 그러나 음주 직전을 기준으로 한 음주 후 60분에서 혈장 β-endorphin 농도변화율은 차이를 보이지 않았다. 6) 음주 직전을 기준으로 한 음주 후 결정 cortisol 농도 변화율은 NTX 전처치시와 cortisol 전처치시에 차이가 없었다. 결론: NTX는 사회적 음주자에서 음주갈망의 감소를 야기하며, 이는 NTX의 신체적, 심리적 불편감 등의 간접적 결과하기 보다는 NTX의 opioid 긍정 강화체계에 대한 차단작용과 NTX의 알코올 유사효과라 여겨진다. Objectives: The present study was performed to evaluate whether naltrexone treatment are effectively lowering the urge of alcohol drinking, and to investigate the its mechanism of action. Methods: 15 healthy mals social drinkers were voluntarily participated. The experimental method was double-blind placebo-controlled cross over design. Subjects ingested a naltrexone (50mg)/day or placebo for 1 week. Plasma β-endorphin, plasma ACTH and serum cortisol levels were measured before, at 20 minutes and at 60 minutes after alcohol exposure. Subjects completed self-report questionnaires such as the visual analog scales of drink urge and the alcohol sensation scales at regular intervals. Results: 1) During naltrexone pretreatment period, subjects reported more headache, dizziness, nere-ousness, fatigue, day somnolence, nausea, and decreased appetite than placebo pretreatment period. But serum GOT/GPT levels were not significantly different between two pretreatment periods. 2) In case of naltrexone pretreatment, subjects reported significantly less urge to alcohol drink on the self-reporting urge scales, especially at post-drinking 20 minutes and 60 minutes than placebo pretreatment. 3) After alcohol challenge, subjects reported significantly more dizziness on the alcohol sensation scales in case of naltrexone pretreatment, and reported less mood elevation trend though it was not statistically significant. Other scores were not significantly different between two pretreatments. 4) Plasma β-endorphin levels were significantly different when treated with naltrexone. In case of naltrexone-pretreatment, the increasing degree of plasma β-endorphin during 20 minutes after alcohol challenge was significantly higher than placebo pretreatment. 5) Basal plasma ACTH level and basal serum cortiso level were not significantly different between two pretreatments. After alcohol challenge, only the decreasing degree of plasma ACTh levels during 20 minutes was significantly lowered in the naltrexone pretreatment than placebo pretreatment. Conclusion: Naltrexone reduced urge to alcohol drinking in social drinker. The action mechanism of naltrexone may be partially blocking opioid positive reward system and partally alcohol mimicking its property.

학교구강보건실 운영 평가에 관한 연구

민희홍,신승철,서현석,김은주,김호선 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.2

School dental clinic programs is the most active and effective programs to prevent the oral disease for school-children and it is one of the recommended programs by the advanced and welfare countries. In Korea, 15 primary schools have been established the school dental clinics in 1999 as one of the public oral health programs supported by the Ministry of Health and Welfares, and expanded more every year. 11 school dental clinics among 15 were participated for 2-years evaluation project. Such items as the structure, the process, the supply of dental services, the promotion of the health level and the community supports were evaluated through the standardization by governmental suggestions. Average score for 2-years evaluation was estimated as 81.35% as considerably good remark. In detail, score 4.74 for the structure, 22.10 for the process, 19.77 for supply of dental services, 26.22 for promotion of the oral health level and 8.53 for the community supports were calculated. In conclusion, school dental clinic programs in Korea were evaluated considerably good and they should be extended to all primary schools as possible.

도시 개발에 따른 기상장 변동의 3차원 수치해석에 관한 연구

이희철,이범주,이도훈,이은태 경희대학교 산학협력기술연구원 1999 산학협력기술연구논문집 Vol.5 No.-