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        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.

      • 이방향성 형상기억합금을 이용한 공동 주택용 방화 댐퍼 설계 연구

        황성태,이찬희,장진수,변창수,히식수렝,이상욱 순천향대학교 산업기술연구소 2022 순천향 산업기술연구소논문집 Vol.28 No.2

        The purpose of this paper is to redesign, compare, and study using bi-directional shape memory alloy spring to compensate for the shortcomings of the existing fire damper performance. Through the spring constant measurement experiment, using the difference in force between the coil spring and the shape memory alloy spring, the damper closes when the set temperature is reached, and opens again when the temperature is lowered. In addition, the internal structure was redesigned through smoke leakage experiments. As a result, semi-permanent usable dampers were modeled.

      • KCI등재

        Clozapine 투여후 발생한 급성 간염

        장순주,이호택,백주희,이상연 대한신경정신의학회 1999 신경정신의학 Vol.38 No.1

        Clozapine 투여 후에 급성 간염이 발생했던 두 명의 환자에 대한 증례로, 두 명 모두 이전에 약물에 이한 간염이 발생한 과거력이 있었던 환자로서 무증사의 급성 간염이 발생한 후에 보존적 치료 후에 호전 되었다. 간염이 발생한 후에 간효소수치에 대해 정기적으로 검사를 하면서, 사용하고 있던 clozapine의 용량을 낮춘 후 간장제를 투여함으로써 간효소수치는 정상화되었다. Clozapine과 비교하면 clozapine은 간세포의 cytochrome P450에 영향을 미치는 것으로 생각되고 있고 chlorpromazine은 간내 담즙저류에 영향을 미치는 것으로 생각된다. 과거 약물에 의한 간염을 경험한 환자는 clozapine에 의해 유도된 감염에 보다 취약성을 보일 가능성이 있으며, 이런 관점에서 이전의 간 기능 이상을 경험했거나 물질 사용 장애 등의 병발이 있을 경우 정기적인 간기능 평가가 임상적으로 중요할 것으로 판단된다. The authors report two cases of clzapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protections, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.

      • 분해성 고분자를 이용한 지속성 비료에 관한 연구

        장상희,신부영,조무환,이일희 嶺南大學校 環境問題硏究所 1997 環境硏究 Vol.16 No.2

        요약문농작물에 사용된 비료중 30~705가 농작물의 영양분으로 이용되고, 나머지는 지표수 에 의하여 하천으로 유입되거나, 지하수로 스며든다. 이러한 이유로 경제적 손실과 더불어 지하수에 질소 성분이 농축되어 식수 오염에 큰 영향을 미친다. 본 연구에서는 고분자 가공 기술을 응용하여 120。C에서 무정형 폴리 프로필렌과 요소비료를 혼합하여 지속성 비료 제 조를 제조하였다. 제조된 지속성 비료는 25。C 수중에서 비료성분의 방출속도를 측정하였 다. AbstractIt is estimated that only 30∼70% of the fertilizer applied in agriculture is used for plant nutrition, the rest is carried away by ground water or lost through mtrification-denitrification. Apart from the economic loss due to wastage, severe environmental problems arise due to increasing nitrate concentration in public drinking water. The fertilizer urea was mixed with APP (atactic polypropylene) by super mixer at 120 'C. The rate of fertilizer release was determined by checking dissolution rate in water at 25。C.

      • 모 통신관련, 사업장 연작업자들의 건강수준 평가

        장덕희,황보영,리갑수,김화성,이성수,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

        To evaluate the health status of lead workers in telecommunication industry, author studied 369 male workers working in a telecommunication industry. Study variables chosen were blood zinc protoporphyrin(ZPP), hemoglobin, serum glutamic oxalacetic transaminase(SGOT), serum glutamic oxalacetic transaminase(SGPT), γ-glutamyltrans-peptidase(GGT) and hepatitis B virus antigen and antibody. Personal data such as smoking and drinking habit, work duration were also collected. 15 lead related symptom questionnaires were provided to all lead workers and filled up by themselves and reconfirmed by physician. The results were obtained as follow; 327 workers(89%) among 369 workers were healthy and 42(11%) workers abnormal health state. 9 workers were disease state among 42 workers those who were abnormal health state. The most frequent disease was liver disease(52.4%), and next was hypertension(26.2%) and then anemia(9.5%), hyperlipidemia(4.8%) and pulmonary tuberculosis(4.8%) in order of frequency. There was no case of lead intoxication. The mean of blood ZPP concentration of study subjects was 14.4±6.9㎍/㎗ and maximum blood ZPP concentration was 48.0㎍/㎗. The means of GOT, GPT and GGT were 29.4±10.0unit/L, 19.7±14.4unit/L and 38.7±31.5unit/L, respectively. The prevalence rate of hepatitis B virus antigen was 6.8% and the one of hepatitis B virus antibody was 43.6%. The symptoms with high prevalence rate above 40% were six; 'loss of appetite', 'frequent numbness of fingers or feet', 'feeling tired or fatigue generally', 'becoming nervous or sensitive to not important things', 'feel dizziness when standing up', and 'feel sleepy frequently'. The prevalence rate of symptoms were increased by the increase of age. The prevalence rate of symptoms were higher in smoking group and drinking group than non-smoking group and non-drinking group, respectively.

      • KCI등재

        大邱市 所在 老人福祉會館 利用者의 虐待經驗 實態

        장세희,권진희,황병덕,이성국 대한보건협회 2003 대한보건연구 Vol.29 No.1

        The purpose of this study is to examine current status of elderly abuse by their own children. The study was performed with sample group of 385 people over 60 years old(Male: 135, Female: 2-50) Daegu city residents, who attended the senior welfare center. By categorizing specific type of abuse experience, the study showed B.l%(male: 25.2%, female: 22.0%) of verbal * psychological abuse, 4.9%(male: 3.7%, female: 5.6%) of permissive abuse, and 4.7%(male: 5.2%, female: 4.4%) of financial abuse. There was no record of physical abuse experience. In the review of elderly abuse experience following general characteristics, especially in case of female elderly, the difference in verbal psychological abuse experience was observed depending on the existence of spouse and composition of family. And there was also a difference in financial abuse experience related to health condition. In the study of elderly abuse experience according to the financial status, the female elderly who were a pool economic status had experienced comparatively high level of verbal . psychological abuse. In the review of reaction against abuse, direct confrontation(35.0%) was the most dominant among male elderly, however, majority of female elderly(56.5%) was found to be bear with the suffer . The main reason for such endurance was for the sake of own children . There was only one elderly(0.9%) who had ever reported to the police with abuse experience.

      • SCOPUSKCI등재
      • 장기간의 장거리 달리기가 골대사 마커에 미치는 영향

        장성동,이은희,홍명엽,문성진,김주혁,이윤관,김영준 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

        This study is purposed to analyse the effects of long-term & one-time 10km running exercise from bone metabolic marker change on bone metabolism. 7 male members(18.6±1.08) from a marathon club were subjected to the study. They were allowed to do long-term 10 km running training once a week for 6 months. And bone metabolism mark was determined according to the respective times : before/after 6 months training, before/after 10 km race, one day after the race, 3 days after the race. The examination items of bone metabolism mark were serum calcium, phosphorus, paratyroid hormone, osteocalcin, calcitonin, alkaline phosphatase in blood and calcium, phosphorus, deoxypyridinolin in urine. The results of study were as follows; 1) There was no change in deoxypyridinolin and alkaline phosphatase but there was significant change in calcitonin, paratyroid hormone and osteocalcin(p<.01). 2) There was no change of Calcium in serum and urine but there was significant change of phosphorus in blood(p<.01). To make a conclusion, it is determined that long-term 10 km running at low intensity and low frequency tends to restrict bone metabolism circulation, but exercise at a little high level activates bone metabolism into building up bones and absorbing bones and finally shows up high bone metabolism circulation, which is inferred to have an effective influence on bone health. It is considered there is a possibility that different exercise intensity, even same kind of exercise, influences on bone metabolism sdifferently.

      • 카오틱 신경망을 이용한 비선형 시스템 모사에 관한 연구

        장창화,박원우,김상희 金烏工科大學校 1998 論文集 Vol.19 No.-

        In this paper, we investigated the identification of a nonlinear dynamic system and chaotic system using chaotic neural networks. Because of chaotic characteristics and self-connections in neuron itself, and interconnections between neural network identifiers could showed good performance in highly nonlinear dynamics such as chaotic system. Simulation results for some nonlinear dynamic system and the chaotic system with chaotic responses were presented to demonstrate robustness of chaotic neural network identifier.

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