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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

유한 요소법에 의한 절편 회전자를 가진 자기저항전동기의 특성 해석

주수원,한성진,홍정표 東亞大學校 附設 情報通信硏究所 1997 情報通信硏究所論文誌 Vol.5 No.1

This paper deals with improving the characteristics of the reluctance motor with the segmental rotor. These improvements result from incorporating a shallow axial channel in the centre of the air gap face of each segment, filling of this channel with conducting material and shaping of the ends of the segment. To know the characteristics of the distribution of flux, the f.e.m. is applied on the direct-axis so that the ratio of the direct-axis and the quadrature-axis in the test machine is larger than in the conventional machine. The torque has the maximum value at the load angle of 45°as generally is expected.

H9c2 심근 세포주에서 외인성 nitric oxide가 허혈에 의한 세포 독성에 미치는 영향

정성구,장현용,김명천,고영관,정주호,배영미,박원서,김대중,유영민,김성수,임성빈 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Nitric oxide(NO) is known to have protective effects on an ischemic heart and to exert triggering effects on ischemic preconditioning. However, the effects of NO during the ischemic period have not been investigated. To investigate the role of exogenous nitric oxide in a model of ischemic heart cell death, we studied the effects of ischemic preconditioning and ischemia in a normal and an ischemic buffer. Methods: Rat cardiac myoblast cells(H9c2) were cultured in a normal and an ischemic buffered medium. For the ischemic culture of heart cells, the cells were cultured in a dessicator with GasPak for 5 hrs. In ischemic preconditioning, the cells were pretreated with ischemic buffer for 5 min and then perfused with normal medium for 30 min. For the measurement of the cytotoxicity, a MTT(3-4-Sdimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay was performed. A DAPI(4',6-diamidino-2-phenylindole dihydrochloride) staining procedure and a flow cytometry analysis were performed to confirm apoptotic cell death by ischemia. Results: Cell viability, as determined by using a MTT assay, showed that the preconditioned group treated with NO showed more cell death than with the not-preconditioned groups in both normal and ischemic buffers. But, In normal medium and not-preconditioned groups, NO showed protective effect according to the concentrations(100,1000μM) . No treatment with NO produced the different results. In normal medium, the protective effect of ischemic preconditioning was demonstrated, but no protective effect of ischemic preconditioning could be seen in the case of the ischemic buffer. The DAPI staining and flow cytometry analysis of heart cells showed characteristic apoptotic features. Conclusion: NO added in the ischemic phase had deterious effects on heart cells. Ischemic preconditioning was more harmful than ischemia alone. The toxicity of the cells was characteristic apoptosis.

分割法에 依한 電力潮流計算에 관한 硏究

鄭亨煥,周秀元,禹靖仁 동아대학교 공과대학 부설 한국자원개발연구소 1979 硏究報告 Vol.4 No.1

The Newton-Raphson Method has now gained widespread popularity in Load-Flow calculation. In this paper programming is developed with aims to improve the covergence characteristic, speed and memory requirements in the above method.

시민참여와 정부신뢰

정수현,강한솔,황은진,이정주,노승용 서울여자대학교 사회과학연구소 2012 사회과학논총 Vol.19 No.-

이 연구는 시민참여와 정부신뢰와의 관계를 분석하는데 그 목적이 있다. 이를 위하여, 이 연구에서는 시민참여를 전통적인 오프라인 시민참여와 디지털 방식인 온라인 시민참여로 그 유형을 분류하고, 오프라인 시민참여와 온라인 시민참여의 경험이 정부신뢰와 어떤 관계가 있는지를 분석하였다. 2차 자료를 활용하여 빈도분석, 교차분석, t-test, 분산분석, 회귀분석 등을 실시한 결과 먼저, 우리나라 시민참여 경험자는 약 22% 정도이며, 오프라인 시민참여 경험자는 약 12%, 온라인 시민참여 경험자는 약 15%, 그리고 온라인과 오프라인 시민참여를 모두 경험한 시민은 약 5% 정도인 것으로 나타났다. 또한, 시민참여와 정부신뢰와는 관계를 분석한 결과 통계적으로 유의미한 관계가 없는 것으로 나타났다. 오히려, t-test 및 분산분석 결과 오프라인 및 온라인 시민참여 경험자에 비하여 무경험자의 정부신뢰 수준이 상대적으로 약간 더 높은 것으로 나타났다. 시민참여의 경험 유무 만으로 정부신뢰를 설명하는데는 한계가 있음을 보여 주는 결과일 뿐만 아니라 시민참여를 제도적으로 보장하는 것에서 나아가서 시민참여가 실질적 효과를 높일 수 있도록 시민참여과정에서 정부와 시민의 보다 적극적인 노력이 필요함을 보여주는 결과라 하겠다. Trust in government adds legitimacy to political system, provides social stability, and helps government to work effectively. In addition it increases cooperation between governments and citizens, and improves effectiveness of government affairs. However, citizens' trust in government has been quite low sine 1990s. In Korea, citizens' trust in government dropped after financial crisis in late 1990s. Various literatures indicated that citizen participation is one of the best ways to increase citizens' trust in governments. Especially as information technology increases, it is expected that citizens acquire information about different policy areas, and actively participate in surveys, discussion, and policy evaluation through internet. This research attempts to prove the relationship between citizen participation and trust in government by comparing online and offline citizen participation. The research utilized 2nd dataset from 'the influence of information on citizens' participation in policy-making.' With various statistical techniques such as frequency analysis, cross tabulation, ANOVA, and regression analysis, the characteristics of offline and online policy participants are examined. The results showed that citizens, who participate in policy-making processes more actively both online and offline, trust in government less. Comparing online and offline participation, online participants distrusted government more than offline participants. Such variables as policy competitiveness, democracy in government, quality of government, and transparency in government have direct influences on trust in government. However, citizen participation is not statistically significant. Key Words:Citizen Participation, Traditional Citizen Pariticipation, Digital Citizen Participation, Trust in Government.

백서 해마에서 카이닌산에 의한 조기유전자의 발현과 p42, p44 MAPK 및 EIK-1 인산화의 발달 단계에 따른 변화

정희연,김수진,김종흔,정선주,박주배,김용식,조수철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.4

연구목적 : 어린 백서에게 카이닌산(kainic acid, KA)을 주사하여 발작을 일으킨 후, 해마에서 조기유전자 -c-fos, junB, 및 TIS1의 발현 유도 양상을 발달 단계별로 조사하여 전기경련충격(electroconvulsive shock, ECS)에서의 결과와 비교함으로써 백서 뇌 신호전달계의 성숙과정을 파악하고자 하였다. 그리고 KA 주사후 p42, p44 mitogen activated protein kinase(MAPK)의 인산화 및 그에 의해 활성화되는 것으로 알려진 전사인자 Elk-1의 인산화를 관찰하여, KA 주사후 MAPK 신호절달계를 통한 c-fos의 발현로 알려진 전사인자 Elk-1의 인산화를 관찰하여, KA 주사후 MAPK 신호전달계를 통한 c-fos의 발현 경로를 발달 단계별로 밝히고자 하였다. 방 법 : 생후 7, 14 21일 된 수컷 백서에서 KA를 복강내 주사한 후, 백서 해마에서 조기유전자의 발현 양상은 northern blot analysis로, p42, p44 MAPK와 Elk-1의 인산화는 immunoblotting으로 관찰하였다. 결 론 : 생후 7일된 백서의 해마에서는 ECS와는 달리, KA에 의한 세 가지 조기유전자의 발현이 관찰되지 않았다. 그러나 생후 14일부터 이들 조기유전자의 뚜렷한 발현을 관찰할 수 있었고 생후 21일에는 성숙한 백서와 같은 수준의 발현 양상을 볼 수 있었다. 세 가지 유전자 모두 백서의 연령과 KA 주사 후 시간에 따른 발현 유도 양상은 비슷하였다. p42, p44 MAPK는 생후 7일부터 상당한 수준의 기저치 인산화가 관찰되었으나, KA에 의한 인산화 증가는 생후 14일부터 관찰되었다. Elk-1의 인상화 역시 생후 7일부터 높은 수준으로 관찰되었으나 KA 주사 후 시간에 따른 Elk-1 인산화의 변화는 관찰할 수 없었다. 결 론 : ECS와 KA가 조기유전자 발현 양상에 차이를 보이는 것은 이들 유전자의 발현과 관련되어 활성화되는 신호전달경로의 차이 때문으로 생각된다. 백서 해마에서 KA에 의한 MAPK 활성화에 관여하는 신호 전달 기구는 연령이 높아짐에 따라 점차 성숙하고, MAPK의 활성화로 전달된 신호는 Elk-1 이외의 다른 경로를 통해 c-fos 발현을 조절하는 것으로 추측된다. Objectives : In order to investigate the maturational process of intracellular signal transduction system in rat brain, we studied the induction of the immediate early genes(IEGs)-c-fos, iunB, and TIS1 in each developmental stage after kainic acid(KA)-induced seizure in young rat hippocampus and then compared these with the results after electroconvulsive shock(ECS) And to elucidate the induction mechanism of c-fos via mitogen-activated protein kinase(MAPK) by KA in each developmental stage, we investigated the phosphorylation of p42, p44 MAPK and Elk-1 after KA treatment in young rat hippocampus. Methods : We examined the induction patterns of IEGs by northern blot analysis, and the phosphorylation of p42, p44 MAPK and Elk-1 by immunoblotting in rat hippocampus at post-natal day 7, 14, and 21(P7, P14 & P21), respectively after intraperitoneal injection of KA. Results : Unlike ECS, KA did not induce c-fos, junB, and TIS1 in P7 hippocampus. But these genes were apparently induced at P14 and to an adult level at P21. These three IEGs showed similar temporal patterns of induction in each developmental stage. Although the basal level of phosphorylated 42p, 44p MAPK was considerable in P7 rat hippocampus, the increase or phosphorylation after KA treatment was observed at P14. While the phosphorylation of Elk-1 was detected with high basal level in P7 rat, the amount of phosphorylated Elk-1 was not changed after KA treatment. Conclusion : Our results suggest that the differences in IEGs induction patterns between KA and ECS may be due to the differences in the activated signal transduction pathways. And our results also implicate that the signal transduction system involved in MAPK phosphorylation after KA treatment mature with aging and c-fos induction via MAPK activation may be regulated through some pathways other than Elk-1 in rat hippocampus.

프로 야구선수와 아마추어 야구선수들의 최대운동시 호흡순환기능에 대한 비교 연구

문용수,김정주 경희대학교 체육과학연구소 1999 體育學論文集 Vol.27 No.-

The purpose of this study is to investigate the cardiorespiratory function of the Professional baseball player and amateur baseball player. For this study, the total of 37 subjects were selected including 9 professional baseball players, 10 college baseball players,10 junior high school baseball players, and 8 non-athlete college students. The results of the study were as follows; 1.In factors of rest HR showed in CG 81.36±5.88beats/min, HBG 73.71±4.36beats/min, PBG 67.34±4.30beats/min, UBG 64,58±5.41beats/min. Among these group there was significantly(p=.0001). In factors of HRmax showed in CG 203.01±4.38beats/min, HBG 200.83±9.38beats/min, UBG 192.15±7.26beats/min PBG 186.23±8.86beats/min. Among these group there was significantly(p=.0003). 2.In factors of TVE showed in PBG 2676.67±386.78mlf/min, UBG 2519.30±275.40ml/min, HBG 1992.40±393.77ml/min, CG 1935.13±627.36ml/min. Among these group there was significantly(p=.0010). In factors of VEmax showed in PBG 141.79±25.94l/min, UBG 127.85±9.64l/min, HBG 99.44±23.68l/min, CG 94,15±23.32l/min. Among these group there was significantly(p=.0001). 3.In factors of VO2max showed in PBG 4413.67±581.42ml/min, UBG 4077.00±239.72ml/min, HBG 2913.90±379.45ml/min, CG 2513.00±441.88ml/min. Among these group there was significantly(p=.0001). In factors of VO2/kg showed in PBG 59.09±5.81ml/kg/min, UBG 57.79±2.29ml/kg/min, HBG 46.13±3.64ml/kg/min, CG 39.22±5.20ml/kg/min. Among these group there was significantly(p=.0001). 4.In factors of VCO2max showed in PBG 5937.67±970.59ml/min, UBG 5165.30±627.79ml/min, HBG 3713.20±635.47ml/min, CG 3319 13±624.26ml/min. Among these group there was significantly(p=.0001). 5.In factors of RR showed in HBG 62.70±16.03f/min, PBG 59.33±7.47f/min, CG 58.50±25.76f/min, UBG 54.30±3.30f/min. Among these group there was not significantly. 6.In factors of VO2/HR showed in PBG 24.96±2.09ml/beats, UBG 24.71±1.5 ml/beats, HBG 14.73±2.25ml/beats, CG 12.68±2.27ml/beats. Among these group there was significantly(p=.0001).

외상성 흉·요추접합부 파열골절의 Kaneda 기구를 이용한 내고정술에 대한 임상적 검토 : Results of Anterior Decompression and Stabilization with Kaneda Device

장주호,김수한,정신,김재휴,강삼석,이제혁 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.4

The authors report clinical results of twenty-three traumatic thoracolumbar burst fractures treated by internal fixation with Kaneda device after anterior decompression during recent three years. Thoracolumbar injuries made up 28.9% of total spinal injuries and the burst fractures treated by anterior decompression and stabilization with Kaneda device constituted 19.0% of all spinal injuries. The burst fractures occurred most frequently at the age of twenties and thirties. The main causes of injury were fall and vehicle accident. Superior end-plate fracture type was most common according to the types of burst fracture. The first and the second lumbar vertebrae were frequently involved. No patient showed neurological deterioration after surgery. Conus medullaris lesions in burst fractures of the thoracolumbar junction have a high potentiality for functional recovery because the lesions are not due to discontinuity or severe crush injury but due to simple compression by bony fragments. The Kaneda device offered enough stability to enable early ambulation with good alignment and solid fusion.

폴록사머-폴리아크릴산 IPNs의 약물 조절 방출

변은정,박주애,이승진,김길수 梨花女子大學校 藥學硏究所 1998 藥學硏究論文集 Vol.- No.7

Poloxamer-poly(acrylic acid)(PAA) interpenetrating polymer networks (IPNs) were prepared via matrix polymerization of acrylic acid with poloxamer prepolymer. The equilibrium swelling of poloxamer/PAA IPNs was determined in various pH medium. The swelling of poloxamer/PAA IPNs was more affected by pH difference compared with the swelling of homo PAA gel due to protonation and deprotonation of the PAA network. followed by reversible formation and dissociation of the interpolymer complex due to hydrogen bonding between acidic hydrogens and ether oxygens. Nonionic/anionic/cationic drugs were incorporated into IPN matrices as a model drug and their release behavior was studied. Nonionic drug revealed release patterns depending solely on pH dependent swelling kinetics. In contrast, the release of ionic drugs was significantly affected by ionic drug-polymer interaction as well as the swelling kinetics.