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.

진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암공동연구소 2006 암공동연구소 업적집 Vol.5 No.

Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472) 연구배경 : 일차항암화학요법 후에 생존의 이득을 얻었음에도 불구하고 비소세포폐암 환자들의 대다수가 결국은 재발하거나 진행성 병변을 보인다. 이에 저자들은 기존의 여러 연구에서 보고 된 구제요법으로서 docetaxel의 항암효과와 비교적 적은 독성의 결과를 바탕으로,platinum을 근거로 한 항암화학요법을 시행 밖았으나 개발되거나 진행된 비소세포폐암 환자들을 대상으로 docetaxel 단독요법의 치료효과와 부작용에 대하여 알아보고자 하였다. 방법 : 조직학적으로 비소세포폐암으로 진단을 받고 platinum을 근거로 한 항암화학요법을 받았으나 재발 또는 진행성 병변을 보인 31명의 환자들을 대상으로 docetaxel 75 mg/m² 또는 100 mg/m²을 3주마다 정주하였다. 임상기록을 통한 후향적인 방법으로 분석하였다. 결과 : 1) 재발 또는 진행성 병변을 보인 31명중 남녀 비는 24:7이고 중앙연령은 60세였다. 2) 반응평가로 완전 관해는 없었고 부분관해는 14명(45.2%), 불변이 10명(32.3%), 진행이 7명(22.6%)으로 전체적인 반응율은 45.2%이었다. 3)중앙생존기간은 12.5개월(95% 신뢰구간: 7.3개월 17.6개월) 이었고, 1년 생존율은 52%였다. 무진행생존기간의 중앙값은 3.0개월(95%신뢰구간: 1.6개월 -4.5개월)이며, 반응군에서의 중앙반응지속피간은 3.7개월(95% 신뢰구간: 3.0개월 - 4.4개월)이었다. 4) 60세 미만인 경우(20.1 months vs 6.6 months. p=0,0105), 조직학적 아형이 선암일 경우(25.6 months vs 7.9 months, 0=0.0055) 통계적으로 유의한 생존기간의 증가가 있었다. 5) 부작용으로 3도 이상의 백혈구 감소증은 12명(38.7%),호중구 감소증에 동반된 발열은 6명(19.3%),감염이 동반된 호중구 감소증은 4명(12.9%)에서 발생했다. 치료와 관련되어 1명이 사망하였다. 6) Docetaxel 용량에 따른 생존기간의 차이나 독성의 차이는 없었다. 결론 : Platinum을 근거로 하는 항암화학요법으로 치료받은 후 재발 또는 진행성 병변을 보이는 비소세포폐암환자들에게 docetaxel을 투여하는 것은 비교적 안전하고 효과적인 항암치료법으로 사료된다.

진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암연구소 2006 암연구소 업적집 Vol.5 No.-

Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472)

간세포암과 하대정맥 막성폐쇄의 치료 후 호전된 백혈구파괴혈관염 1예

이준엽 ( Jun Yeob Lee1 ),이주원 ( Ju Won Lee1 ),이진욱 ( Jin Wook Lee ),박현준 ( Hyun Joon Park ),장국환 ( Gook Hwan Jang ),김다정 ( Da Jung Kim ),김선민 ( Sun Min Kim ),한병훈 ( Byung Hoon Han ),정규식 ( Gyoo Sik Jung ),김근태 ( 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

저자들은 하지 자색반과 고환 통증으로 내원한 알코올성 간경화증 환자에서 LCV의 원인 감별하는 과정에서 HCC와 하대정맥 막성폐쇄를 진단하고 이에 대한 치료 후 LCV의 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature. (J Rheum Dis 2015;22:322-326)

중합효소연쇄반응을 이용한 도말양성 폐결핵 환자에서의 결핵균 DNA 검출방법에 관한 연구

이종진,김애경,조해정,한표성,홍석철,김주옥,김선영 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Polymerase chain reaction (PCR) is the most sensitive and rapid method for the diagnosis of M.tuberculosis infection. Many reports have shown different methods for mycobacterial DNA extraction, but revealed many differences in simplicity and time-consumption. We studied which method was the best among 7 different ones for DNA extraction from 32 smear-positive sputa, using PCR of targeting 123bp DNA fragment of IS6110. The methods were the following : SDS-Microwave oven method, NaOH Lysis method, Triton X-100, Proteinase K method, Lysis buffer method. SDS-Proteinase K method, Bead Beater method, and Bead Beater/CTAB method. The amplification products were identified by electrophoresis on ethidium bromide-stained agarose gels, and confirmed by restriction enzyme, Southern blot hybridization, and DNA sequencing. All 32 cases were positive (100%) by the 7 different methods. It took 1 hour or more to detect DNA in SDS-Microwave oven method, NaOH Lysis method, and Bead beater/CTAB method. It took 2 hours or less in the others. SDS-Proteinase K method and Bead Beater/CTAB method were simpler and more convinient than the others. These results suggest that SDS-Proteinase K method and Bead Beater/CTAB method might be better than the others for the extraction of mycobacterial DNA in terms of simplicity and time-consumption, although all the methods were sensitive.

Microcapsule을 이용한 생물학적 처리방법에 의한 오·폐수 중의 탈질소화에 관한 연구

이상호,최재선,송주영 國立 昌原大學校 産業技術硏究所 1996 産技硏論文集 Vol.10 No.-

Various experiments were conducted to test denitrification ability of immobilized Paracoccus denitrificans on calcium alginate microcapsules from synthetic waste water. Paracoccus denitrificans one of a typical denitrifying strain, showed good denitrification ability on both as a immobilized strain and as a strain itself. Calcium alginate microcapsule wall did'nt play a role to interrupt the diffusion rate of substrate in and product out. This system showed a possibility for the development of denitrifying apparatus if the immobilization technique could be improved.

노후아파트의 리모델링에 대한 거주지의 요구 경향

이선녕,주서령 대한가정학회 2003 Human Ecology Research(HER) Vol.41 No.5

The deteriorated apartments make a social problem in now a days. After all, a new alternative plan for deteriorated apartments such as the remodelling concept must be considered. This study airns to survey the needs levels among residents in deteriorated apartments relating to remodelling. I might provide the basic data which could be used for the analysis of consumers in the future implementation of deteriorated remodelling projects. The analytical methods applied for this study were t-test, one-way ANOVA, post-hoc estimation(Scheff test) by the SPSS 10.1 for Windows program. The analysis of the need levels for the areas of remodelling, by the family characteristic variable, residence value viewpoint, and residence satisfaction level, indicated that the demand level for 'equipment' was the highest, followed by the order of 'structure' and 'interior'. The need levels fo r'security', 'parking lot', 'public facilities in apartment block', and 'landscape' were generally low but in the group of high income, the need levels were comparatively high.

Compass 연산자를 이용한 Edge의 방향정보 표현

이병일,최현주,최흥국,전순미 인제대학교 1998 仁濟論叢 Vol.14 No.1

에지(edge)의 검출은 영상처리를 하기 위한 전처리 단계로서 중요하고도 기초가 되는 부분이다. Compass 기울기 연산자는 방향에 따른 마스크를 사용하여 에지를 검출하여 주는데, 본 논문에서는 이러한 Compass 기울기 연산자를 이용하여 찾아지는 에지를 방향에 따라서 색상을 지정하여 표현함으로써 에지 정보의 방향성을 시 각화하도록 하였다. 예제 이미지는 임의의 타원으로 구성된 실험용 이미지와 다른 하나는 쥐와 운동 신경조직을 현미경으로 확대하여 본 이미지이다. Digital Image Processing is divided into two branches. One is Improvement of Image Information which helps human beings to understand image, and another is Image Data Analysis which helps the machine to have cognizance of image. Edge Detection is indispensable part to apply two branches, for it is basic application. Edge Detection is important and basic preprocess at Image Processing. Edge can be found by Compass operator as direction with 3×3 Masks. Compass operator has 8 element to be compared. Each has an information about direction of an edge. To visualize edge information, We propose the method of edge detection as direction showed by color. First, We had experiment on 4-Direction, then on 8-Direction. 8-Direction 8-Color method was better than 4-Direction 4-Color method, for Compass operator had 8 elements. Result Image shows the color which has direction information.

牧楡湯이 人體 肺癌細胞의 變化에 미치는 影響에 關한 分子生物學的 硏究

李炯周,金相贊,徐富一,金先熙,卞晟僖 대한본초학회 1999 大韓本草學會誌 Vol.14 No.1

This experimental study was performed to investigate the effects of Mokyou-Tang on cell cycle and gene expressions of human lung cancer cell. I examined the cell cycle progression and cell cycle-related gene expression in A549 using a flow cytometry and a quantitative PT-PCR analysis. The treatment groups, in accordance with concentration of Mokyou-Tang were classified as 3 group(MYT 100㎕/㎖, MYT 500㎕/㎖, MYT 1,000㎕/㎖), and according to treatment time, were classified as 2 group(24hours, 48hours). The results were summarized as follows; 1. In cell cycle stage, MYT 100㎕/㎖(48hours) and 1000㎕/㎖(48hours) groups were increased as compared with control group, especially 1000㎕/㎖(48hours) group showed eminent increase. 2. In p53 gene, MYT 500㎕/㎖(48hours) and 1000㎕/㎖(48hours) groups showed eminent suppressive effect to cancer cell. 4. CDKNI gene was decreased in all treatment groups, this mean that MYT has suppressive effect to proliferation of cancer cell. 4. In GADD45 gene was decreased in all treatment groups, this mean that MYT has suppressive effect to proliferation of cancer cell. The results suggest that MYT promotes G1 cell cycle arrest and suppresses the proliferation of cancer cell. Thus, it seems likely that MYT has suppressive effect to proliferation of lung cancer cell.

관광자의 문화적 경험측정에 관한 연구

李仙熙,全柱炯 문화관광연구학회 2002 문화관광연구 Vol.4 No.2

The evaluation of tourist's cultural experience just has recently discussed an issue for tourism academics. This paper was explored the concept and evaluating method of tourist's cultural experience. Based on the documentary study, this paper was surveyed the tourist's cultural experience through the field research and analyzed regression analysis through SAS program. In this paper I presents the findings the tourist was changed by cultural experience a little bit that includes the understanding of destination, learning culture of destination, experience of unusual culture, cultural change of tourists.