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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

교잡종 찰옥수수에 대한 연구 III : Ⅲ. 국내 옥수수 유전자원 수집종에 대한 주요 특성 분포

서정은,주현민,최윤표,홍범용,조양희,주정일,지희정,이희봉 충남대학교 농업과학연구소 2007 농업과학연구 Vol.34 No.2

2006년 국내 각 지역으로부터 수집된 재래종옥수수 유전자원을 관행방법에 의해 파종하고 주요특성별로 분포도를 살펴본 결과는 다음과 같다. 1. 수집된 유전자원에 대한 발아율은 대부분 80∼100%이상의 분포를 보였으나, 일부 수집계통에는 30% 미만의 극히 저조한 발아율을 보였다. 2. 수집자원에 대한 초기생육을 살펴보면 극히 생육이 저조한 것이 40% 정도를 보였고, 극히 우수한 자원은 3%미만으로 나타났다. 3. 간장은 대부분이 150∼199cm범위에 55%가 분포하고 있었으나, l00cm이하가 5%, 250cm이상이 8%로 나타나 수집종간에 큰 차이를 보였다. 4. 주당 분얼수는 1개 미만이 40%의 분포를 보였으나, 일부 수집종에서 2 내지 3개의 분얼수를 보이는 계통이 확인되었다. 5. 개화소요일수는 61∼64일의 범위에서 40%, 57∼60일의 범위에서 30%의 분포를 보였으며, 특히 일부 수집종의 경우 55일 이하의 극조생종도 10% 정도의 분포를 보였다. 6. 이삭길이는 대부분 11∼15cm범위에 60%가 포함되어 있으나, 일부계통에서 5cm미만이 2%, 16∼20cm의 이삭길이도 10%가 분포하였다. Germination ratio on the 300 collected genetic resources showed 80 to 100 percentage, but those of some accessions were very low as below 30 percentage. Early growth phase of most of these lines were very poor while some collected lines were very vigor. Range of stem height showed from 150 to 199cm, but that of some accessions showed below 100cm as five percentage and some of them was over 250cm as eight percentage. Number of tillers per plant appeared less one but some collected lines have two to three tillers per plant. In days to tasseling, some accessions showed more four per plant. Ear length of these accession showed above 60 percentage as 11 to 15cm, while that of some collected lines showed over 10 percentage as 16 to 20cm.

미치광이풀 모상근 배양에서 Tropane Alkaloid 생산성 증진을 위한 최적 생물학적 엘리시터 선발

정희영,강승미,강영민,김용덕,양재경,정영관,최명석 Plant molecular biology and biotechnology research 2003 Plant molecular biology and biotechnology research Vol.2003 No.-

Scopolamine and hyoscyamine which belong to tropane alkaloids are the pharmaceutically valuable anticholinergic drugs. In order to increase the productivities, the effects of elicitation were investigated during hairy root cultures of Scopolia parviflora. Biotic elicitors originated from 3 fungi and 1 yeast were prepared as homogenate and supernatant and added to 3-week-old cultures. Both of homogenate and supernatant of Candida albicans elicitors increased the scopolamine production. The production of hyoscyamine was enhanced by homogenate of Fusarium solani and supematant of C. albicans. Most of the other fungal elicitors were also improved on the tropane alkaloid production compared to non-treatment. Among the elicitors tested, C. albicans was proved the optimal biotic elicitor on tropane alkaloids production. These results will be served mass production of tropane alkaloids by large-scale production.

A STUDY ON THE RISK PROTECTION OF THE MOLD TRANSFORMER

Chung,Young-Ki,Jung,Jong-Wook,Kim,Jae-Chul,Kwak,Hee-Ro,Lee,Su-Kyung 한국화재소방학회 1997 한국화재소방학회 학술대회 논문집 Vol.1997 No.-

This paper investigates and analyzes the installation and failure status of mold transformer being used in domestic subways and describes the extinguishing process by time through the combustion test of winding part of mold transformer. Condition of installed mold transformers and classes of fire were surveyed and the mold transformer was burned in a horizontal heating furnace. It was confirmed that the mold transformer is self extinguishing and nonflammability. According to this results, the suitable standard of fire protection for the mold transformer was demanded after review of domestic and abroad law. It is expected that the cost of fire protection equipment can be reduced by using the status and combustion test result of mold transformer.

Tissue conditioner를 이용한 dynamic impression

정재현,장두익,김희중 조선대학교 구강생물학연구소 2003 口腔生物學硏究 Vol.27 No.1

Recently, it is frequently accepted for impression of complete denture that alginate (irreversible hydrocolloid) is used for primary impression and special tray is used for secondary impression. But, most standard textbooks recognize the variation in academic opinion and each offers various materials and techniques for functional(secondary) impression. The variety of recommendations in standard textbooks suggests no one technique is satisfactory for all clinical situations. Especially, impression taking is more difficult in mandible that has many muscle movement than in maxilla. The possibilities of overcoming treatment difficulties of patients with advanced mandibular residual ridge resorption by means of a dynamic impression method was stressed in a previous article Numerous presentations of dynamic impression methods include those of Schrott, Momme, Skogsborg, Greene, Loos, Hromatka, and Matthews, At the beginning, this method was applied tentatively for special patients after variations of conventional method was failed. The results were encouraging and, eventually, the dynamic impression became the impressicn of choice in the treatment of patients with a questionable prognosis with conventional dentures. Recently, dynamic impression has been used for treatment of patients with extreme resorption of the mandibular residual ridge. The shape of the osseous structures in these patients offers little possibility of retention and stability of complete dentures. Furthermore, muscle attachments are located near the crest of the residual ridge and, consequently, the dislocating effect of the muscles on the denture is great. For these reasons, the range of muscle action, as well as spaces into which the denture can be extended without dislocation, must be accurately recorded in the impression. Such impressions can be made by means of dynamic method.

틱 장애의 진단분류에 따른 임상특징과 질환 심각도와 연관된 변인들

정선주,정희연,황정민 대한소아청소년정신의학회 2001 소아청소년정신의학 Vol.12 No.1

연구목적 : 본 연구는 일과성 틱 장애(Transient tic disorder : TTD), 만성 틱 장애(chronic tic disoder : CTD), 뚜렛 장애(Tourette's disorder TD) 아동의 임상 양상을 비교하고, 틱 장애의 질환 심각도와 연관된 변인을 알아보기 위해 시행되었다. 방법 : DSM-IV 진단분류에 따라 틱 장애로 진단된 69명의 아동과 대조군 43명을 대상으로 인구학적 변인 및 틱과 관련된 임상적 변인을 조사하였다. 틱 증상의 심각도를 알아보기 위해 예일 틱 증상 평가 척도(Yale Global Tic Serverity Scale)을 시행하였으며 연구 대상 모두에게 동반된 정서/행동 문제를 평가하기 인해 아동 행동조사표(Child Behavior Checklist)를 시행하였다. 결과 : TTD군은 CTD및 TD군과 비교할 때 틱 증상의 지속 기간이 짧을 뿐 아니라 틱 증상의 심각도와 장해 정도도 미약하였다. TTD군의 동반된 정서/행동 문제 역시 CTD, TD군에 비해 유의하게 적었으며 공격성 소척도 점수를 제외하고는 정상대조군과 차이가 없었다. CTD군과 TD군간에는 틱 증상의 종류, 개수와 CBCL의 사회성 문제 소척도 점수외에는 통계적으로 유의한 차이를 나타내는 변인이 없었다. 틱 증상으로 인한 장해 정도를 가장 잘 예측해 주는 변인은 운동틱의 강도와 방해도, 틱 증상의 지속기간이었으며, CBCL 총 문제행동 점수와 가장 높은 연관성이 있는 변인은 주의력결핍/과잉운동장애(Attention deficit hyperactivity disorder : ADHD) 의 존재여부였다. 결론 : 본 연구의 곁과는 틱 증상의 심각도 외에 증상의 지속 기간이 틱 장애 아동들의 틱으로 인한 장해도에 큰 영향을 미치며, 동반된 ADHD의 존재가 이득의 임상상을 결정하는 데 있어 중요한 역할을 한다는 점을 시사한다. 또한 위와 같은 임상 변인들이 틱 장애의 진단적 분류보다도 틱 장애 아동의 질환 심각도를 판단하고 치료방침을 결정하는데 있어 더욱 중요함을 시사한다. 중심 단어 : 틱 장애 · 하위 진단 · 질환 심각도 · 장해. Objective : The purpose of this study was to compare the clinical features of children with three sub-diagnoses of tic disorder (transient tic disorder (TTD) , chronic tic disorder (CTD) and Tourette's disorder (TD)) and to exam the factors related with illness severity of them. Method : Subjects were 69 children who met DSM-Ⅳ criteria for tic disorder and 43 control chil-dren. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale (YGTSS) in tic disorder children. The Child Behavior Checklist (CBCL) was accomplished by parents of all subjects. Results : Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a pre-ictor of the total behavior problem score of CBCL. Conclusion : These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder. KEY WORDS : Tic disorder ㆍ Sub-diagnosis ㆍ Illness severity ㆍ Impairment.

Supply Chain Network 구성요소들의 양방향 선호도를 고려한 생산/분배 통합 모형

정병희,최정일 한국경영과학회 2002 한국경영과학회 학술대회논문집 Vol.- No.1(2)

The importance of efficient Supply Chain Management is increasing in accordance with recent industrial environment, such as globalization of business, complexity and diversity of company's management structure, and variety of customer's demand. In a rapidly changed environment of business, quick and efficient decision making is the important matter to the survival of the company. The purpose of this study supports decision making for efficient supply chain management. In this study, we consider simultaneously and mutually reflection the preference of each constituent (Supplier, Manufacturing plant, Distribution center, Customer) on supply chain network, and decide company's strategic choice and coordinated production/distribution models of company. The Analytical Hierarchy Process is used for decision making of qualitative and quantitative elements. We use the results of AHP as inputs and propose mathematical models thru Mixed Integer Programming.

공격성이 주호소 문제인 경도 정신지체 아동의 미술치료 사례연구

정계숙,구정희 부산대학교 영유아보육연구소 2004 영유아보육연구 Vol.10 No.-

The purpose of this case study examined the effect of a child-centered art therapy for a primary grade child with mild mental retardation, who showed moderately severe aggression as a main problem and other maladjusted behaviors. The subject was a 10 years old boy. The program consisted of art activities for enhancing emotional expression, emotional stability, seif regulation and seif esteem. Fach of 33 sessions nm 50 minutes once a week The process of the session was recorded and client's art works and products were gathered at every session. It administerd the Aggression Checklist, K-HTP, FD and KSD before and alter the art therapy program. The effectiveness of the program was analyzed qualitatively and quantitatively. The results of this study were as follows: First, the program reduced aggression of a child with mild mental retardation effectively. Second, the program improved his other maladjustive behaviors. It discussed about practical implications, limitations of the study and future research directions.

서울시내 국민학교 아동의 호기속도-용량곡선

정규철,이정희 중앙대학교 의과대학 의과학연구소 1988 中央醫大誌 Vol.13 No.2

Maximal expiratory flow rates: PEFR, PEF25%, FEF50%, FEF75%, FEF25-75% were measured on 378 primary school children aged from 5 to 12 years in Seoul (183 males and 195 females) using Collins Survery Spirometer with Eagle One Microprocessor (Warren E. Collins, Inc,, U.S.A.). Mean values of PEFR and FEF25-75% were 4.66±0.99 and 2.61±0.59 1/sec for males and 3.98±1.00 and 2.54±0.64 1/sec for females showing at FEF25-75% amounted to approximately 60% of PEFR. Mean values of FEF25%, FEF50%, and FEF75% were gradually decreased in order in both sexes. Variability of the maximal expiratory flow rates was quite big in all measurements: indicating 20% in males and 25% in females for PEFR, FEF50% and FEF25-75%, and about 30% in both sexes for FEF75%. Maximal expiratory flow rates were closely correlated with age and physical growth, especially stature. Simple regression equations of maximal expiratory flow rates on stature and multiple regression equations on age and physical growth were derived for both sexes. These equations were proved to be valid in predicting maximal expiratory flow rates of primary school children.