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.

전자상거래시대 인터넷 EDI의 동향과 전망

문희철,심상렬 충남대학교 경상대학부설 경영경제연구소 1997 경영논집 Vol.13 No.2

세계화, 정보화시대의 도래와 함께 EDI는 전자상거래의 핵심요소이자 경영혁신의 필수적인 수단으로서 그 중요성을 한층 더해 가고 있다. 다만, 전세계를 하나로 연결하는 인터넷의 확산과 이에 따른 비즈니스 환경의 변화로 말미암아 그 역할과 구현방법에는 약간의 변화가 일어나고 있다. 이와 관련하여 본 논문에서는 전자상거래와 인터넷의 확산, 그리고 전자상거래 시대의 도래에 따른 새로운 EDI의 필요성과 함께 이를 해결할 수 있는 수단으로서 주목을 받고 있는 인터넷EDI의 동향과 발전방향 등에 대해 살펴보고 있다.

DTBP 분해를 이용한 난류연소 모델링 가능성 연구

문희장,조성찬 한국항공대학교 항공우주산업기술연구소 2003 航空宇宙産業技術硏究所 硏究誌 Vol.13 No.-

Flame propagation is analysed with the use of simple statistical model in a one dimensional spherical coordinate. The objective of this study is the use of novel fuel which is decomposed in an inert gas atmosphere making the reaction with a single step chemical kinetics. DTBP(Di-Tert-Butyl-Peroxide) chemical kinetics is a potential candidate for the study of turbulent combustion since this fuel may be used in conjunction with the development of turbulent combustion models. It was found that the proposed model results approach that of experimental results of DTBP decomposition. The fact that its heat release is at a low level compared to other substances as hydrocarbon fuel, makes the modeling study with DTBP promising. Results of turbulent flame propagation speed by the numerical study under work show that the general trend of the flame propagation is achieved, however numerical results could not simulate the time increase rate of the turbulent flame speed found by experiments.

백서에 있어서 incision 중지가 하악두 연골의 성장 및 미세구조에 미치는 영향

성재현,배용철,박매자,주강,경희문 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.3

The purpose of this study is to investigate the effect of loss of incisal function on the thickness, growth activities, ultrastructure of the condylar cartilage and on the muscle fibers of masseter superficialis, anterior belly of digastric muscle in the growing rats. 37 day-old-rats of which incisors had been trimmed every day received soft diet from weaning and were studied by the autoradiography, electron microscopy and muscle histochemistry. The results obtained were as follows ; The thickness of the fibrous, proliferative layer in superior, posterosuperior portion of the condylar cartilage was significantly(p<0.01) reduced in experimental groups and the decrease rate of fibrous layer thickness was greater in posterosuperior portion than in superior portion of cartilge and was greater than in proliferative layer. In normal group, more cells of posterosuperior portion moved more rapidly towards the medullary cavity. In experimental group, the labelling index of posterosuperior portion was decreased in proliferative layer at 2 hours, in transitional layer at 1, 2 days, in hypertrophic layer at 4 days after injection relative to posterosuperior portion of control group. But labelling index of superior portion was not different form that of control group at all time course after injection. From the muscle histochemistry, the diameter of type IIB fibers in masseter superficialis muscle, type ⅡA, type IIB fibers in anterior belly of digastric muscle decreased significantly(p<0.01) relative to controls in experimental group. From electron microscopic study, in the fibrous layer of the posterosuperior portion of condylar cartilage in normal group, many fibroblast like cells near the joint cavity showed extensive remodelling activities in ultrastructure. There was no morphological changes between experimental and control group in all cartilage cell layers of superior portion but cells near the joint cavity in fibrous layer of posterosuperior portion of experimental group showed morphologically inactive state relative to control group.

흰쥐 재생간의 알콜대사효소들의 활성치

문교철,곽춘식,정성광,김여희 啓明大學校 醫科大學 1988 계명의대학술지 Vol.7 No.2

A study was made on the change in the activities of the following during 10 post-operative days: alcohol dehydrogenase of regenerating rat livers after 70% (median and left lateral lobes) partial hepatectomy. After partial hepatectomy in the rats, activities of regenerating liver alcohol dehydrogenase significantly increased in the sixth day. The activities of microsomal ethanol-oxidizing system in the regenerating liver markedly increased from the third day after partial hepatectomy. However, no significant changes in hepatic catalase was noted throughout the experiments. The activities of cytosolic and microsomal aldehyde dehydrognease in the regenerating liver significantly increased from the sixthe day and the third to the sixth day respectively, but mitochondrial aldehyde dehydrogenase showed no change.

한국종합예술학교 무용원 예술사과정의 교과과정 특성 고찰

문성철,김재희 仁荷大學校 스포츠科學硏究所 2001 論文集 Vol.13 No.-

Study of the arts in the western world was established under two main structures; academic, theory-based institutions to educate & scholars, teachers and the performance-based conservatory for development of professional artists through apprenticeship. In contrast, arts education in Korea was established under one general structure, thus with neither specification nor specialization. With this reflections and the support of the government, The Korean National University of Arts(KNUA) has been established as a national art school with the purpose of advancing professional artists with both specialized academic and performance-driven programs through the most highly qualified faculty and advanced educational facilities available in the market. The purpose of this study was to analyze the problems of art bachelor's curriculum on school of dance in KNUA. The results of this study as follows: 1.An art bachelor's curriculum on school of dance lean upon kinesiological studies and technology models in the six models of curriculum theory for advancing professional artists with both specialized academic and performance - driven programs. 2.An art bachelor's curriculum on school of dance is insufficient for achieving the purpose of national art school, which is advancing professional artists with both specialized academic and performance-driven programs. 3.An art bachelor's curriculum on school of dance is insufficient for advancing professional artists with both specialized academic and performance-driven programs available in the market.

포도알균 균혈증 환자에서 사망 예측 위험인자

문수연,이미숙,손준성,이희주,이상오 대한감염학회 2008 감염과 화학요법 Vol.40 No.3

Background : Staphylococcus aureus is a common cause of severe infection and frequently results in death or disability. We investigated potential risk factors influencing clinical outcome in S. aureus bacteremia (SAB). Materials and Methods : Our study is based on retrospective chart review for episodes of SAB from 168 patients, identified between January 2003 and December 2005. Twenty patients were excluded: 2 patients with infective endocarditis and 18 patients with metastatic lesions. Demographic, underlying diseases, sources of SAB, antimicrobial therapy, laboratory, and microbiologic characteristics were identified. Outcome was classified as death or survival 12 weeks after onset of SAB. Results : A total of 97 patients had survived and 51 patients died 12 weeks after the onset of SAB. Death group was older (66.4±13.6 vs. 59.4±14.9 years, P=0.007) and had higher Acute Physiology and Chronic Health Evaluation II system score (17.5±6.3 vs. 13.5±5.1, P<0.001) and the acute physiology score (11.1±5.5 vs. 8.0±4.3, P<0.001). Patients with nosocomial SAB (36 (70.6%) vs. 49 (50.5%), P=0.03] and ineradicable primary source of SAB (46 (90.2%) vs. 66 (68.0%), P=0.005] were more vulnerable to death. Multivariate analysis shows that hospital acquisition [adjusted odds ratio (OR)=2.93), ineradicable primary source (adjusted OR=5.74) and high APACHE II score (adjusted 0R=1.22) lead to higher mortality rate from SAB. Conclusion : Our study shows hospital acquisition, ineradicable primary source, and high APACHE II score are the risk factors related to death from SAB. On the other hand, methicillin resistance or initially ineffective antimicrobial therapy is not much correlated with mortality rate from SAB. 목적 : 황색포도알균은 중증 감염의 흔한 원인이며, 사망하거나 합병증이 발생하는 경우가 종종 있다. 본 연구를 통해 황색포도알균 균혈증 환자에서 임상적 결과에 영향을 미칠 수 있는 위험인자를 확인해 보고자 한다. 재료 및 방법 : 본 연구는 2003년 1월부터 2005년 12월까지 3년간 168 명의 환자에서 발생한 황색포도알균 균혈증에 대해 후향적 의무기록 조사를 바탕으로 이루어졌다. 성별, 나이, 기저 질환, 황색포도알균 균혈증의 원발 병소, 항생제 사용력과 미생물학적 특징에 대한 자료를 모았으며, 균혈증 발생 당시 질환의 중증도는 acute physiology score (APS)와 APACHE II 점수(acute physiology and conic health evaluation II system, APACHE II score)를 이용하여 측정하였다. 결과는 균혈증 발생 12 주 후 사망과 생존으로 나누어 분석하였다. 결과 : 황색포도알균 균혈증 발생 12 주 후 97명의 환자가 생존하였으며, 51명이 사망하였다. 사망 환자 군이 나이가 더 많았으며(66.4±13.6 vs. 59.5±14.9세, P=0.007), APACHE II 점수(17.5±6.3 vs. 13.5±5.1, P<0.001)와 APS (11.1±5.5 vs. 8.0±4.3, P<0.001)가 높았다. 병원 내 감염에 의한 황색포도알균 균혈증 환자[36 (70.62%) vs. 49 (50.5%), P=0.030]와 제거 불가능한 원발 병소를 지닌 경우[46 (90.2%) vs. 66 (68.0%), P=0.005] 사망위험성 이 높았다. 다 변량 분석에 의하면 병원 내 감염[adjusted odds ratio (OR)=2.93]과 제거 불가능한 원발 병소(adjusted OR=5.74), 높은 APACHE II 점수(adjusted 0R=1.22)에 의해 황색포도알균에 의한 사망률이 증가하였다 결론 : 본 연구에서 병원 내 감염과 제거 불가능한 원발 병소, 높은 APACHEH 점수가 황색포도알균 균혈증에 의한 사망과 관련된 위험인자이다. 반면, 메티실린 내성과 초기 부적절한 항생제 사용은 황색포도알균 균혈증의 사망률과 연관성이 없었다.

편마비환자의 상지 근전도 소견의 시기별 변화

차상민,김희상,안경회,황치문 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.3

Primary Structure의 Homology로부터의 고찰

성문희 한국생화학분자생물학회 1991 생화학분자생물학회 소식 Vol.11 No.1

A database of 118 amino acid sequence of pyridoxal 5'-phosphate (PLPI-dependent enzyme was compiled. The aminotransferases with a total of 30 amino acid sequence of 7 different enzymes constitute the largest group among them. These 7 aminotransferases could be classified in to three families of the basis of sequence similarity. Aspartate aminotransferase family (family Ⅰ) comprises aspartate, aromatic amino acid, and tyrosine aminotransferases; o-amino acid aminotransferase family (family Ⅱ) o-amino acid: pyruvate aminotransferase and ornithine 6-aminotransferase; D-amino aminotransferase family (family Ⅲ) D-amino acid aminotransferase and L-branched-chain amino acid aminotransferase. Comparison of the amino acid sequence with those of family I from other organisms revealed very low overall similarities (13%). Several amino aciresidues conserved in all the compared sequence include those that have been reported to participate in binding of the coenzyme in three-dimensional structures of the vertebrate and E. coli enzymes. In family I and Ⅱ the sequence identity after alignment was 35% and 31%, respectively.

EDI 도입 및 실행의 결정요인과 성과에 관한 문헌연구

문희철,정인영,성봉석 충남대학교 경상대학부설 경영경제연구소 1996 경영논집 Vol.12 No.1