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.

觀念的 敎授要目의 理論과 實際

鄭尙均 順天大學校 1983 論文集 人文社會科學篇 Vol.2 No.-

The notional syllabus has brought into sharp focus the centrality of communicative purpose in language and culture. Syllabus, one of the most unchallenged area of language teaching showed up with a shock when Trim and Wilkins began to report on this subject in the Council of Europe since 1972. This new casting on the syllabus design and content drew great attention of teachers and educators from the start. It is because this syllabus theory concerns for the basic communicatitive need of human being. Noticing the increasing importance of communicative approach to English teaching (the rise of notional syllabus), the author, at first, surveyed briefly the new trends of English teaching methodology and syllabus types. And this paper illustrated the Notional Syllabus's theoretical back ground, semantic categories, and application. Then, the author tried criticizing the Korea's present High school English curriculum with the viewpoints of this theory. From this work, the author came to believe more firmly in the potential contribution of this new syllabus theory

英語 語義變化의 特徵

鄭尙均 順天大學校 1984 論文集 人文社會科學篇 Vol.3 No.-

This paper was chiefly motivated by the recongnition of diachronic linguist's role, the assimilation of historical linguistic's findings, the pursuance of particular linguistics' independence from general linguistics. The emphasis on generality rather than precision, language contents rater than linguistic forms naturally excluded full-range theoratical arguments, and the efforts were exerted to present as many examples of meaning change as possible. The strategy becomes more noticeable in chapter Ⅳ of this paper. In the chapter, those phenomena of generalization, specialization, deterioration, and elevation of word meanings are verified by the new examples from modern English periord. In the procedure, the author suggets "parrellel transfer" as an additional phenomenon which deserves further debates.

變形文法意味論의 3 模型

鄭尙均 順天大學校 1985 論文集 人文社會科學篇 Vol.4 No.-

In this thesis, 3 types of semantics claiming transformational Cenerative Grammar were examined. The focuses of inquiry were upon the critical comparisons of their hypotheses on the nature of meaning, the backgrounds of their establishments of word meaning structures and different processes of arriving at sentence meanings. The main results are as follows. 1. Adopting the mentalistic attitude toward meaning, all 3 models defined a word meaning as a complex of smaller semantic components, and this position is equal to that of European structuralists. 2. Their adoption of 'compositionality Principle' in building up a sentence meaning is in common with the method of philosophical semantics(truth-conditional semantics). 3. Interpretive Semantics 1 could explain explicitly the ambiguities of some sentences using 'Projection Rules.' 4. Interptetive Semantics 2 set up in semantic properties of words some semantic primitives representing thematic relations of a sentence,and, by them, could explain the functional structures in a sentence. And this mechanism showed stronger explanatory power than that of Interpretive Semantics 1 which had analized all parts of speech with conjunction or disjunction of semantic markers. 5. Introducing the the technique 'Lixical Decomposition', Generative Semantics tried to identify deep syntactic structure with semantic structure of a linguisic expression, and failed to prove the inevitability of 'Lexical Decomposition'. Generative Semantics drew suspicions also in its direction of linguistic description. 6. The primary task of Interpretive Semantics would be setting up more rigorous definition of semantic markers which are now being used rather vaguely on the mentalist hypothesis. In addition, it seems that exploration efforts in T.G. Semantics in the future would be concentrated on the task of establishing and integration into the semantic interpretation of sentences the SI-2rules (suggested by Noam chomsky in his REST-model, esp. those rules corelating sentence structures with cognitive structures and the rules concerning the pragmatic elements like discourse properties, situation, communicative intention, etc.).

B형 간염바이러스 항원 preS 및 S부위가 안정적으로 발현되는 CHO세포주 선별

정성균,한만덕,정대균 경희대학교식량자원개발연구소 2007 硏究論文集 Vol.26 No.1

In order to develop vaccines against HBV, 10 different plasmids expressing various regions of hepatitis B surface antigen (HBsAg) were constructed, first. Then, CHO cells were transfected with the plasmids and examined their HBsAg expression levels. We then established CHO transfectants expressing dhfr and HBsAg using pIEsp2878-dhfr plasmid and treated them with methotrexate (MTX). Finally, we selected IY-CHO-2 and IY-CHO-11 cell lines showing the amplified expression of HBsAg containing pre-S2 and S region. These cell lines expressed expected correct size (about 1 kb in lengte) of HBsAg mRNA.

경구용 장티푸스백신 Salmonella typhi 균주 Ty 21a

정성균,정대균 경희대학교식량자원개발연구소 2007 硏究論文集 Vol.24 No.-

장티푸스를 일으키는 원인 균은 Samonella typhi이다. 이 장티푸스균은 1880년 Eberth(Germanier, 1972)에 의해 환자의 장간 림프절 (mesenteric lymph nodes)에서 처음으로 발견되었으며, 1884년 Gaffky에 의해 처음으로 분리되었다. Samonella typhi는 그람음성의 운동성이 있는 박테리아로 장내세균과(Enterobacteriaceae) 군에 속한다. 이 균은 발효를 할 수 있다는 점과 3가지 종류의 표면 항원 구조에 의해 다른 Salmolnella 종과는 구별되어진다. 3가지 항원은 H, O, Vi으로 H 항원은 flagellar 구조를 하고 있다. O항원의 특이성은 세포벽의 lipopolysaccharide를 구성하고 있는 다당류의 당 성분에 기인한다. O 항원이 결여된 Salmonella는 이 항원을 가진 균에 비해 훨씬 덜 독성을 가지기 때문에 O 항원은 Salmonella가 병원성이 되게 하는데 중요한 요소이다. Vi 항원은 Enterobacteriaceae 중 소수만이 함유하는 가장 바깥의 다당류 층을 구성한다. S. typhi의 Vi 항원은 N-acetylgalactosaminuronic acid로만 구성된 homopolymer이다. Vi 항원은 생쥐에서의 병원성과 연관되어 있고 S. typhi 면역성을 부여하기도 한다. 그러나 사람에서도 Vi가 독성을 유발하는지는 분명치 않다.

척추 유합술에서 자가 이식골과 동종 이식골의 비교 : 증례보고 A Case Report

정필현,김태훈,채동주,문상호,박윤근,배호균,이재학 東國大學校 1999 東國論叢 Vol.38 No.-

척추 유합술에 있어서 자가 골 이식이 가장 좋은 방법으로 알려져 있지만 수술 시간과 실혈량이 늘어나고 공여부의 통증 및 감염의 위험등 단점으로 동종 골 이식도 많이 사용되어지고 있다. 이러한 동종 이식골의 효용성에 대해서 많은 논란이 있어온 것은 사실이나 여러 변수들, 즉 나이, 성별, 흡연력, 수술의 종류등에 따른 영향을 완전히 배제시키지 못하여 순전히 동종 이식골과 자가 이식골간의 비교가 어려웠다. 저자들은 척추관 협착증으로 후방 감압술 및 후방 기기 고정술, 후외방 골 이식술을 받은 환자에게서 우측은 자가 이식골, 좌측은 동종이식골로 골 이식을 시행한 후 4년 추시에서 자가 골 이식한 부위는 견고한 골유합 소견을 보였으나 동종골 이식 부위는 이식 골이 모두 흡수되는 소견을 체험하여 같은 조건하에서 자가 이식골이 동종 이식골보다 골유합체의 형성에 있어서 더 우수하다고 생각한다. Posterior decompression, spinal instrumentation and bone grafting are the standard operative treatment method of spinal stenosis and other low back disorders. Although autograft bone is considered the standard in performing fusion of the bone, allografts are recommended as an alternative bone graft agent becaue of the lack of complications at the donor site such as infection, increased blood loss and prolonged operative time Autografts have the other limitations because of inadequate quality and quantity. Many investigators have compared autografts and allografts in posterior spinal fusion, and there are proponents as well as opponents of allograft use. Numerous factors are thought to affect fusion, including age, sex, nutritional status, associated disease, type of fusion, length of fusion, types of instrumentation and smoking status. The validity of comparison studies between allografts and autografts is questionable when these variables are not controlled. We describe a man who had a spinal stenosis at the level of L4-5 and L5-S1. He was operated with posterior decompression, spinal instrumentation and underwent a posterolateral bone graft, comparing autografts and allografts in the same patient. At 4-year follow up, autografts have a solid union but allografts are resorbed completely.

Chomsky와 Piaget의 言語習得假說 比較

鄭尙均 順天大學校 1983 論文集 人文社會科學篇 Vol.2 No.-

Chomsky's generative grammar and Piaget's cognitive development theory are exerting strong in-fluences on a number of fields of research. While they are being compared more and more frequently,-sometimes in terms of oppositions, sometimes in terms of complementarity-the crossreferences were rather few and unsystematic. In this paper, the theoretical positions and the data on which they are founded were glanced through and the possibilities of transdiscipline synthesis were explored. The essential points are as follows. 1. Both Chomsky and Piaget rejected Empiricism as a scientific research strategy. 2. Their points of view were divergent from the beginning as Chomsky had taken the innateness of language structures as a starting point of his linguistic theory and Piaget had been interested mainly in the functions of language in the cognitive development of children. 3. Piaget denies the innate language structures and argues that language does not constitute the source of logical thoughts but language is constructed from thoughts. He also contends that the mutations, specific to humans, that might have given rise to the postulated innate structures are biologically inexplicable. Chomsky's refutation against it is based upon the fact that the evolutionary development of physical organs of the human body like eyes or the cerebral cortex is 'still' biologically unexplained and it gives no reason to believe that it is 'biologically inexplicable'. 4. Piaget's constructivism ulitimately relyes on the notions of 'phenocopy' and 'transfer of structures' taken from explanatory concepts for the biological evolutionary aspects. But this postition is contrary to that of most contemporary molecular biologists. The more supported one is Chomsky's assumption that all laws of order, whether they are biological, cognitive, or lingusistic, come from inside.

아일랜드英語의 게일語的 要素 : 關係詞節을 中心으로 with Emphasis on Relative Clause

鄭尙均 순천대학교 어학연구소 1993 어학연구 Vol.5 No.-

Hiberno-English is quite different from standard English in its devices of subordination, tenseaspect-mood markers and idiomatic expressions as well as its pronunciations. This paper proposes showing that all those apparently independent constructions of Hiberno-English(e.g. deletion of nominative relative pronoun as in (1), it clefting as in (2) and 'and free phrase' as in (3)) are directly or indirectly related to the special characters of Gaelic relative partcle a (nach in negative). (1)There is no one can drive a mountain ewe but the men do be reared in the Glen Malure. (2)It wasn't make trouble we came. (3)She walked out 'him talkin'. For this, after collecting carious samples maforly from the texts of a representative Hiberno-English writer, J.M.Synge(The Complete Plays, 1907),surveyed in detail the degree of equivalency between these constructions and Gaelic relative clauses. THe author's finding is that those constructions (1)~(3) were the very results of the tranfer of the following Gaelic usages. 1. Sinec the basic word order of Gaelic is VSO, even though relative particle a were omitted in the following sentence, there is no difficulty in recognizing the later part (VN) as a relative clause. · Chonnaic Sean an fear(a) thing an sgeal. 'saw John the man who understood the story' 2. In contrast to the fact that Gaelic subordination conjunction go(='that') demands dependent (verb) forms or the eclipsis of the verb when the dependent form is lacking, in direct relative clauses, however, these dependent forms are never used and the verb become lenited, not eclipsed as we see in the following examples. · Bainfe se an fear:deirim go mbainfe se e.(CONJUNCTIVE CLAUSE) 'he'll cut the say; I say he'll cut it'. · duine bhainfeas an fear(RELATIVE CLAUSE) 'a person who will cut the hay' So, even when the relative particle is omitted, the construction cannot be misunderstood as a conjunctive clause. 3. In 'is-clefting'of Gaelic, unlike the it-clefting of English, almost any elements in the second clause except a finite verb can be extracted as focal constituents: noun, pronoun, present participle, past partciple, manner adverbial, etc. And the second clause after is is always led by relative particle as we see from following examples. · Is 'It's John who went to Derry yesterday.' · Is 'It's doing his lessons that Tim is.' · Is 'It's drunk he is' · Ni go maith a chonaic se iad. 'It's not well he saw them.' 4. In Gaelic there are various varieties of 'is-clefting' such as 'adverb(ial)+is+relative clause,' 'is amhlaidh(='it is thus')+relative clause,' and the question emphasis like 'an amhlaidh(or an e)+relative clause.' 5. In Gaelic the syntactic relation which, in English, would require a relative pronoun is occasinonally expressed by the 'agus(='and') free phrases' as we see in the following example. · Bhi fear ann agus bhi teach deas aige. 'There was a man who had a nice house.' Besides, among Hiberno-English researchers, there occasinonally have been debates on whether Gaelic is the only source of construction as (1)&(3) were found in Shakespeare English. Harris(1991) also mentions some similarities between the tense-aspect system of Hiberno-English and those of earlier Englishes(especially 17C's). As this matter has not been treated systematically in the literature yet, the research ifself could possibly turn out a misdirection as some near future. It is because even if the research ifself could possibly tyrn out a misdirection as some researchers suspects, nevertheless, this kind of research, in a roundabout way, would give us some valuable knowledge on the 'linguistic distance' between 2 important European languages: English and Gaelic.

B형 간염바이러스 항원 preS 및 S부위가 포함된 동물세포 발현벡터의 제작

정성균,윤미숙,정대균 경희대학교식량자원개발연구소 2007 硏究論文集 Vol.26 No.1

현재까지 혈장유래 백신이나 재 조합 DNA 기술을 이용한 백신이 HBV 감염을 우수하게 억제하였음에도 불구하고, 성 관련 질병이나 마약중독 환자의 경우 낮은 면역력을 나타내며, HLA haplotype 유전자의 이상으로 인하여 T 세포 면역 반응이 활성화 되지 않는 환자들에게는 제한적인 면역능이 확인되고 있다. 이와 같은 문제점을 해결하기 위하여 기존에 사용하던 S 항원에 Pre S1이나 Pre S2 항원을 첨가하는 새로운 백신 개발에 많은 연구가 진행되고 있다. Pre S2 항원은 HBV 비리온의 표면에 존재하는 표면 단백질이며(Heermann 등, 1984) human serum albumin과 결합 한 후(Krone 등, 1990) 간세포의 표면에 존재하는 human serum albumin receptor를 통하여 HBV를 간세포에 결합시키는 역할을 한다(Pontisso 등, 1989). 또한 pre S2 항원은 현재 S 항원 a 결정자의 HBV의 subtype 별 아미노산 차이에 의한 B 세포 관련 면역성 차이를 극복할 수 있어 heterologous strain의 감염에 따른 비 면역성의 문제를 극복 할 수 있다. 이와 같은 pre S2 항원의 특징을 근거로 하여 본 연구에서는 pre S2와 S 항원을 백신으로 사용하고자 발현벡터인 pIEspHBVS2-dhfr을 제작하였다. 일반적으로 포유동물 세포주에서 고 농도의 단백질을 발현시키기 위한 방법으로 2가지 구별된 벡터를 사용한다. 그 중 하나는 cytotoxic drug인 methotrexate(MTX)와 반응하여 유전자가 증폭되는 dihydrofolate reductase 유전자(dhfr)을 포함하는 발현 벡터를 사용하는 것이며, 다른 하나는 chromatin structure을 조절하는 요소인 matrix attachment regions(MARs)와 scaffold attachment regions(SAR)을 사용하여 높은 transcriptional 활성을 나타내는 유전적 환경을 제공함으로써 유전자 발현을 증가시키는 벡터를 사용하는 것이다(Raju 등, 2001). 또한 포유동물세포에서 외래 유전자 발현의 최대화는 프로모터의 세기와 연관이 있음으로, 우수한 프로모터를 사용하는 것이 가장 필수적이다. 이런 이유로 본 연구에서는 HBsAg유전자 증폭을 위하여 dihydrofolate reductase 유전자(dhfr)와 다양한 포유동물세포에서 강력한 프로모터로 알려져 있는 HCMV immediate-early enhancer promotor를 사용하였다(Kim 등, 2002). 따라서 본 연구에서 제작된 발현벡터인 pIEspHBVS2-dhfr은 dhfr 유전자가 발현시키고자 하는 HBsAg 유전자와 동일한 벡터 내에 존재함으로 이 벡터를 포유동물세포주인 CHO 세포에 형질 전환 시 동시에 CHO 세포 내로 도입되고 또한 염색체 DNA상의 동일 위치에 삽입되게 되어 동시 발현함에 따라 dhfr 선별배지에서 선별된 dhfr 양성 세포주들 모두는 고농도의 HBsAg 단백질을 발현할 것으로 사료된다. A new mammalian cell expression vector for HBsAg, preS and S, was constructed using HCMV imediate early enhancer promoter. In order to develop vaccines against HBV, 10 different plasmids expressing various regions of hepatitis B surface antigen (HBsAg) were constructed. In order to amplify the HBsAg expression, we inserted dihydrofolate reductase (dhfr) gene into the plasmid containing nucleotide 2878 to 846 of HBV genome (pIEsp2878-dhfr).