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.

서울시에서 산발적으로 분리된 Salmonella enterica Serotype Typhi 임상분리균주들의 분자역학적 분석

이희무,김철현,손장욱,김민자,박미선,이복권 대한감염학회 2000 감염 Vol.32 No.5

산소의 첨가가 박막 백금측온저항체의 온도저항계수에 미치는 영향

설철규,김영진,장경훈,이건환,이정희 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

A thin film Pt-RTD(resistance temperature device) was fabricated by using DC magnetron sputtering and laser patterning. A study was fulfilled to adjust the TCR(temperature coefficient of resistance) to 3850 ppm/℃ which is IEC751 standard and the influence of oxygen addition(0 ~ 20 %) on TCR was measured. The resistance of Pt-RTD was set to 1000 Q at 0 ℃ using laser patterning and trimming. The analyses of XRD and AES were used to characterise the platinum thin film. The TCR of Pt-RTD was measured by a high precision oil bath. When the addition of oxygen flow rate was 1 %, TCR was 3850 ppm/℃.

새로운 유사 원자층 증착 방법에 의한 산화막의 형성 및 터널링 자기 접합에의 응용

한신희,정원철,이장식,김병동,주승기 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The tunneling barrier is crucial to the overall performance in magnetic tunnel junction. We have suggested a new formation method for the tunnel barrier, which has utilized pseudo atomic layer deposition with sputtering (PALDS). As is well known, all metallic thin films oxidize more or less under atmospheric conditions. With using this property of metallic thin films, we have prepared tunnel barrier by sputtering metallic thin film and exposing it to the oxygen ambience. From transmission electron microscopy (TEM) observation, the formed tunnel barrier has been confirmed to have clear and good interface between magnetic layers and tunnel barrier. From atomic force microscopy (AFM) observation, it has been also confirmed to have low surface roughness. The TMR MRAM cell manufactured using PALDS method has been shown to exhibit typical tunnel resistance of 86 KΩ·μm^2 and TMR ratio of about 40%. The 40% of MR is quite large. It is considered that this value is geometrically enhanced magnetoresistance due to the low junction resistance of MTJ.

지방분권화를 위한 지방재정확충 방안

이장희,이상철 한국세무회계학회 2003 세무회계연구 Vol.12 No.-

지방자치단체의 책임과 자율을 제고시키고 지방자치의 성공적인 정착을 위해서는 지방자치단체의 자주적인 재원확보와 지출의 자율성이 확보되어야 할 것이다. 따라서 본 연구에서는 균형적인 지역발전을 위해서는 지방자치단체의 지방재정 확충이 큰 관건이 되므로 우선 지방재정의 현황 및 세원배분현황을 살펴보고, 국세와 지방세, 지역간 세원배분의 합리적인 방안을 통한 영세적인 지방재정을 극복하기 위한 방안을 모색해 보고자 한다. 지방자치단체의 자주재정과 재정책임성의 강화를 위해 지역주민들의 편익과 조세부담이 제대로 연계되도록 하고, 지역간의 재정격차를 줄일 수 있는 효과적인 제도 및 중앙정부의 많은 양보가 뒷받침된다면 지방재정은 확충되고 지방자치제가 효율적으로 정착되리라 본다.

개의 심낭내 투여한 Quinidine이 삼장 유효불응기에 미치는 영향

한명철,김재형,노태호,김희열,김종진,조은주,진승원,유기동,이만영,채장성,홍순조,최규보 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

중압 배전망에서의 전력선 통신을 위한 OFDM 기법의 성능 분석

임장규,김산해,장희동,이원철,신요안 崇實大學校 生産技術硏究所 2002 論文集 Vol.32 No.-

Recently, PLC (Power Line Communication) on medium voltage power lines have been gaining much attention for high data rate access networking. In this paper, we evaluate the performance of OFDM (Orthogonal Frequency Division Multiplexing) schemes on medium voltage power line channels in the frequency range up to 20 ㎒. We analyze fading characteristics of multi-path channel models for medium voltage power lines, and simulations have been carried out for the OFDM using adaptive bit loading scheme. Simulation results indicate that the OFDM schemes with the adaptive bit loading show good bit error rate performance under harsh medium voltage power lines channel.

평면형 Bi-Sb 다중접합 열전변환기의 특성

이현철,유호종,김진섭,함성호,신장규,이종현,이정희,권성원,박세일 경북대학교 센서기술연구소 1997 센서技術學術大會論文集 Vol.8 No.1

A planar Bi-Sb multijunction thermal converter for the precise measurements of ac voltage and current has been fabricated and its characteristics was discussed. In order to convert ac power into heat, a bifilar thin film Pt-heater, which could cancel its Thomson and Peltier effects, was prepared on the Si_(3)N_(4)/SiO_(2)/Si_(3)N_(4) diaphragm for the thermal isolation between heater and silicon substrate. To convert the temperature or the heat generated by the heater into dc voltage and current, hot and cold junctions of the Bi-Sb thermopile, which has a large difference in Seebeck coefficients, were formed on the dielectric diaphragm and the silicon substrate, respectively. The respective thermal sensitivity of the thermal converter with a bifilar heater was about 10.1 mV/mW and 14.8 mV/mW in the air and vacuum, which is about eight times higher than that of commercial 3-dimensional thermal converter. In the case of ac 2 V-input voltage, the ac-dc voltage transfer difference was about ±2.0 ppm, and in the case of ac 10 mA-input current, the ac-dc current transfer difference was about ± 0.6 ppm, in the frequency range from 10 Hz to 10 kHz.

광주지역 일부 남성의 연령과 배뇨량에 따른 최고요속 정상치

윤희철,박희수,노준,장대수 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background and Objective : The Peak or maximum uroflow rate has been useful in screening test for the diagnosis of lower urinary tract dysfunction, and is used as a parameter in the diagnosis of lower urinary tract dysfunction, such as prostatism, urethral stricture, or neurogenic bladder, and the postoperative assessment of adequate surgery in urologic patients. We need a peak uroflow rate nomogram for the adjusted peak uroflow, because uroflow in normal healthy men depends on the voided volume and decreases with age. Materials and Methods : Peak flow rates and volumes voided were measured in 315 males who were free of voiding dysfunction, ranging in age from 10 to 80. To search for the equation of age, voided volume and peak uroflow, we used the least squares method for the equation providing least residual standard deviation by SPSS program. Results : The equation of age, volume voided and peak flow rate is Q=24.383+0.413A-0.006934A2-1164.644/V (Q: peak flow rate, A: Age, V: voided volume). Means of measured age, volumes voided, and peak flow rate was 45.7, 227.6ml, and 20.7ml/sec respectively. At this point, reference peak uroflow is 23.6m1/sec. Adjusted peak uroflow was obtained by subtracting the difference between the measured and expected peak uroflow from the reference peak uroflow. According to the equation Q, We designed nomogram with adjusted peak uroflow rate used. Conclusions : In our nomogram an adjusted peak flow rate <.8ml /sec(1.2 standard deviation) should be considered suspicious for lower urinary tract obstruction. This peak uroflow rate nomogram can be used clinically to evaluate lower urinary tract obstruction and its postoperative assessment.

간경변증 환자에서 Escherichia coli 균혈증 합병 시 간기능 장애에 따른 C-reactive protein 생성 능력에의 영향

박완범,강철인,김동민,이기덕,장희창,김홍빈,오명돈,이효석,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : C-reactive protein(CRP)은 간에서 생성되는 급성 반응물질이다. 하지만 간부전증 환자에서 CRP의 반응이 간기능에 따라 어느 정도 영향을 받는지는 별로 알려진 바가 없다. 본 연구에서는 간기능에 따른 CRP 생성 능력을 평가하고자 하였다. 방법 : E. coli 균혈증이 있는 간경변증 환자 30명을 대상으로 하였고 간기능은 균혈증이 발생하기 전 2개월 이내에 측정된 혈청 빌리루빈, 혈청 알부민, 프로트롬빈시간, Child-Pugh 점수로 평가하였다. 대조군 A는 간질환이 없으면서 E. coli 균혈증이 발생한 환자 30명으로 하였고 대조군 B는 간경변증이 있으면서 급성 감염의 증거가 없는 환자 30명으로 하였다. 환자군과 대조군 간에 CRP의 최대값을 비교하였다. 결과 : CRP의 최대값은 환자군에서 7.3±5.0㎎/dL, 대조군 A에서 17.9±8.3㎎/dL로 환자군에서 유의하게 낮았다.(P<0.001). 간경변증 환자에서 CRP의 생성은 Child-Pugh 점수에 비례하여 감소하였으나(P=0.004) Child=Pugh class C의 간기능을 가진 환자군에서도 대조군 B와 비교하여 의미있는 CRP의 생성을 보였다(5.3±3.2 vs. 0.5±0.4㎎/dL, P<0.001). 결론 : 간기능부전 환자에서 CRP 반응은 간기능 저하 정도에 따라 둔화되지만 심한 간기능 장애를 가진 환자에서도 CRP의 생성은 유지된다. Background : C-reactive protein (CRP) is an acute phase reactant produced in the liver. To assess the influence of liver dysfunction on the production of CRP, we evaluated CRP response to E. coli bacteremia in patients with or without liver cirrhosis (LC). Methods : 30 LC patients who developed spontaneous peritonitis with E. coli bacteremia were enrolled in the study. Baseline values of total bilirubin, serum albumin, and prothrombin time were obtained within 2 months prior to infection. Liver dysfunction was categorized according to the Child-Pugh score. 30 patients with E. coli bacteremia who had no underlying liver dysfunction were included as a control group. Matched-control of 30 LC patients without evidence of acute infection was also included. The peak CRP values were compared among the groups. Results : In the patients with E. coli bacteremia, the mean value of peak CRP was 7.3 (+/- 5.0) ㎎/dL in LC patients, 17.9 (+/- 8.3) mg/dL in patients without liver dysfunction (p<0.001). In the advanced LC patients with Child-Pugh class C, the level of CRP was 5.2 (+/- 3.3) ㎎/dL in patients with E. coli bacteremia, 0.5 (+/- 0.4) ㎎/dL in patients without acute infection (P<0.001). Child-Pugh score had correlation with decrease of CRP (linear regression test, P=0.004). Conclusion : CRP response during E. coli bacteremia was attenuated but maintained even in patients with advanced liver dysfunction.