제주시 지역 강수의 특성 분석 : 1997-1998년 빗물의 산성화 특성

강창희,김원형,홍상범,이기호 제주대학교 환경연구소 1998 환경연구논문집 : 제주대 Vol.6 No.-

The precipitation samples were collected in Cheju city and the major soluble ions were analyzed during the period of October in 1996 to August in 1998. The volume-weighted mean value of pH was 4.82. and that of electric conductivity was 23.3㎲/cm. The mean concentrations of ions in Cheju city have been found in the order of Cl^(-) > Na^(+)> SO_(4)^(2-)> NH_(4)^(+)> NO_(3)^(-) > H^(+) >Mg^(2+)>Ca^(2+)>K^(+)> HOOO^(-)> F^(-) >CHO_(3)^(-) >CH_(3)S0_(3)^(-). The comparison between several correlation coefficients has been applied for the investigation of analytical reliabilities. such as equivalent concentrations sum. the measured and calculated conductivity, and the acid fraction. It showed a value of over 0.936 so that the analfid data has been in good rehability. Also. the ionic strengths of the precipitation were obtained as well as the effect of the sea-salt components. The origins of the precipitation components in Cheju city were studied with a factor analyzing way, and they showed the most probable factor as anthropogenic. oceanic, soil-sourced, respectively. The concentration of CHEOOH was hlgher than that of HCOOH, and there was also a small contribution in acidty by organic acids. From the MSA analyses, it was found that the air in Cheju city has been influenced by the pollution from the other areas. The neutralization factors were 0.36-0.56 for NH_(4)^(+), 0.12- 0.25 for Ca^(2+). and the free acidity was 19-60%. The results of multiple regression analysis has shown that the acidification contribution of acidc gas (H_(2)SO_(4), HNO_(3)) was about 24%.

청정 지역 강우의 분석 : 1997-1998년 한라산 1100 고지와 제주시 강우의 특성 Characteristics of Rainwater at 1100 Site of Mt. Halla and Cheju City in 1997-1998

강창희,김원형,홍상범,이기호,홍민선,심상규 濟州大學校 基礎科學硏究所 2000 基礎科學硏究 Vol.13 No.1

The rainwater samples were collected from the 1100 Site of hlt. Halla and Cheju city during the period of March in 1997 to August in 1998. and the major soluble ions were analyzed. The confidence of analytical data was confirmed by using the comparison methods such as ion-balance, electric conductivity and acid fraction. all of which correlation coefficients were above 0.94. The ionic strengths lower than 10^(-4)M, the basis for the pure rainwater, were found in 47% and 38% at 1100 Site and Cheju city, respectively. The precipitations in Cheju city were more influenced by the oceanic effect than those in 1100 Site. The acidity contribution was mainly by SO_(4)^(2-) and NO_(3)^(-) in both areas. and the organic acids have contributed to the acidity with only 5-7%. The neutralization factors by NH_(3) were about 46% at both 1100 site and Cheju city, whereas those by CaCO_(3) were 11% and 15% at 1100 site and Cheju city respectively, and the free acidity were both about 35% in average. From the MSA analysis. it was found that the air in Cheju island has been influenced by the pollution from the other areas. The sources of the rainwater components in 1100 Site and Cheju city were also studied with a factor analyzing way and the most probable factors were found to be anthropogenic, oceanic, and soil-sourced. The results of multiple regression analysis have shown that SO_(4)^(??) was dissolved mostly in the form of H_(2)SO_(4), CaSO_(4) and (NH_(4))_(2)SO_(4). and NO_(3)^(-) was in the form of HNO_(3), Ca(NO_(3))_(2) and NH_(4)NO_(3).

에이즈 환자에서 발생한 조류형결핵균 뇌수막염 1예

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

에이즈 환자의 중추신경계 합병증으로 에이즈 바이러스 자체에 의한 합병증, 기회감염, 종양 등이 있다. 저자들은 전신긴장간대발작을 일으킨 31세 남자 에이즈 환자에 발생한 조류형결핵균 뇌수막염을 조직학적 및 미생물학적으로 증명하고, 항비결핵미코박테리아 약제를 고농도로 투여하여 치료하였다. 조류형결핵균 뇌수막염은 결핵성 뇌수막염으로 잘못 진단되면 치명적인 결과를 초래할 수 있으므로, 조직검사를 포함한 적극적인 검사가 필요하다. We report a case of Mycobacterium avium-intraceliuiarae meningoencephalitis found in a 31-year-old patient with AIDS and preexisting disseminated Mycobacterium avium-intracellularae infection. He had been taking highly active antiretroviral therapy and antimycobacterial medications when he developed generalized tonic-clonic seizure. Repeated workups including blood and cerebrospinal fluid examinations and magnetic resonance image (MRI) of the brain revealed nondiagnostic. The diagnosis was made by stereotactic brain biopsy of the nodule, which was detected 9 month after the first seizure attack in brain MRI. Acid-fast bacilli were observed on microscopic exam. Mycobacterium avium-intracellularae was isolated from the biopsy specimen.

성인의 만성 기침에 대한 감별진단으로서의 백일해

박완범,박상원,이기덕,이창섭,장희창,김홍빈,김의종,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 백일해는 소아기에 발생하는 전염병으로 오랫동안 알려져 왔다. 그러나, 미국과 유럽에서는 1990년대에 들면서 성인에서도 백일해가 유행하며, 만성 기침 환자의 20% 정도가 백일해를 앓는 것으로 보고하고 있다. 저자들은 국내에서 성인 만성기침의 원인으로 백일해의가능성을 확인하고자 하였다. 재료 및 방법 : 2002년 9월부터 2003년 5월까지 서울의 일개 대학보건진료소 또는 일개 시립병원 외래를 방문한 환자 중 기저 폐질환 없이 1주 이상 기침을 하는 성인을 대상으로 Bordetetlla pertussis에 대한 배양검사와 중합효소 연쇄반응검사(PCR)를 시행하였다. 결과 : 1주 이상의 기침을 하는 성인 102명 중 배양검사에서 양성인 환자는 없었으나 3명(2.7%)에서 PCR 양성이었으며 이들 모두 3주 이상 기침이 지속되었고 백일해의 특징적인 증상을 호소하였다. 결론 : 국내에도 성인에서 백일해가 발생하고 있음을 확인하였고 따라서 성인 만성기침의 원인으로 백일해를 감별 진단해야 한다. Background : Pertussis was long considered a childhood illness. However, in the last two decades, it has been reported as a cause of prolonged cough in adolescents and adults in other countries. Infection of Bordetella pertussis was prospectively searched among adults with a persistent cough. Materials and Methods : Adult patients, who visited either the outpatient clinic of a municipal hospital or a university health service center due to cough of more than six days' duration without underlying pulmonary disease, from September 2002 to May 2003, were enrolled. The culture and polymerase chain reaction (PCR) were used for confirming of B. pertussis infection. Results : 102 adult patients with persistent cough were evaluated. 3 (2.9%) patients were PCR positive for B. pertussis. There were no patients with positive culture. All patients with positive PCR had one or more classic symptoms of pertussis and their cough persisted for 3-7 weeks. Conclusion : We confirmed the morbidity of pertussis in Korean adults with persistent cough. Pertussis should be considered as a differential diagnosis of chronic cough in adults.

개인의의 개방병원 참여에 대한 의견

김석범,권굉보,강복수,김기홍 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

A mailed survey with structured questionnaire was conducted to study the demand of private physicians who were operating their own clinics in the community to be a attending physician at the general hospital. The responding proportion was 21.6 percent of the 960 private physicians. A total of 207 responders : 65.2 percent wanted to be a attending physician. In particular, the physicians who were male, young, surgeon and teaching hospital careered after specialist were more highly motivated. The major activities what they wanted as a attending physician were medical care for the admission patients. They responded that the hospital charges for the medical services and the responsibility of malpractice issues should be fairly shared by attending physician and hospital according to their contributions. There is growing consensus that the need of attending physician at the general hospital will become wide spread, but little organizational preparation to assure the quality of medical care of attending physicians including training of resident physicians and students. In addition, the effective reimbursement system should be develop to compensate appropriately according to the medical achievement of the attending physicians.

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.

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

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

인간 면역부전 바이러스(HIV) 감염자 사이에서의 1기 및 2기 매독의 유행

장희창,조재현,박완범,이기덕,이창섭,김홍빈,오명돈,최강원 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내 HIV 감염자 사이에서 발생한 매독의 유행을 보고하고, 그 역학적 특성을 규명하고자 하였다. 재료 및 방법 : 1999년 7월부터 2003년 9월까지 서울대학교 병원에서 추적 관찰을 받아온 HIV 감염자를 대상으로 하여 1기 및 2기 매독의 발생을 조사하였다. 발생률을 정확히 구하기 위해 추적 관찰을 받은 모든 HIV 감염자의 인년을 6개월 간격으로 구하였다. 결과 : 51개월 동안, 465명의 HIV 감염자가 서울대학교 병원에서 추적 관찰을 받았다. 이중 38명이 1기 및 2기 매독으로 진단되었다. 1기 및 2기 매독의 발생률은 이기간 동안 100인년 당 4.1명이었다. 1999년 7월부터 2001년 12월 사이에는 발생자가 없었으나, 이후 발생률은 꾸준히 증가하여 2003년 9월에는 100인년 당 18.8명이 되었다. 1기 및 2기 매독의 발생률은 동성애자 및 양성애자에서 이성애자에서보다 4.3배 높았고, HAART로 치료를 받지 않은 환자에서 HAART로 치료를 받고 있던 환자에서 보다 10.9배 높았다. 결론 : 2002년부터 국내 HIV 감염자 사이에서 1기 및 2기 매독이 유행하기 시작하였고, 이러한 유행은 동성애자와 양성애자 및 HAART로 치료를 받고 있지 않던 사람 사이에서 발생하였다. Background : This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. Materials and Methods : A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. Results : In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). Conclusion : The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.

Human Papillomavirus에 감염된 에이즈 환자에게 발생한 항문암 2예

이창섭,박완범,이기덕,장희창,강철인,박소연,김지현,김홍빈,오명돈,최강원 대한감염학회 2005 감염과 화학요법 Vol.37 No.1

We report two cases of anal cancer in patient with acquired immunodeficiency syndrome infected by human papillomavirus (HPV). One patient presented with huge anal abscess of long duration which developed after incomplete resection of anal warts 2 years ago and the other patient presented with anal bleeding. They were diagnosed as having anal squamous cell carcinoma. Highly oncogenic HPV 69 and 16 were detected by HPV-DNA chip on the previous specimen of warts and anal cancer tissue, respectively. The possibility of anal cancer should be considered in patients infected with human immunodeficiency virus who present anal problems such as anal abscess, anal bleeding, or condyloma accuminatum in anus. 항문암은 HIV 감염자에게 발생하는 빈도가 비감염자에 비해 더 높다. HIV 감염자에게 항문암의 발생 빈도가더 높은 까닭은 항문 성교와 이로 인해서 발생하는 human papillomavirus (HPV) 감염이 이들 환자에게 더 흔하기 때문이라고 생각한다. 항문의 농양, 첨규 콘딜로마로 내원한 HIV 감염자에게서 항문암을 진단하였으며, 이환자로부터 2년 전에 수술로 떼어낸 첨규 콘딜로마 조직에서 HPV 유전형 69를 발견하였다. 또한, 항문 출혈로병원을 방문한 HIV 감염자에게서 항문암을 진단하였으며, 조직 생검으로 얻은 종양 조직에서 HPV 유전형 16를발견하였다. HIV 감염자에게 항문의 농양, 첨규 콘딜로마, 항문 출혈 등의 임상 증상이 발생하면 HPV와 관련된항문암을 감별해야 하겠다.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.