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.

흰쥐 성장기간에 따른 Xylene의 독성에 관한 연구

이혜자,이상희,전태원,이상일,윤종국 대한의생명과학회 2000 Journal of biomedical laboratory sciences Vol.6 No.3

실험동물에 있어서 연령 차이에 따라서 xylene 독성이 어떠한 차이가 있는지를 검토하는 일환으로 5주령 및 12주령 흰쥐에 50% m-xylene을 체중 100 g 당 0.25 ml씩 1회 투여한 다음 24시간 후에 처치하여 다음과 같은 결과를 얻었다. Xylene 투여로 인한 요 중 methylhippuric acid 함량은 5주령군이 12주령군에 비해 현저하게 높게 나타났다. 그리고 간조직 중 cytochroms P-450 함량은 대조군에 있어서 5주령군이 12주령군 보다 약 50% 정도 낮게 나타났으나 xylene 투여로 인한 cytochrome P-450 함량 증가율은 12주령군 보다 5주령군에서 높게 나타났다. 간 alcohol dehydrogenase 활성치도 대조군에 있어서는 5주령군이 12주령 보다 약 35% 정도 낮게 나타났으나 xylene 투여로 인한 본 효소의 활성 증가율은 5주령군에서 오히려 높게 나타났다. 그러나 간 aldehyde dehydrogenase 활성치는 대조군 및 xylene 투여군 모두 5주령과 12주령간에 유의한 차이를 나타내지 않았다. 한편 xylene 투여시 체중 당 간무게, 간조직 malondialdehyde 함량 및 혈청 ALT 활성 변동을 통하여 간손상 정도를 상호 비교 관찰하였을 때, 12주령군이 5주령 실험동물 보다 간손상이 다소 심하게 나타남을 알 수가 있었다. 이상 실험결과는 연령에 따라 xylene에 의한 간손상의 차이는 이물질의 생체내 대사율이 달리 나타나기 때문일 것으로 생각된다. To evaluate an effect of aging on the xylene toxicity, 50% m-xylene in olive oil (0.25 ml/100 g body wt.) was administered to 5 week and 12 week-old rats one times intraperitoneally and sacrificed at 24 hrs afterwards. The increasing rate of urinary H-methylhippuric acid concentration was higher in 12 week-old rats than 5 week-old rats by the treatment of m-xylene. On the liver function findings, i.e., liver weight/body weight (%), serum levels of ALT activity and hepatic malondialdehyde content, 12 week-old rats showed more severe liver injury than 5 weeks those in xylene-treated rats. And the hepatic cytochrome P-450 contents was higher in 12 weeks rats than those of in 5 week-old rats, but the increasing rate of that was lower in 12 week-old rats. Hepatic alcohol dehydrogenase activity was also higher in 12 week-old rats than in 5 week-old rats whereas the increasing rate of that was higher in 5 week-old than those in 12 week-old rats by the xylene treatment. Furthermore, the hepatic aldehyde dehydrogenase activities were no differences between the 5 and 12 week-old rats both in the control and xylene-treated group, In conclusion, age may influences upon the hepatotoxicity with xylene and it may be responsible for xylene metabolism in rats.

자기 효능의 개념 분석

서순림,이은남,박송자,양영희,이동숙,최은옥,구미옥,김인자,이인숙,김성재,박영임,이은옥 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Today human needs for health promotion and maintenance are increasing. The nursing progression has a great responsibility for helping clients to practice good health behavior. self efficacy was found to be potent predictor in initiating and maintaining the health-related behavior. Therefore, the concept is important in nursig intervention for change of health behavior. The purpose of this paper was to analyze and clarify the meaning of the concept, self efficacy. This study used Walder & Avant's process of concept analysis. Critical attributes of self efficacy were : 1) positive perception of his won capability; 2) intrapersonal strength; 3) possibility of being learned; 4) individuality; 5) specificity; 6) generalizability. Antecedents of self efficacy consist of those facts that 1) new situation occurs; 2) individuals have needs to change the new situation; 3) there are some required actions in new situation. Consequences occurring as a result of self efficacy consist of those facts that 1) individual initiates the of failure; 5) cope with the situation; 6) controls the situation; 7) the level of self efficacy is enhanced; 8) the level of self-esteem is enhanced.

마우스에서 조합시험법에 의한 고려홍삼의 생식발생독성 평가

김미라, 박동선, 장자영, 신선희, 이예은, 백인정, 연정민, 이세라 , 남상섭, 황방연, 노재섭, 김순선, 조대현, 남상윤, 이범준, 김윤배, 윤영원 충북대학교 동물의학연구소 2006 Journal of Biomedical and Translational Research Vol.7 No.1

본문참조

한국해안으로부터 Purple, Non-Sulfur Photosynthetic Bacterium, Rhodobacter sp. EGH-24의 분리 및 특성

차미선,김기한,조순자,이나은,이정은,이재동,이상준,박재림 한국환경과학회 2003 한국환경과학회지 Vol.12 No.12

A species of facultative photo-organotrophic, purple, non-sulfur bacterium was isolated from the 47 point at west and south coast of Korea in September 2001. Separated 13 samples of changes with red color under 28~32 ℃, 3000 lux, anaerobe conditions for 7 days cultivated in basal medium. For pure isolation from 13 samples, we used agar-shake tube method (0.4 % agar) and separated 5 strains through 13-repetition test. EGH-24 and EGH-30 was identified as the same strain through the RAPD(Random Amplified Polymorphic DNA)-PCR of strain EGH-9, EGH-13, EGH-23, EGH-24, EGH-30. Four isolates cultivated in synthesis wastewater for wastewater biodegradation test. EGH-24 was selected with efficient wastwater treating strain. Based on the results obtained from morphology, nutrient requirements, major bacteriochlorophyll content, 16S-rDNA phylogenetic analysis, EGH-24 strain may be identified as a new strain of the genus Rhodobacter and named Rhodobacter sp. EGH-24.

마우스에서 고려홍삼 추출물의 단회 및 반복투여독성 평가

임숙희, 신선희, 장자영, 변상국, 이예은, 박동선, 전정희, 이용경, 이동만, 이세라, 김재승, 황방연, 노재섭, 남상윤, 윤영원, 김윤배 충북대학교 동물의학연구소 2005 Journal of Biomedical and Translational Research Vol.6 No.2

본문참조

하루 콩단백질 25g 섭취를 위한 메뉴작성 및 영양성분 분석

한재숙,김정애,서봉순,이연정,서향순,조연숙,한경필,이신정,오옥희,우경자,조은자,구성자,김수진,李承彦,南出隆久 동아시아식생활학회 2002 동아시아식생활학회지 Vol.12 No.2

The purpose of this study was to develop menus for daily intake of 25g soybean protein and to analyse nutrients of these foods. Analytical values were compared to the theoretical one using the food composition table and recommended dietary allowances for Koreans (7th revision). The results are as follows. 1. Soybean curd residue stew, Soybean curd, Kimchi saute, and hard boiled soybean and lotus root were selected for the menu for January, of which the content of soy bean protein(SBP) was 33.1g, soybean stew, soybean curd and soybean sprout saute, and Italian deep fried soybean curd were for February, of which the content of SBP was 35.0g. The content of SBP in soybean paste soup with soybean curd, fried soybean curd and fried soybean curd roll, the menu for March, was 24.9g. That of April were soybean curd gratin with soymilk, soybean curd and ham with garlic dressing and the content of SBP was 26.3g. That of May were soybean porridge, soybean flour cake with honey (Dasik), soybean sprout soup and the content of SBP was 26.7g. That of June were soymilk, pan-fried soybean curd, steamed soybean curd with chicken and the content of SBP was 28.4g. That of July were noodle with soymilk, mapatofu, soybean curd salad and the content of SBP was 24.7g. That of August were soybean sprout with mustard dressing, Tossed green pepper with raw soybean flour, Tofu and Kimchi stew, soybean curd steak and the content of SBP was 26.2g. That of September were Chinese cabbage soup with raw soybean flour, sweet and sour tofu and the content of SBP was 23.2g. That of Oct. were Fermented soybean stew, soybean pan cake and the content of SBP was 24.3g. That of November were not-pressed soybean curd casserole, pan-fried mashed soybean curd with egg, stir frying deep-fried soybean curd with vegetables and the content of SBP was 22.4g. That of December were soybean curd and mushroom casserole, fried soybean curd and vegetables, hard boiled soybean curd and the content of SBP was 28.9g. 2. The ratio of the analytical value over theoretical value (A/B%) of one serving in kcal, carbohydrate, protein, fat, ash and dietary fiber were 57.7~107.7%, 42.9~131.9%, 79.2~118.3%, 54.5~100%, 40.7~80.8% and 42.1~113.2%, respectively. 3. The ratio of A/B% of one serving in Ca, K, Na, P and Fe were 44.1~93.6%, 59.0~153.1%, 53.1~117.7% 64.6%~138.8 and 33.8~77.3%, respectively. That in Fe was the lowest among minerals. 4. The ratio of analytical value over Korean R.D.A(A/C%) in Ca was relatively higher (22.0~85.9%) than that in kcal(18~63%). 5. The ratio of A/C% in Fe was 25.1~64.3% and lower than that in Ca and protein in general.

국내 시판 항생제의 허가 용량 및 용법의 적정성에 대한 고찰 : 국내 약제사용설명서(package insert)와 미국 Physicians' Desk Reference의 비교 Comparison of Domestic Package Inserts with Physicians' Desk Reference

이재갑,이연주,황병연,정혜원,정성주,김성범,정희진,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 국내 시판중인 항생제의 1일 투여량과 투여간격의 적정성을 확인하고 적응증 및 중증도에 따른 항생제 용량 제시 여부를 확인하기 위하여 항생제 시판시 KFDA의 허가사항을 담은 약제사용설명서을 미국 FDA 공인 약제에 대한 사용지침으로 쓰이고 있는 PDR(Physicians' Desk Peference)과 비교하였다. 방법 : PDR에 등재되어 있는 항생제 중에서 시럽 및 도포용 항생제를 제외한 총 61종에서, 국내에 시판되어 있는 51종 항생제의 약제사용설명서를 대상으로 1일 투여량, 투약횟수, 적응증 및 중증도에 따른 설명 정도를 비교하였다. 결과 : 1) 1일 투여량 비교 : 비교 가능한 전체 항생제에서, 약제사용설명서가 PDR보다 적은 용량을 제시한 경우는 경구용 8종, 주사용 11종으로 총 19종(37%)였으며, 많은 용량을 제시한 경우는 경구용만 2(4%)종이었고, 동일하거나 비슷한 용량을 제시한 경우는 경구용 15종, 주사용 15종으로 총 30(59%)종이었다. 약제사용설명서에서 적은 용량이 제시된 항생제 중 경구용인 cefdnir, cefixime, cefpodoxime, ofloxacin, levofloxacin, norfloxacin(6종), 주사용인 cefazolin, cefotetan, ceftizoxime, meropenem (4종) 등 반수이상의 약제가 일본제약회사로부터 국내에 수입된 약들이었으며 일본의 약제 사용설명서와 동일한 용량을 제시한 것을 알 수 있다. 2) 투여간격 비교 : 비교가능한 항생제 51종 중에서 국내약제사용설명서가 PDR과 동일한 투약횟수, 투여간격을 제시한 항생제는 30종(59%)이었다. 국내 약제사용설명서가 PDR보다 적은 투약횟수, 긴 투여간격을 제시한 항생제는 9종(17%)이었다. 오히려 많은 투약횟수, 짧은 투여간격을 제시한 항생제가 12종(24%)이나 되었다. 경구용만 비교하였을 경우 국내 약제사용설명서가 PDR보다 적은 투약횟수를 제시한 항생제는 없었으며, 동일하세 제시한 경우는 15종, 빈번한 투약횟수를 제시한 경우는 10종이었다. 주사용 항생제에서 국내 약제사용설명서가 PDR보다 긴 투여간격을 제시한 항생제는 9종, 동일한 경우는 15종, 짧은 투여간격을 제시한 경우는 2종이었다. 3) 적응증 및 중증도에 따른 비교 : 약제사용설명서에서 적응증 또는 중증도에 따른 용량에 대한 설명이 부족한 경우는 경구용 13종, 주사용 7종으로 총 20종(39%)이었으며, PDR에서는 경구용 1종, 주사용 2종으로 총 3종(6%)이었다. 결론 : 항생제에 첨부되는 약제사용설명서 및 약제사용설명서를 바탕으로 편집되는 의약품집이 항생제를 처방하는 의사들이 용법과 용량을 결정함에 있어 참고 역할을 하고 있으나, 국내의 시판 허가사항을 담은 약제사용설명서가 많은 수에서 적응증 또는 중증도에 따른 1일 투여량과 투여간격에 대한 정확한 정보를 제공하고 있지 못하고 있다. Background : The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. Materials and Methods : Package inserts about antibiotics, only oral or parenteral agent, wereperused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. Results : Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases: 15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases: 8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases : 10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases: 13 oral and 7 parenteral agents) revealed no information for dose adjustment commons to indications or the severity of infection. Conclusion : This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.

담도에 국한되어 증상을 유발한 석회쓸개즙 2 예

윤성우,이지영,하경호,이수경,한나,배효근,박선자 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Limy bile is a rare condition characterized by excessive precipitation of calcium carbonate in the gallbladder or bile duct. Recently we experienced two cases with obstructive jaundice in which limy bile in the common bile duct but not in the gallbladder for one case, and in the common bile duct and intra hepatic duct but not in the gallbladder for another case. The patients were treated by endoscopic sphincterotomy. Here, we report the cases and review the literature.

EDTA의 세정시간에 따른 근관 내 smear layer의 제거효과에 관한 연구

이자경,박상혁,최기운 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.3

본 연구는 EDTA 용액의 적용 시간에 다른 도말층의 제거 효과를 비교하여 EDTA 용액의 최적 적용 시간을 알고자 시행되었다. 단근치 35개를 NaOCI 용액 하에서 근관 형성 후 대조군은 NaOCI 용액 5㎖로 2분간, 실험군은 30초군, 1분군, 2분군으로 세분하여 17% EDTA 용액 5㎖로 각각 30초, 1분, 2분간 세정하였다. 세정이 끝난 치근의 도말층 제거 정도와 상아 세관의 erosion 정도를 주사전자현미경을 이용하여 관찰한 결과는 다음과 같다. 1. 대조군: 도말층이 전혀 제거되지 않았다. 2. 실험군: 1) 중간⅓: 세 군 모두에서 도말층이 거의 완전히 제거되었고, EDTA 적용 시간이 증가할수록 erosion 발생 빈도가 증가하였다. 2) 치근단⅓: 2분군이 다른 두 군에 비해 도말층 제거 정도가 우수하였다. 따라서 erosion 발생을 최소화면서 도말층을 효과적으로 제거하기 위해서는 17% EDTA 용액을 2분간 사용하는 것이 적절한 것으로 사료된다. This study was to verify that the combined application of NaOCI and EDTA was more effective in removal of smear layer than the application of NaOCI alone. Furthermore it was aimed to find out the optimal time for the application of EDTA. Thirty five single rooted teeth were cleaned and shaped. NaOCI solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5㎖ of NaOCI for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5㎖ of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule. The results were as follows; 1. The control group: The smear layer was not removed at all. 2. The other groups: 1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time. 2) Apical⅓: The cleaning effect of 2 min group was better than the others. The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.