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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

조선음악, 조선음악가의 困難

정수진(Jung Soo-Jin) 한국민속학회 2005 韓國民俗學 Vol.41 No.-

본 연구는 식민지 시대를 거쳐 해방 공간까지 조선음악을 대표하는 음악인으로 살아간 합화진의 삶을 재조명하는 데 목적이 있다. 이 글에서는 그가 일생동안 조선음악을 대표하는 최고 권위자였던 점을 천착하고자 한다. 따라서 그의 삶에 대한 재조명은 그를 둘러싼 조선 음악과, 음악인들과의 관계, 예술이라는 근대 문화적 표상 속에서 그에게 열린 새로운 가능성과 한계가 무엇이었는지를 포착하는 데 집중한다. 이 연구는 조선음악과 조선음악인이 정치적 현실로부터 어떠한 굴절을 거치면서 정체성을 획득해갔는가를 살피는 작업이 될 것이다. 함화진은 이왕직 아악부의 최고 지위인 아악사장에 오른 인물로, 세습 체제를 따르는 전통적인 아악인의 권위와 기량을 겸비하고 있었다. 또한 그는, 근대 예술 개념이 유입되면서 새롭게 형성되기 시작했던 음악을 둘러싼 사회적 변화에도 민감하였다. 그는 신지식과 서양음악 이론을 적극적으로 학습하면서 아악부 외부 음악계와 긴밀한 관계를 맺었고, 아악부의 대중화와 이론 정립에 주력하면서 자신의 권위를 견인하고자 하였다. 그러나 당시 조선음악이 지니는 사회적 의미는 구왕조 체제 뿐 아니라 식민지 지배 하에서, 그리고 해방 이후 민족문화 건설이라는 대의 하에서 정치에 종속적이었다. 특히 조선음악의 최고 권위자인 함화진이 지니고 있었던 조선음악에 관한 지식과 재능, 여타 음악인들을 규합하는 권위는 정치적으로 중요한 활용의 대상이 되었다. 그리고 이는 함화진이 식민지 시대에는 친일음악가로, 해망 이후에는 좌파로 검거 대상이 되도록 했던 직접적인 배경이었다. The primary purpose of this essay is to trace the Ham Hwa Jin’s walk of life as a korean musician. He was the chief of classical court ceremonial music(雅樂司長) in colonial period, went with the stream, the japanese colonial rule. In the liberated period(1945-1948), he worked for the establishment of ‘national music’, and was arrested with leftist roundup-order by american military administration. But it is only one-sided view to see his career at the political situation. In this essay I focus his social identity as musician of korean music and the musician's walk of life in that history. Secondly, this paper aims to examine the historical process, the korean music get the status in modern system of knowledge, especially ‘art’ and ‘music’. In Ham’s life we can see the typical case of that process. He got the highest authority of korean music in his days. But his authority was fragile, as korean music was so.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

정신분열병 환자에서 얼굴 영상의 작동기억 장애 : 기능자기공명영상연구

이창욱,김태석,주라형,박주미,박여진,김종진,전신수,배치운,김정진,이수정,이철,백인호 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with Schi-zophrenia. We aimed to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Methods : Twelve patients with schizophrenia were recruited along with twelve demographically matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the Perfor-mance of a 2-back working memory paradigm using images of neutral faces as mnemonic content. Rcsults : The patient group performed the tasks with reduced accuracy. Group analysis revealed that the left fusiform gyrus, the right superior frontal gyrus, the bilateral middle frontal gyri/insula, the left middle temporal gyrus, the precuneus, the quadrangular lobules and the vermis of cerebellum showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in the lateral prefrontal cortex and the pahetal lobule was observed from the patient group, all in the right hemisphere. Conulusion : A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

건톳 제조에 관한 연구

정창화,오창경,송대진,김수현,오명철 濟州大學校工科大學産業技術硏究所 1999 尖端技術硏究所論文集 Vol.10 No.1

고품질의 건톳제품을 제조할 목적으로 블랜칭 처리조건, 염도, 색도, 톳의 건조조건 등을 연구하였다. 생톳의 최적 블랜칭 조건은 열탕에서 5초간 처리하였고 이때의 염도는 1.8(NaCl%)로 68%의 염분 제거율을 보였다. 건톳 제조의 최적 건조조건은 열풍건조기로 60 에서 2시간 건조시켰을 때이다. 건톳제품의 수분함량은 10%로 조절하였고 색도는 a(-2.61), b(3.58)이었다. For process dried Hizikia fusiforme product of excellent quality, condition of blanching treatment, salinity, color, and dry condition were investigated. The optimum blanching condition of fresh Hizikia fusiforme was 5 seconds at boiling water. Salinity was 1.8(NaCl%), and effect of salinity elimination was 68%. The optimum drying condition was 2 hours at 60℃ in hot-air drying oven. Moisture content of dried Hijizia fusiforme product was control to 10%, Color was a(-2.61), b(3.58).

치료 저항성 환청을 나타내는 만성 정신분열병 환자에서 측두두정부 반복 경두개자기자극의 효과

정경희,최충식,박진수,이규항,함웅,이승환,채정호 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.5

Objectives : It has been reported that repetitive transcranial magnetic stimulation (rTMS), which stimulate the focal region of brain may relieve auditory hallucination in patient with schizophrenia. This study was aimed to evaluate the effect of rTMS on left and right temporopahetal cortex in schizophrenic patients with treatment-resistant auditory hallucination. Methods : Twenty-six patients with chronic schizophrenia with treatment -resistant auditory hallucination were randomly a1-located to rTMS group on left and right temporoparietal head regions. The rTMS was applied to TP3/4 region by EEG 10-20 international system at 1 Hz for 20 minutes per day for 101reatment days. A Figure of eight TMS coil with a solid core was used for rTMS at 100% of individual motor threshold. Efficacy was evaluated with Auditory Hallucination Rating Scale (HRS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) Scale on 5 and 10 days of treatment. Results : Ten days administration of l-Hz rTMS to temporopahetal cortex significant improved frequency (p<0.001) and attentional salience (p=0.038) of auditory hallucination, Positive (p<0.001) and negative symptom (p=0.02), and CGI-impro-vement (p<0.001). There were no significant differences between right and left side stimulations. Conclusion : These results suggest that the low frequency rTMS on temporopahetal cortex may be useful in treating Schizo-phrenic patients with treatment-resistant auditory hallucination and it could be a useful novel treatment option.

사람, 집박쥐 및 마우스 파네트세포의 Lysozyme 면역반응성

정진웅,차정호,오수자,전정수 대한해부학회 1991 Anatomy & Cell Biology Vol.24 No.2

반복적인 실신 및 실신전환자의 기립경사 검사시 뇌혈류 변화

조수진,김준수,이광호,정진상,송희정,이상철,서정돈,이원로 대한신경과학회 1999 대한신경과학회지 Vol.17 No.3