• 한국화재소방학회논문지
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• 제34권1호
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• pp.135-141
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• 2020

2015년 바레인에서 귀국한 한국인이 처음으로 메르스 확진 판정을 받으면서 대한민국 메르스 유입이 확인되었다. 최초 메르스 확진 판정 후 감염자가 병원으로 후송 된 후 2차 감염자가 늘어났고 그 이후 대한민국은 메르스 공포에 떨어야 했다. 이 때 격리구급차 도입이 이루어지고 있었으나 들것 이송 중 오염에 대해서는 뾰족한 방법이 없었고 격리구급차 도입이 제한적으로만 이루어지고 있었기에 서울대학교 병원과 서울시립대학교에서는 이송용 격리 이송 장치 및 공기정화장치(양·음압기)를 개발하였다. 하지만 메르스 사태가 발생한지 4년이 지난 현재까지도 격리이송장치 및 공기정화장치에 대한 성능평가 시험법이 미흡한바 본 연구에서는 시뮬레이션 및 시험을 통하여 도출된 차압, 공기의 흐름에 따른 결과를 통하여 소형격리장비 내부와 외부의 차압을 측정하여 바이러스의 외부유출 및 내부밀폐가 가능한 최소 수치를 제안 하였으며, 이를 통하여 소형격리이송장비의 성능평가 및 시험법에 대하여 제안하였다. 해당 소형격리이송장비의 중요 기능을 정의하고 이를 평가항목으로 선정하여 현실과 유사한 상황을 모사하여 성능평가를 수행하였다. 그 결과 격리이송장치 내부의 양압과 음압의 적절한 압력 구성과 헤파필터의 명확한 기준이 명시되어 격리이송장치 및 공기정화장치의 성능기준을 명확하게 규정해야 함을 도출하였다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1318-1326
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• 1992

Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

• Journal of Chest Surgery
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• 제27권3호
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• pp.177-186
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• 1994

Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.

• Journal of Chest Surgery
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• 제45권2호
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• pp.110-115
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• 2012

Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

• 대한핵의학회지
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• 제25권1호
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• pp.46-52
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• 1991

Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a BARC(Bhabha Atomic Reserch Center, India) nebulizer with 15 mCi of $^{99m}Tc-phytate$. The scanning was peformed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with $^{99m}Tc-MAA$. Follow-up scans were obtained in 5 patients after bronchodilator therapy. The patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of basal interstitial markings in 26 of the 31 patients. Chest radiographs were norma! in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 17 patients. The abnormality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abnormality and the effect of treatment with bronchodilators in patients with bronchial asthma.

• International Journal of Automotive Technology
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• 제4권2호
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• pp.77-86
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• 2003

How to compare the environmental damage caused by vehicles with different foe]s and drive trains\ulcorner This paper describes a methodology to assess the environmental impact of vehicles, using different approaches, and evaluating their benefits and limitations. Rating systems are analysed as tools to compare the environmental impact of vehicles, allowing decision makers to dedicate their financial and non-financial policies and support measures in function of the ecological damage. The paper is based on the "Clean Vehicles" research project, commissioned by the Brussels Capital Region via the BIM-IBGE (Brussels Institute for the Conservation of the Environment) (Van Mierlo et at., 2001). The VriJe Universiteit Brussel (ETEC) and the universite Libre do Bruxelles (CEESE) have jointly carried out the workprogramme. The most important results of this project are illustrated in this paper. First an overview of environmental, economical and technical characteristics of the different alternative fuels and drive trains is given. Afterward the basic principles to identify the environmental impact of cars are described. An outline of the considered emissions and their environmental impact leads to the definition of the calculation method, named Ecoscore. A rather simple and pragmatic approach would be stating that all alternative fuelled vehicles (LPG, CNG, EV, HEV, etc.) can be considered as ′clean′. Another basic approach is considering as ′clean′ all vehicles satisfying a stringent omission regulation like EURO IV or EEV. Such approaches however don′t tell anything about the real environmental damage of the vehicles. In the paper we describe "how should the environmental impact of vehicles be defined\ulcorner", including parameters affecting the emissions of vehicles and their influence on human beings and on the environment and "how could it be defined \ulcorner", taking into account the availability of accurate and reliable data. We take into account different damages (acid rain, photochemical air pollution, global warming. noise, etc.) and their impacts on several receptors like human beings (e.g., cancer, respiratory diseases, etc), ecosystems, or buildings. The presented methodology is based on a kind of Life Cycle Assessment (LCA) in which the contribution of all emissions to a certain damage are considered (e.g. using Exposure-Response damage function). The emissions will include oil extraction, transportation refinery, electricity production, distribution, (Well-to-Wheel approach), as well as the emission due to the production, use and dismantling of the vehicle (Cradle-to-Grave approach). The different damages will be normalized to be able to make a comparison. Hence a reference value (determined by the reference vehicle chosen) will be defined as a target value (the normalized value will thus measure a kind of Distance to Target). The contribution of the different normalized damages to a single value "Ecoscore" will be based on a panel weighting method. Some examples of the calculation of the Ecoscore for different alternative fuels and drive trains will be calculated as an illustration of the methodology.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.161-166
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• 1985

기관지결핵은 폐결핵 환자의 상당수에서 관찰되며, 폐침윤이 없는 경우에도 기관지폐쇄로 인한 무기폐, 임파선 종대로 인한 종괴의 형성으로 타폐질환과 감별을 요하게 된다. 저자들은 1983년 5월부터 1985년 7월까지 영남대학병원에서 굴곡성 기관지경을 사용하여 기관지결핵으로 진단하였던 25예를 대상으로 그 임상상을 관찰 조사 하였기에 보고하고자 한다. 1) 25명의 기관지결핵 환자 모두 항결핵제 투약을 받았으며, 이중 호흡곤란이 심하거나 주 기도내에 광범위한 육아종 병변이 있었던 6명에서는, corticosteroid의 투여로 호전을 보였다. 2) 기관지결핵의 진단에 굴곡성 기관지경을 통한 조식검사나 항산균의 도말 및 배양검사가 필수적이다.

• 생명과학회지
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• 제16권1호
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• pp.58-63
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• 2006

모 조선수리업에 근무하는 1,086명 중 석면에 노출되는 작업공정에 10년 이상 근무한 근로자 118명을 대상으로 단면조사연구를 수행하였다. 연구대상자들에 대해 흥부방사선검사, 폐기능검사와 미국의 산업안전보건청 석면표준, 의학적 감시 프로그램(OSHA asbestos standard, medical surveillance program)에 따라 국내 실정에 맞게 일부 편집한 설문조사를 시행하였고 아울러 이들의 작업장에 대한 작업환경측정 자료도 분석하였다. 흉부방사선검사상 석면관련 폐질환 소견의 유병율은 118명의 근로자중 16명으로 $13.6\%$였다. 흉부방사선검사상 정상군에 비해 석면관련 폐질환 유소견군에서 유의한 요인들은 폐기능검사상 이상소견, 기침, 가래, 호흡기 질환의 과거력, 근무력이었다. 본 연구 결과를 통해 볼 때 폐기능검사 소견상 이상소견, 기침과 가래의 임상증상을 호소하거나 호흡기질환의 과거력, 20년 이상의 근무력이 있는 근로자에 대해서는 석면관련 폐질환의 엄격한 관리가 필요할 것으로 생각된다. 그리고, 본 연구에서 관련성 여부를 완전히 배제할 수 없었던 요인들에 대해서는 향후 광범위한 전향적 연구를 통하여 연관성을 규명하여 석면노출 사업장의 의학적 감시 프로그램에 적극 활용되기를 기대한다.

• Journal of Chest Surgery
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• 제31권5호
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• pp.509-512
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• 1998

후측개흉술은 흉근을 절단하는 단점은 있으나 훌륭한 수술시야를 제공하므로 표준개흉술로 이용되고 있다. 이에 반하여 근육보존수직개흉술은 흉근이 보존되며 팔을 내리면 액와부 수술 상흔이 감추어지는 미용상의 장점이 있다. 그러나 수직개흉술은 흉부의 정측면에 절개선이 이루어지므로 측와위에서 수직으로 수술시야를 내려다보게 되어 흉강내의 구조물, 특히 폐문부나 첨부 및 하부의 길이가 멀어져 수술조작이 불편하다. 본 인하대병원 흉부외과에서는 수술조작에 관련된 차이를 알아보고자 후측개흉술(15례)과 수직개흉술(14례)을 이용해 폐쐐기절제술 이상의 수술을 실시한 29례에서 수술과 관련된 임상지표들을 비교관찰한 결과, 수술시간, 수술 1일과 2일의 흉관 배액량, 흉관 거치기간, 수혈 수와 수혈량, 수술 중 실혈량, 수술 후 합병증 등에서 양군간에 차이가 없었다. 이상의 결과를 볼 때 근육보존수직개흉술도 후측개흉술과 마찬가지로 폐절제술시 안전하게 사용될 수 있다고 본다.

• Molecules and Cells
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• 제39권7호
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• pp.543-549
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• 2016

MicroRNAs (miRNAs) have been reported to be involved in many neurodegenerative diseases. The present study focused on the role of hsa-miR-144-3p in one of the neuro-degenerative diseases, Parkinson's disease (PD). Our study showed a remarkable down-regulation of miR-144-3p expression in 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-treated SH-SY5Y cells. MiR-144-3p was then overexpressed and silenced in human SH-SY5Y cells by miRNA-mimics and miRNA-inhibitor transfections, respectively. Furthermore, ${\beta}$-amyloid precursor protein (APP) was identified as a target gene of miR-144-3p via a luciferase reporter assay. We found that miR-144-3p overexpression significantly inhibited the protein expression of APP. Since mitochondrial dysfunction has been shown to be one of the major pathological events in PD, we also focused on the role of miR-144-3p and APP in regulating mitochondrial functions. Our study demonstrated that up-regulation of miR-144-3p increased expression of the key genes involved in maintaining mitochondrial function, including peroxisome proliferator-activated receptor ${\gamma}$ coactivator-$1{\alpha}$(PGC-$1{\alpha}$), nuclear respiratory factor 1 (NRF-1) and mitochondrial transcription factor A (TFAM). Moreover, there was also a significant increase in cellular ATP, cell viability and the relative copy number of mtDNA in the presence of miR-144-3p overexpression. In contrast, miR-144-3p silencing showed opposite effects. We also found that APP overexpression significantly decreased ATP level, cell viability, the relative copy number of mtDNA and the expression of these three genes, which reversed the effects of miR-144-3p overexpression. Taken together, these results show that miR-144-3p plays an important role in maintaining mitochondrial function, and its target gene APP is also involved in this process.