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.

Floristic characteristics of vascular plants and first distributional report of Pseudostellaria baekdusanensis M. Kim in Yongneup wetland protected area

Young-Chul Kim,Hyun-Hee Chae,Sang-Heock Oh,Seung-Ho Choi2,Moon-Pyo Hong3,Gi-Heum Nam,Jae-Yoon Choi,Hyun-Sook Choi,Kyu-Song Lee 한국환경생태학회 2015 한국환경생태학회지 Vol.29 No.2

Yongneup wetland protected area, the only high moor in Korea, is a core area to conserve biodiversity. Even though the Yongneup wetland protected area is relatively small, various plant species are distributed in the Yongneup wetland protected area because it includes various habitats showing different environmental gradients. Vascular plants distributed in the Yongneup wetland protected area were identified as a total of 376 taxa that is composed of 73 families, 217 genera, 322 species, 3 subspecies, 44 varieties and 7 forms. For endangered plants designated by the Ministry of Environment, 5 species including Trientalis europaea var. arctica, Lilium dauricum, Halenia corniculata, Lychnis wilfordii and Menyanthes trifoliata were found and 34 taxa were confirmed to be distributed only in the mountainous wetland habitats. Regarding naturalized plants, a total of 11 taxa were distributed, but most of them were distributed in the areas where artificial interference has occurred. And in areas inside the wetlands that are relatively well preserved, 2 species of Bidens frondosa and Erigeron annuus were observed. In this study, the occurrence and distribution of Pseudostellaria baekdusanensis M. Kim, which was recently found in Mt. Baekdu and reported as a new species, were identified in the Yongneup wetland protected area. A wetland is a very vulnerable area to drastic environmental changes and damages to its ecosystem could cause the extinction of rare plant species which are distributed only in the wetlands. Therefore, it is mandatory that current status of the Yongneup wetland protected area is evaluated and actions to prevent rapid environmental changes are taken. Fourteen separate investigations were conducted in 2013 and another four in 2014, to evaluate current status of the Yongneup wetland protected area. These investigations have provided us the basic information for future actions of conservation and restoration.

광주시 도로방음벽 실태 조사에 관한 연구

최형일,정경훈,정숙희 조선대학교 환경공해연구소 1998 環境公害硏究 Vol.14 No.-

Our country has been advanced in the organization of society with rapid industralization for more over 30 years. Gravitation of the population and traffic increase made change in life style and brought about a lot of noise pollution which is not able to be confirmed in sight. The damage of traffic noise will be a serious problem, so the effective and economical counter-measuring of noise will be proceeded when we build up a large building or housing complex and it also needs enlightment activity in order to reduce sound by improvement of how to drive. So, It is possible to be suggested as follows 1) Enforcing the every-ten-day limit on auto usage continuously. 2) Expended execution of noise restriction area. 3) Improvement of procedure in parceling-out. 4) Establishment of walfare facilities on the road side. 5) Application of matrial excluded the outside sounds in the construction on road side. If we consider environmental city condition at the construction and city planning, it is possible to minimize the noise pollution, to make a pleasant environment and to contribute the national health improvement.

혈액에서 연속 분리된 Staphylococcus epidermidis의 항균제 내성 및 Pulsed-Field Gel Electrophoresis 양상

최인옥,정숙인,신동현,박영규,신종희 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : 혈액배양에서 Staphylococcus epidermidis가 분리될 경우 임상적 의의를 판정하기가 쉽지 않으나, 일반적으로 연속해서 분리된 균주가 동일한 유전형을 보이면 균혈증의 원인균일 가능성이 높다고 한다. 재료 및 방법 : 동일한 환자(12명)의 혈액에서 연속 분리된 S. epidermidis 각 2주씩을 대상으로 PFGE를 이용하여 유전형을 분석하여 동일 균주가 분리되는지 유무를 조사하고, 이를 항균제 내성양상 및 균주간의 분리일 간격과 비교하여 보았다. 결과 : 동일인에서 분리된 두 균주간의 PFGE 양상을 비교한 결과, 8명(66.6%)에서 분리된 균주는 동일한 PFGE 양상을 보였으나 4명(33.3%)에서는 서로 다른 양상을 보였다. PFGE 양상이 동일한 8명 중 7명에서는 항균제 내성양상도 동일하였으며, PFGE 양상이 서로 다른 4명에서는 항균제 내성양상도 서로 달랐다. 따라서 동일인에서 연속 분리된 균주에 대한 PFGE와 항균제 내성검사의 일치율은 91.7% (11/12)였다. PFGE 양상은 동일 환자에서 균이 분리된 시간 간격이 4일 이내 일 때 88.9%(8/9)에서 동일하였고, 분리일의 간격이 5일 이상일 때는 모두(3명)에서 서로 다른 PFGE 양상을 보였다. 결론 : 혈액에서 연속 분리된 S. epidermidis 균주의 PFGE 양상은 상당 수 환자에서 서로 달라, 동일 균종일지라도 오염의 가능성도 상당히 높음을 알 수 있었다. 연속 분리된 S. epidermidis 균주의 항균제 내성양상과 분리된 날짜 간격은 유전자형별 검사가 어려울 경우, 동일균주가 연속 분리되었는지 유무를 아는데 도움을 주리라 생각된다. Background : The significance of Staphylococcus epidermidis positive blood cultures is difficult to determine, but repeated isolation of the same organism with the same genotype is suggestive of true bacteremia. Materials and Methods : Two sequential isolates of S. epidermidis from blood cultures of the same twelve patients were genotyped by PFGE. The results were compared with those of antibiotyping and isolation time intervals between the two strains. Results : The two sequential strains from each patient had identical PFGE patterns in 66.6% (8 of 12) of the patients and two different types in 33.3% (4 of 12) of the patients. Antibiotypes of the two isolates from the same patient were different in all 4 patients whose isolates had different PFGE patterns, and they were the same in 7 of 8 patients whose isolates had identical PFGE patterns:the PFGE results were in agreement with the antibiotyping for 91.7% (11/12) of patients. The isolation time interval between the two strains was ≤4 days in 9 cases, 8 of which had identical PFGE patterns. In the 3 cases whose isolates had different PFGE patterns, the isolation time interval between the two strains was ≥5 days. Conclusion : These data showed that two consecutive isolates of S. epidermidis from blood cultures had different PFGE patterns in 33% of patients, suggesting a high prevalence of contamination. In the absence of genotyping measures, both antibiotype and isolation time interval can be alternative and useful tools for determining strain relatedness of sequential isolates of S. epidermidis from blood cultures.

학교급식에 일반 HACCP 모델 적용시 장애요인에 대한 인지도

최숙희,김성희,곽동경 대한영양사협회 2003 대한영양사협회 학술지 Vol.9 No.3

The purpose of this study was to identify obstacles by surveying dieticians' perception in implementing Generic HACCP Plan for school foodservice operations from 2001. The survey was conducted in five areas; Seoul, Kyoung-gi Province, In-cheon, Kwang-ju and Dae-jean. Five hundred and sixty questionnaire were sent by the e-mail address and the local school dietician's Community Board on the internet, 263 were returned. Two hundred and forty were returned by E-mail, return rate was 42.86%. Twenty three were received by the local school dietician's Community Board on the internet. The obstacles were grouped of six fields and indicated thirteen factors in implementation of the Generic HACCP Plan for school foodservice. The six fields were 'status of cooperation within HACCP team', 'cooperation with the external people' such as teachers, food suppliers, student's parents, 'understanding HACCP system of the dieticians', 'hygiene facilities', 'training & educating employees', and 'monitoring'. We used Likert's scale to assess the factor as a obstacle : 5-agree strongly, 4-agree, 3-medial, 2-don't agree, 1-dont't agree strongly. Results of this study are as follows; 1) The scores of thirteen factors indicated as obstacles were over 3(medial) except 'lack of dietician's understanding about HACCP System(2.86±0.97)'. Also only about 63% dieticians recognized that as an obstacle factor. 2) 'Deficiency of hygiene facilities(4.41±0.76)', 'lack of teachers' cooperation(4.23±0.77)', 'inadequacy of the kitchen lay-out(4.19±0.95)' and 'lack of training and educating program for employees(3.97±0.85)' scored most highly. Results from this study show that financial resources and educating system are very important to settle down HACCP system for School Foodservices successfully.

고춧가루내의 고추씨 함량이 김치발효와 항돌연변이 활성에 미치는 영향

최선미,전영수,이숙희,박건영 부산대학교 김치연구소 2002 김치의 과학과 기술 Vol.8 No.-

The fermentation characteristics such as pH, acidity, lactic acid bacterial counts and panel taste of kimchi, and antimutagenic activity of kimchi were studied when the kimchi prepared with different ratio of seed (S) pericarp (P) in red pepper powder and fermented at 15℃. The pHs of P:S = 9:1 kimchi and P:S = 7:3 kimchi decreased gradually during the kimchi fermentation, however, pHs of P:S = 5:5 kimchi and P:S = 3:7 kimchi decreased very fast during the fermentation. The counts of Leuconostoc sp were high in P:S = 9:1 kimchi and P:S = 7:3 kimchi but the levels were low in P:S = 5:5 kimchi and P:S = 3:7 kimchi. Whereas Lactobacillus sp counts were low in P:S = 9:1 kimchi and P:S = 7:3 kimchi, but the counts were high in P:S = 5:5 kimchi and P:S = 3:7 kimchi during the fermentation. P:S = 3:7 kimchi showed the highest prevalence in the panel taste of the kimchis and the P:S = 3:7 kimchi resulted in the lowest prevalence. The antimutagenic activities of the kimchi juices were studied by Ames test using Salmonella typhimurium TA100 and SOS chromotest using E. coil PQ37. As the ratio of the seed increased, the antimutagenicities increased. Among the kimchi samples, P:S = 5:5 kimchi significantly reduced (p<0.05) the mutagenicities induced by aflatoxin B_1(AFB_1) in Ames test and SOS response against N-methy1-N'-nitro-N-nitrosoguanidine (MNNG) in SOS chromotest. From the results of the experiments, the P:S = 7:3 kimchi seems to be the best seed ratio of red pepper powder for the preparation of kimchi in terms of fermentation characteristics and antimutagenicity of the kimchi.

악관절잡음 환자의 하악운동에 관한 연구

최숙희,기우천 전남대학교 치과대학 1991 전남치대논문집 Vol.3 No.1

The purpose of this study is for in the diagnosing, assessing the prognosis, and evaluationg the treatment procedures in TMJ noise patients. The auther measured the msximum mandibular border movements included opening, protrusion, lateral movement and measured the velocity of maximum opening, closing and tooth contacting using the Mandibular Kinesiograph in both thiry-one normal peoples and twenty-six TMJ noise patients. The results obtained were as follows : 1. The experimental group was significantly decreased than control group in the vertical(P<0.001), antero-posterior (P<0.01), lateral(P<0.001) and total(P<0.001) dimensions of maximum mandibular opening. 2. The experimental group was significantly decreased than control group in the antero-posterior(P<0.05), and lateral(P<0.01) dimensions of maximum mandibular protrusive movement. 3. The affected side of experimental group was significantly decreased than control group in the vertical(P<0.05), anteroposterior(P0.01), and total(P<0.05) dimensions of maximum lateral movement. 4. The experimental group was significantly decerased than control group in the maximum/average opening and closing velocity(P<0.001), but was not in the both contact velocity.

암환자를 위한 김치의 개발 : 1. 김치레시피조절에 의한 항돌연변이효과 증진연구 1. Studies on Enhancing Antimutagenic Effect of Kimchi by Changing the Recipe

최선미,전영수,이숙희,박건영 부산대학교 김치연구소 2002 김치의 과학과 기술 Vol.8 No.-

To develop kimchi for cancer patient, we studied on enhancing antimutagenic effect of kimchi by manipulating the recipe from the result of prevalence test on kimchi by cancer patients. According to the result of prevalence test, the patients wanted to reduce the level of red pepper powder and increase some sub-ingredients such as garlic and mustard compared to the standardized kimchi. The recipe-manipulated kimchi was fermented at 15℃ for 1 day and then ripened at 5℃ for several days up to pH 4.2~4.3. The antimutagenic effect of the methanol extracts of the kimchi was evaluated by using Ames mutagenicity test with Salmonella typhimurium TA100. Among the kimchi samples, CP_2-M kimchi (2.5% red pepper powder +7.5% mustard leaf added kimchi) exhibited higher inhibitory effect on the mutagenicity induced by aflatoxin B_1 in the Ames test. In vivo supravital staining micronucleus assay, anticlastogenic effect of the CP_2-M kimchi group was higher than that of the control group. The induction of chromosome aberration by mitomycin C was significantly suppressed by CP_2-M kimchi suggesting in post-treatment.

'확률과 통계'교육을 위한 전자교재 개발에 관한 연구

최숙희 한국컴퓨터교육학회 2002 컴퓨터교육학회 논문지 Vol.5 No.4

컴퓨터와 네트워크의 급속한 발달로 인터넷 사용자가 급증하면서 모든 분야에서 정보전달 매체로서 웹의 활용이 보편화되고 있다. 교육적인 측면에서도 기존의 교실에서의 수업이나 인쇄매체를 통한 교육의 대체매체로서 웹의 활용에 대한 관심이 증대하고 있다. 본 연구에서는 7차 고등학교 수학과 교육과정에서 독자적인 영역으로 새로 분리된'확률과 통계' 영역에 대해 웹상에서 활용가능한 교육용 전자교재의 구현사례를 제시한다. 확률의 계산이나 통계치의 계산 등과 같은 수리연산 보다는 응용학문으로서의 확률과 통계의 개념과 원리의 이해에 중점을 두어 개발하였다. With advancement of computer and network, world wide web(WWW) as medium of information communication is generalized in many fields. In educational aspect, applications of WWW as alternative media for class teaching or printed matter are increasing. In this article, we demonstrate a web based electronic text on the 'probability and statistics' which is one of six fields of mathematics in 7th curriculum. This text places importance on comprehension of concepts and fundamentals of probability and statistics as applied sciences and not on simple calculations of probability and statistics.

健康한 韓國人의 動脈血液 가스 및 酸一鹽基 平衡値에 對한 觀察

崔震守,曺方煥,朴喜淑,金顯承,金瑛,白正敏,徐錫助 순천향의과대학 1979 Journal of Soonchunhyang Medical Science Vol.2 No.3

The purpose of this paper is to make an attempt in this investigation to determine normal adult values of arterial blood gas and acid-base balance in 53 healthy Korean male and female subjects of varying age and then compare with the data obtained by others. Determinations of the acid-base status of the arterial blood were performed at 37℃ by the Astrup method using a radiometer instruments, consisted of BGA2A/3-MK 2 system. The mean and standard errors of each component were as follows: pH 7.42±0.043, oxygen saturation 96.96±0.089%, pO?? 97.66±0.91mmHg, pCO?? 37.08±0.68mmHg, CO?? content 24.29±0.43mM/L, bicarbonate 23.26±0.68mM/L, buffer base 46.56±0.66mEg/L, and base excess -0.024±0.001mEg/S. Compared with normal adult values in literatures, all the components of the data appear to be in the same range without any significant difference.