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.

시중 절임배추의 품질 평가

김진희 ( Jin Hee Kim ),박건영 ( Kun Young Park ),최혜선 ( Hae Sun Choi ),양지영 ( Ji Young Yang ) 한국식품영양학회 2010 韓國食品營養學會誌 Vol.23 No.4

This research aimed to investigate the quality of conventional salted cabbages. Here, we studied the general characteristics and microbiological aspects of purchased salted cabbage samples from 15 companies. The purchased salted cabbages used a sun-dried salt, but two samples used a mixture of sun-dried salt and processed salt. There were 4 times of washing, 3 steps of washing after automatic washing, and 3 steps of washing after bubble washing as washing methods for the salted cabbages and ground water was used as the washing water. Also, three samples received HACCP certification. The salt contained in the purchased salted cabbages ranged from 0.5% to 2.0%, representing low salted cabbages. The pH of the purchased salted cabbages ranged from 5.32 to 6.47, and hardness ranged from 1,997g to 3,665g. Rewashing was necessary before using some salted cabbages due to foreign materials such as insects, soil, etc. Total bacterial counts of the purchased salted cabbages ranged from 3.36 log to 6.06 log and coliform bacteria ranged from below 1 log to 6.05 log, whereas other pathogens were not detected.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

여성 외음부에 발생한 선상 편평상피세포암종

김창옥,양기화,강석진,이안희,김병기,김선무 대한병리학회 1991 Journal of Pathology and Translational Medicine Vol.25 No.1

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.

근위축성 측삭경화증과 연관된 돌연변이 SOD1과 HAX-1과의 상호작용

최진선,이도희 서울여자대학교 자연과학연구소 2011 자연과학연구논문집 Vol.23 No.-

Mutations of SOD1 gene have been linked to certain cases of familial amyotrophic lateral sclerosis (ALS). Despite numerous attempts to elucidate its role in the molecular mechanism, how the mutant SOD1 causes death of motor neurons still remains elusive. A hallmark for ALS is the presence of intracellular inclusions containing mutant SOD1 and ubiquitin suggesting that cells' failure to eliminate aberrant proteins by ubiquitin- proteasome system may be a cause of cytotoxicity. Additional proteins also associate with mutant SOD1, some of which are likely involved in the protein aggregation. Previously we have demonstrated that human SOD1 proteins preferentially interact with molecular chaperones and proteasome subunit in yeast Saccharomyces cerevisiae. To identify human proteins interacting with SOD1, we isolated G93A mutant SOD1 proteins expressed in cultured human cells and analyzed the associating proteins by 2-DE followed by MALDI-TOF mass analysis. As with yeast cells, in human cells mutant SOD1 strongly bound to chaperone proteins, mostly hsp70 and hsc71 proteins. Unexpectedly, we also found that HS-1-associated protein-X-1 (HAX-1), a member of apoptotic regulators, interacts with G93A SOD1. These results suggest that the components of both cellular chaperone and apoptotic machinery are sequestered together with misfolded SOD1 which may eventually lead to the neuronal death. Key words:Amyotrophic lateral sclerosis; mutant SOD1; chaperone; HAX-1.

초등학교 시 교재 선정 기준 탐색

진선희 청람어문교육학회 2004 청람어문교육 Vol.28 No.-

본고는 초등학교 어린이들에게 제공할 시 작품의 선정 기준 마련을 위한 시론으로서, 예술로서 시가 가지는 문학성을 평가하는 원리와, 일반 독자가 아닌 초등학교 학습독자를 대상으로 하는 문학교육 상황에서 교재로 활용하기 위한 시 평가와 선정의 원리를 탐색하려는 의도로 작성되었다. 그리고 이러한 이론적 토대 위에서 필자의 시 교육 경험과 어린이들의 시에 대한 반응을 중심으로 구체적 작품 읽기를 통한 시 교재 선정을 시도하였다. 먼저 예술작품으로서의 시 평가기준이 시 교재 선정의 중요한 원리가 되어야 한다는 논리를 확인하고 그 원리의 구체적 항목으로 새로운 세상을 열어 보이는 독창성, 경직된 사고를 풀어주는 쾌감과 카타르시스, 삶을 성찰하고 북돋우는 도덕성, 정서적 감동으로 일깨워지는 지력, 어린이의 시 수용 경향 및 수용 능력, 문학교육과정 내용과 작품 내적요소로 정리하였다. 그리고 이러한 원리를 근간으로 하고, 또 필자가 초등학교 교실에서 경험하였던 시 교육의 여건과 상황 및 당시 시 수업 과정에서 보이던 어린이들의 반응 내용을 참고하여, 구체적인 작품 읽기를 통해 초등학교 학습독자에게 주어져야 할 좋은 시의 선정에 대한 논의를 전개하였다. 시는 바라보는 각도에 따라 그 평가가 달라질 공산이 크며, 더욱이 동시문학에 대한 평론의 부재 또는 미미함과 초등학교 학습독자들의 반응에 대한 연구 부진, 그리고 교과서에 게재할 시 작품 선정에서 일부 집필자들의 임의적인 작품 선정으로 인해 초등학교 시 교육이 빈약하게 전개되는 상황을 생각할 때 이러한 논의는 앞으로 더욱 활발하게 전개되어야 할 것으로 생각된다. This study is an essay for making bases of selecting poetries for elementary school students prepared to search the principle of evaluating literary characteristics of poetries as art, how to select and evaluate poetries for elementary students, not adults. Moreover, on the basis of those theories, I tried to select poetries through concrete work with priority given to my experience of teaching poetries and the response of children to poetries. First of all, it certifies the theory that the evaluation basis of poetries as an art work should be the important principle and divides it into several details : originality showing new stage, pleasant sensation and catharsis releasing rigid consideration, mentality awakened as emotional excitement, poetry reception tendency/ability, literature education courses, and internal elements of the work. Then it shows the discussion on selecting good poetries which elementary kids should read through reading coherent work with the information about condition of poetry education in elementary school and the reaction of kids in the class which I experience.

학습독자 반응 연구의 문학교육적 함의 및 연구 방향

진선희 한국문학교육학회 2005 문학교육학 Vol.16 No.-

The purpose of this study is to search for position of learning-reader's responses at study and practice of literary education. For that, search for major factor of literary education state and decision factor of learning-reader's responses to develop discussions for state of literary education. I want to help scientific and practical development of literary education through searching for literary educational significance of study on learning-reader's responses. For this, investigate the substance of learning-reader's response. In various respects Learning-reader's response could divided into reading/post-reading response, inner/expressive response, conscious/unconscious responses, individual/correlative response, typical/ nontypical responses, cognitive/emotional response. And through it, the ground-work is done for seek method and category of study on learning-reader's response, and for seek significance of study on learning-reader's responses. It confirm that study on learning-reader's response is presupposition This sort of study have a significance for formulate a system of curriculum literary education, at the same time have a meaning at seek for direction and method of research about learning-reader's response.

경동맥 내막 절제술 후 발생한 과관류 증후군 1예

송희정,박광열,정진상,조수진,이순정,허승,김동익,이광호,이병붕 대한신경과학회 1999 대한신경과학회지 Vol.17 No.2

시 텍스트에 대한 초등학생들의 반응 양상 연구

진선희 한국문학교육학회 2004 문학교육학 Vol.14 No.-

The object of this study is to compare and investigate the preference of elementary students and teachers on poetry and to search for provision in the class, which keeps students close to poetry. Elementary students prefer poetry, which they can sympathize and indulge themselves in easily related to their own experience, which they can see creative world, which the poetic scene is concrete by the harmony of sensitive expression and content, and which the rhythmic factor is strong. On the other hand, students had difficulty on poetry, which the temporal and spatial distance with reality makes it difficult to understand, simple descriptive poem, and which is written by hard metaphor. There were some different things between teacher's preference and students'. These results show that we should consider on textbook selection and teaching-learning in poetry education. Furthermore, the study is required for detailization of student's response on poetic characteristic, systematic explanation and structualization of response process and content, and category classification and hierarchialization of response by an age group.