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.

여성 외음부에 발생한 선상 편평상피세포암종

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

GC-ECD를 이용한 유기염소계 및 Pyrethroid계 농약 동시 분석법

김우성,이선화,김재이,정지윤,이명자,박영채,이영자,정성욱,이봉헌,박흥재 한국환경과학회 2003 한국환경과학회지 Vol.12 No.4

Pesticides were extracted from samples with 70% acetone and methylene chloride in order, and then cleaned up via open-column chromatography apparatus packed with florisil, and finally analyzed simultaneously the organochlorine and pyrethroid pesticides using GC(ECD). An ultra-2 fused silica capillary column was used to separate and identify the products. The resolution between the last isomeric peak of cypermethrin(59.987min) and the first isomeric peak of flucythrinate(60.043min) was not satisfactory. The last isomeric peak of fenvalerate(62.344min) and the first isomeric peak of fluvalinate(62.397min) were overlapped. Recoveries of soybean sample for the most pesticides were 73.3% to 102.4%. Detection limits were between 0.004 and 0.063 ㎍/㎎ when this method was used.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

경기도 안성군내 초등학교 학생들의 요충감염 양상

이선화,이옥란,남해선 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

We examined the prevalence rate of Enterobius vermicularis infection by single examination of cellotape anal swap for 658 children of 4 primary schools and attatched kindergartens in Ansung of Korea in June, 1996. The total positive rate was 12.9%, and that of female children(15.9%) was higher than male(10.0%). Treatment was achieved by three different ways with albendazole 400 mg as a total. Six months later, follow-up examination was done. Overall egg positive rate of follow-up study was 6.8%. The change of egg positive rates between first and follow-up examination of each group were as follows: 1. A group of single medication for egg positive children only : 13.3% to 7.5% (reduction rate, 43.6%). 2. A group of single medication for all individuals in a class : 9.2% to 4.6% (reduction rate, 50.0%). 3. A group of twice medication at an interval of 20 days for all individuals in a class : 19.3% to 8.6% (reduction rate, 55.4%). These results suggest that medication of albendazole of every six months may be reduce the egg positive rate of Enterobius vermicularis remarkably, especially the group that has relatively low prevalence rate of enterobiasis.

천안 순천향병원 입원환자의 와포자충 난포낭 감염율

이옥란,이선화 순천향의학연구소 2000 Journal of Soonchunhyang Medical Science Vol.6 No.2

From March 1998 to December 1999, 497 stool samples from inpatients with various disease in several departments of Chunan Soonchunhyang hospital were examined for the prevalence of Cryptosporidium. Stool samples were stained by a modified acid-fast technique for oocyst of Cryptosporidium. In results, Cryptospridium oocysts were found in 76 of 497 stools by modified acid-fast staining technique. The prevalenve was 15.29%. The prevalence of Chungcheongnamdo that hold to 91.35% of examined stools was 15.29%. The prevalence was 13.98%(33/236) in chunan, was 16.5%(36/218) in other chungnam areas except chunan. By age groups, the prevalence was more higher in sixties~seventies age groups than to that other age groups. By sex, the prevalence were more higher in male than female in age groups before forties, and were more higher in female in age groups after fifties. Consistency(diarrhea, semi-solid, solid) of stools were not associated with Cryoptosporidium positive rates. In conclusion, it was considered that the prevalence of Cryptosporidium was spreading in all over the chungcheongnamdo.

高血壓性 腦實質內 血腫

李和東,韓允善,鄭煥永,李憲梓 中央醫學社 1971 中央醫學 Vol.20 No.2

A total of 32 cases of spontaneous intracerebral hematoma caused by hypertension and unknown origin is surgically treated and reviewed. Thirty two cases comprised 22 males and 10 females with a ratio of 2.2 too 1. The age ranged from 30 to 61 years with the highest incidence at 5th and 6th decades. The most important one as to prognosis is the level of consciousness, and the age per se does not influence significantly to the mortality or morbidity. Surgical exploration is better, attempted when the clinical features denote a space occupying lesion.

아로마요법이 혈액투석환자의 불안과 우울에 미치는 효과

이명화,고광욱,송명숙,우경미,조선화 대한기초간호자연과학회 2004 Journal of korean biological nursing science Vol.6 No.1

Introduction : Chronic hemodialysis patients have been psychological problems because of being compelled to follow a dialysis schedule for a long period of time. Specificially, depression and anxiety are so frequently observed that psychological management is requireed for most hemodialysis patients. Fragnance has been known to have beneficial psychological and physiological effects on human. This study was designed to investigate the psychological effect of aromatherapy on chronic hemodialysis patients. Methods : 40 subjects of this study selected from Je Young-Sung Internal Medicine Clinic in Busan. The experimental group were random assigned to 20 subjects who had visited on Monday,& Wendesday & Friday and received aromatherapy every day for 2 weeks. the control group were random assigned to 20 subjects who had visited on Tuesday & Thursday & Saturday and did not receive any intervention. Experiment had been conducted from July. 7th July 21, 2003 and anxiety by Spilberger's state anxiety scale and depression by Zung's Scale were measured in the course of aromatherapy for both experimental group and control group. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing 100% lavender necklace for 2 weeks. Data were analyzed by, frequency, percentage, mean, S.D. χ²- test, t-test. Results : 1) Anxiety scores were not significantly decreased in the experimental group(54.57±13.20) after treatment compared to the control group(49.45±12.41)(t=1.225, p=.228). 2) Depression scores were significantly decreased in the experimental group(43.95±5.63) after treatment compared to the control group(49.65±9.84)(t=-2.367, p=.023). Conclusions : These findings indicate that the aromatherapy may decreased depression. It is suggested that the aromatherapy could be an effective nursing intervention to reduce to depression by chronic hemodialysis patients.

흰쥐 간장 내 일록춘폐흡충의 충낭 1례

이옥란,이선화 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

The ectopic infection except lung of Paragonimus species are frequent occurrence, but the liver rare involved as a site of ectopic Paragonimiasis. There are not reported till now for liver invasion of Paragonimus iloktsuenensis. This is a report that we have observed a case of the ectopic liver infection of P. iloktsuenensis in an experimental infected albino rat. As a rat among 1,017 rats that were experimented infection with P. iloktsuenensis during 13 years(1989~2001) in the department of Parasitology in Soonchunhyang Medical College, the rat was experimentally infected with 70 excysted metacercariae of P. iloktsuenensis through oral route, was autosied on sixth week after infection, At autopsy of the rat, 7 cysts contained two worms in each cyst was detected in lung and a cyst were detected in live as ectopic site. The cyst lesion in the liver was located inside the right lobe of the liver that was a slightly protrudent domeshaped lesion about 10mm in maximum dimensions. In excision of the cyst, two viable worms of P. iloktsuenensis was reside in well developed cyst wall that was surrounded with numerous leukocytes and thick fibrous tissues. These two worms were adult worms that were measured with size of 7×4.3mm and 9×4.1mm respectively and were well developed ovary, testis, vitellaria and uterus on Semicon's Acetocarmine staining. Two adult worms of P. iloktsuenensis in ectopic liver syst of alvino rat was developed as same as development in lung. We supposed that the route of ectopic liver infection was assumed to be a direct invasion during larval migraton from intestine to lung of albino rat.

大學에서의 心理劇 集團相談

李恩順,康順華 韓國臨床藝術學會 1990 임상예술 Vol.5 No.-