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.

Sarcomatoid Carcinoma Arising from Mature Cystic Teratoma

Ho-Chang Lee1, Seung-Myoung Son, Yong-Moon Lee, Ji Hae Koo, Song-Yi Choi, Ok-Jun Lee, Eun-Hwan Jeong 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.2

Malignant transformation of mature cystic teratoma (MCT) is rare. Sarcomatoid carcinoma is a neoplasm comprising malignant mesenchymal cells and a conventional carcinomatous area. Here, we report on a case of sarcomatoid carcinoma arising from an MCT in the left ovary of a 45-year-old female. A unilocular cyst consistent with MCT was observed; however, a nodule within the cyst was confirmed from the resected ovary. Microscopically, the nodule showed both squamous cell carcinoma and pleomorphic sarcomatous components admixing with each other. Lining epithelial cells at the periphery of the main tumor showed squamous metaplasia. When a sarcomatous component is observed in the ovary tumor, it is important to find a squamous cell component, either benign or malignant.

자기 효능의 개념 분석

서순림,이은남,박송자,양영희,이동숙,최은옥,구미옥,김인자,이인숙,김성재,박영임,이은옥 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Today human needs for health promotion and maintenance are increasing. The nursing progression has a great responsibility for helping clients to practice good health behavior. self efficacy was found to be potent predictor in initiating and maintaining the health-related behavior. Therefore, the concept is important in nursig intervention for change of health behavior. The purpose of this paper was to analyze and clarify the meaning of the concept, self efficacy. This study used Walder & Avant's process of concept analysis. Critical attributes of self efficacy were : 1) positive perception of his won capability; 2) intrapersonal strength; 3) possibility of being learned; 4) individuality; 5) specificity; 6) generalizability. Antecedents of self efficacy consist of those facts that 1) new situation occurs; 2) individuals have needs to change the new situation; 3) there are some required actions in new situation. Consequences occurring as a result of self efficacy consist of those facts that 1) individual initiates the of failure; 5) cope with the situation; 6) controls the situation; 7) the level of self efficacy is enhanced; 8) the level of self-esteem is enhanced.

노인 낮병원의 심리사회적 치료 프로그램이 노인의 신경인지기능과 우울 증상에 미치는 효과

유계준,송정은,오병훈,안석균,이홍식,오희철,구은형,황혜숙,이은철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

노인에게 있어서 신경인지기능의 저하와 우울 증상은 가장 흔한 장애이며 신체적, 정신적인 면에 많은 영향을 미치고 있다. 또한 이러한 장애중 비임상군에서 심리사회적 치료개입의 효과가 보고되고 있다. 이러한 측면에서 지역사회에서 노인에게 제공되는 심리사회적 치료개입의 중요성이 높아지고 있다. 이전의 연구에서는 대상이 특정 집단이거나, 비교군이 없거나, 치료효과에 대한 추적 관찰이 이루어지지 않는 등의 제한점이 있었으며, 현재 국내의 노인 낮병원은 소수에 불과하고 이러한 낮병원의 치료효과에 대한 연구는 거의 없는 실정이다. 따라서 본 연구는 지역사회 정신보건센터에서 운영하는 노인 낮병원에 참가하는 노인들을 대상으로 낮병원의 심리사회적 프로그램이 노인들의 신경인지기능과 우울 증상에 미치는 효과와 이에 대한 유지 효과의 유무를 알아보고자 하였다. 경기도 광주군 정신보건센터의 노인 낮병원에 참여한 노인을 치료군으로, 치료를 거부하거나 치료 중 탈락한 노인을 비교군으로 하여 10주간의 낮병원 치료전후와 치료종결 후 10주에 신경인지기능은 한국형 간이 정신상태검사(이하 MMSE-K)로, 우울 증상은 단축형노인우울척도(이하 SGDS)로 평가하여 두 군을 비교하였고 치료군의 치료 직후와 치료종결 후 10주를 비교하였다. 연구결과 노인 낮병원의 심리사회적 치료가 시간에 따른 SGDS점수 변화에 통계학적으로 유의한 영향을 미쳤으며, MMSE-K점수 변화에는 통계학적으로 유의한 영향을 미치지 않았다. 또한 10주 추시가 가능했던 치료군 중 약 43%가 10주 후 SGDS가 증가하여 호전되었던 우울증상의 악화를 보였다. 본 연구 결과 노인 낮병원의 심리사회적 치료 프로그램 개입은 노인에게 있어서 우울 증상을 호전시키며 신경인지 기능에는 직접적인 영향을 미치지 않는 것을 알 수 있었다. 또한 상당수에서 심리사회적 치료 개입으로 인한 우울 증상의 호전이 유지되지 않음을 알 수 있었다. 이는 노인우울증상의 치료에 낮병원의 심리사회적 치료 프로그램이 효과적일 수 있음과 치료 후 이를 유지하기 위한 부가적인 치료개입의 필요성을 시사한다. Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K), and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS). The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.

갑상선 유두암이 병발된 가족성 대장 용종증 1예

백종현,소창배,이은영,이지숙,신은경,박은호,서정아,양재홍,송준영,박선자,박요한,최영식 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome, typically characterized by multiple colorectal adenomas and increased incidence of colorectal carcinomas if it is not treated. Moreover, a variety of extracolonic manifestation are seen. The prevalence of thyroid tumors developing in patients with FAP is about 1∼2%. Generally, papillary thyroid cancer indicates low mortality but ,however, as people get older, the cancer becomes more aggressive. So, the operation is required. Recently we experienced a case of FAP, presenting with papillary thyroid carcinoma, and reported with a brief review of literatures.

식품 기준·규격의 합리적 관리 ·운영에 관한 연구(Ⅰ) : 두부,식용유지, 전분의 분말상 원료에 관하여 Powdered marerials of Tofu, Edible oil, Starch

김희연,홍진환,박혜경,한상배,박종석,이은주,이정성,송경희,최은희,최영준,소경아,성영제,이주엽 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-

본 연구는 분말상 원료(전분, 대두분)의 저장유통시 품질변화를 건전성과 안전성 측면에서 검토하여 식품의 기준 ·규격 설정f.」 합지적으로 반영하고자 하였다. 전분과 패두분의 이물을 검사하고, 2종 대두분(중국산, 미국산)을 ?0일간 IS'c와 30t에 저장하면서 성상, 수분, 산가, 과산화물가, 지방산 조성,아플라톡신 BB의 생성여부를 분석하였다. 중국산 대두분 30'』 저장군에서 50일 이후 곰팡이가 발생한 것 이외에 모든 시료에서 양호한 성상을 나타내었고, 전분과 대두닥 모든 시료에서 이물은 검출되지 않았다. 산가는 중국산과 미국산 시료간에 편차를 보여 증국산 30"C, 50일 저장시료에서 약 10배끙도 증가하였고, 과산화물가는 저장 90일후 15'E 저장군은 약 2.3배, 30'c 저장군은 3배정도 증가하였다. 대두분의 주요 지방산은 linoleic acidf18. 2), oleic acid(18 : 1), palmitic acid(16 : 0)이었으며, 3개월 저장에 따른 지방산 함량의 변화는 미미하였다. 아플라톡신 B₁은 모든 시료에서 검출되지 않았다. The objective of this study was to investigate auality changes of type raw materials(starch, soy flour) during various storage conditions. Starchflour(source of China, U.S.A) were slfred under two temperature(15'C, 30'c) forSensory evaluation, (o.reign material test, moisture content, acid value, peroxide ualue,composition, aflatorin Bi were analyzed. China soy flour(stor·ed 30'f) was contaminated by fungj on 50 days. Except for soy flour contardnated by fungi, sensory characteristics were not changed and foreign mater;als were notdetected. Acid value of China soy flour(stored at 30'C, 90 days) was about 10 times higherlevel before storage and acid value was more influenced by source(China, USA). Peroxide valuewas in proportion with the storage period slightly. The major fatty acid of soy flour waslinoleic acid(18 . 2), an(3 the change of fatty acid composition was not observed. Aflatoxlrl Blwas not detected.

VRSA에 대한 항생물질을 생산하는 방선균의 분리

이지연,양시용,고은지,이승구,김시관,조왕식,송민동 建國大學校 自然科學硏究所 2002 建國自然科學硏究誌 Vol.13 No.2

본 연구가 VRSA에 대한 신규 항생물질 생산 균주를 얻기 위하여 실시하였다. 국내외에 채취한 토양시료에서 분리한 방선균 중, 임상분리 VRSA와 돌연변이 유발 VRSA에 대해 항균성을 나타내는 JY-24를 선별하였다. 선발 균주는 원통형의 포자 모양을 갖고 있으며, Bennett's 배지에 배양시 aerial mycelium color는 흰색을 나타냈으며, reverse side color는 대체로 노란색을 나타내었다. 항균물질 생산을 위한 탄소원으로는 fructose, mannose, 질소원으로는 yeast extract가 가장 우수하였으며 glucose의 첨가로 항균 물질 생산성이 증가하는 것으로 나타났다. 최적 초기 pH는 pH 7로 나타났으며, 28 ℃, 37℃, 45 ℃의 온도에서 균이 성장하는 것으로 나타났다. 또한 배양기간에 따라 항균물질 생산성을 조사한 결과, 임상분리 균주에 대해 5일 배양 시 가장 높았으나, 3일 배양과 7일 배양 시 동일한 생산성을 나타내 생산속도가 빠르며, 안정한 물질인 것이 파악되었다. 향후 균주동정 및 항균물질 정제에 관한 연구를 수행하고자 한다. An antibiotic substance producing strain JY-24, effective to the VRSA (Vancomycin-resistant Staphylococcus aureus), was isolated from soil. The spore chain of JY-24 was cylindrical, and its sulface was smooth. The aerial mass color of the strain was white, and its reverse side color was yellow. The strain did not produce soluble pigment. For the production antibiotics, fructose, mannose and yeast extract were favorable as carbon and nitrogen sources. Optimal initial pH for the production of the antibiotic was pH 7. Accumulation of the antibiotic in the culture broth reached at maximal level after 5 days cultivation in Bennett's medium.

혐기·호기공정을 이용한 생물막법에서 유기물, 질소 및 인제거에 관한 연구

이성기,송영일,김현중,진성기,김은영 조선대학교 환경연구소 2001 環境硏究 Vol.17 No.1

Anoxic and Oxic process with contact media is used to remove an organic matter, nitrogen and phosphorus in sewage which derives from domestic wastewater. Experiments have been done with various conditions that concentration of oxygen can be 3mg/ℓ, 4∼5mg/ℓ and 5∼6mg/ℓ by controlling an retention time can be 10hr, 12hr and 14hr, return rate can be 0%, 100% and 200%. As the concentration of oxygen is 2∼3mg/ℓ. The rate of removal of BOD. COD. SS. T-N and T-P is 87%, 76%, 82%, 34% and 24%. As the concentration of oxygen is 5∼6mg/ℓ. The rate of removal of BOD, COD, SS, T-N and T-P is 92%, 84%, 88%, 45% and 33%. In the rate of removal of an organism, nitrogen and phosphorus thus It well be known that the rate of removal an organic matter, nitrogen and phosphorus will be increased as the concentration of oxygen becomes higher. As th retention time is increased, the rate of removal of BOD, COD, SS, T-N and T-P is gradually higher in the rate of removal of an organic matter, nitrogen and phosphorus. Because contact time and contact area will be increased, which generates active substrate transfer and metabolic react according to increment of retention time. As the return rate is increased. The rate of removal of BOD, COD and SS is likely to be increased. In the case of T-N. It is also increased by 28% at 0% of the return rate and by 60% at 200% of the return rate. In the case of T-P, however, It is deceased, as the return rate is increased by 42% at 0% of the return rate and by 30% at 00% of the return. As the return rate is increased the retention time is decreased, which causes less activity of bacterial which affects that the rate of removal of Phosphorus is decreased.

딜티아젬 함유 코아 펠렛으로부터 약물의 용출에 미치는 폴록사머 함량의 영향

이승우,감성훈,홍지웅,최기송,박은석,지상철 한국약제학회 2002 Journal of Pharmaceutical Investigation Vol.32 No.4

In order to evaluate the effect of poloxamer 407 content on the dissolution profiles of pellets, diltiazem HCl (DTL) core pellets were prepared with poloxamer 407 (50∼90% w/w, with lactose as filler) using an extruder and a spheronizer. Any possible interaction between the drug and excipients was evaluated using DSC, IR and TLC. Dissolution tests were performed using USP basket method. In addition, scanning electron micrograph was performed to examine the surface roughness and cross sections. The release of DTL from the core pellets was decreased with increasing poloxamer 407 content. Cracks appeared on the surface of the core pellets with increasing the poloxamer 407 content, which may play a role on the retardation of the release of DTL from core pellets. There was no any significant interaction between the drug and excipients employed to prepare the core pellets.

農業系高等學校 學生의 벼농사 基礎能力과 그 關聯要因

李殷雄,李庸煥,宋海均 서울大學校 農科大學 1979 서울대농학연구지 Vol.4 No.2

The purpose of the study was to determine what kind of basic ability the farmers need for rice farming and to examine the level of basic ability in rice farming retained by students in agricultural high schools and to evaluate the relationship between their abilities and certain variables. In October, 1977, fourteen high schools which vocational agriculture subjects are taught were selected by the stratified sampling method. The test of basic ability in rice farming administered by the researcher, and Song's achievement motivation inventory, were then undertaken, using as subjects 1480 third year students from the sampled schools. The test of basic ability in rice farming was also used to measure the cognitive abilities such as knowledge, understanding, application, analysis, comprehension, and evaluation, accrding to Bloom's classification of educational objectives. Various personal information such as effort to acquire knowledge of skill in agricultural subject matter, farming experience, special preparation for entrance or employment examination, club activities, self-confidence, number of brothers and sisters, birth order, father's schooling. family income per month, real estate, preference for agricultural subject matter, and the parents' expectation in the child's career selection, were obtained through the questionnaire. Individual intelligence quotient and academic achievements with regard to rice crop science, soil and fertilizer, farm management, crop protection, and farm machinery, were obtained from the official student records at each school. Course units on each subject matter, which the students had taken for three years, were also surveyed. The basic procedual design in the study was for the researcher to manipulate the independent variables and observe how the dependent variable (the basic ability in rice farming) changes. The statistical techniques used in the study were, frequency, percentile, arithmatic mean, standard deviation, one-way and two-way analysis of varience, Duncan's new multiple range test, factor analysis by principle component analysis with iteration, Hayashi's theory of quantification (Ⅰ), (Ⅱ), (Ⅲ), canonical correlation analysis, simple correlation analysis, and multiple regression analysis. The data were analyzed by SPSS (Statistical Package for the Social Science) utilizing FACOM 230-60/75 at the Hokkaido University Computing Center of Japan. The major findings of the study were as follows; 1. The test of basic ability in rice farming seemed to be able to measure the ability in rice farming and cognitive abilities of the students. The half-split reliability coefficient of the test inventory was. 72 which was calculated by the Spearman-Brown fromula. The full score of the instrument was 46, the highest being 39, the lowest being 5, a mean score of 20.22, and a standard deviation of 5.64. 2. The basic ability scores in rice farming differed significantly among groups of school. 3. The basic ability scores in rice farming of the students in urban areas were the highest and of those in the suburbs of large cities the lowest. 4. The basic ability scores in rice farming differed significantly among the different kinds of schools; the scores of the students of the demonstration agricultural high schools were the highest and those of the students of comprehensive high schools the lowest. 5. The basic ability scores were positively correlated, beyond the significant level, with regard to the intellingence quotient scores, achievement motivation scores, academic achievement scores of subject matter related to rice farming, mean score of total academic achievements, and effort to acquire knowledge or skill in agricultural subject matter. 6. The basic ability scores were positively correlated, beyond the significant level, with regard to the level of farming experience prebvalent in the farming group that the students wanted to engage in farming after graduation. 7. The group of students who had one or two brothers or sisters showed a lower score in their basic ability in rice farming than the groups of students who had more than three brothers and/or sisters, although the scores did not differ with regard to birth order. 8. The role of general factor in factor analysis using the variables-cognitive abilities, ten academic achievement scores, intelligence quotient scores, and achievement motivation scores was not clear. 9. Canonical correlation coefficient was .50 between the first set which consisted of cognitive abilities and the second set which consisted of nine academic achievement scores, intelligence quotient scores, and achievement motivation scores. 10. The multiple correlation ratio was .57 between the basic ability scores used as a dependent variable and the following ninteen variables used as a independent variable by the analysis involving Hayashi's theory of quantification (Ⅰ); location of school, kind of school, major field of study, total course units of the subject matter related to rice farming, total course units of rice crop science, intelligence quotient, achievement motivation, mean score of academic achievements related to rice farming, mean score of academic achievement in total subject matter, effort to acquire knowledge or skill in agricultural subject matter, farming experience, special preparation for the entrance or employment examinations, club activity, self-confidence, number of brothers and/or sisters, father's occupation, father's schooling, family income per month, and real estate. The ninteen variables were found to discriminate the upper group from the lower group in basic ability in rice farming by eighty two percent proportionably in the analysis of theory of quantification(Ⅱ). The important factors influencing the retention of basic ability in rice farming were, in order, total course units of the subject matter related to rice farming, total course units of rice crop science, mean score of academic achievements in total subject matter, location of school, intelligence quotient, major field of study, academic achievement score related to rice farming, kind of school, effort to acquire knowledge or skill in agricultural subject matter, achievement motivation, and so on.