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.

대동맥 판막 치환술 후 반복되는 Acinetobacter baumannii 균혈증의 원인이 된 대동맥염 1예

정용필,김성철,송은희,장은영,김은경,김윤지,성흥섭,김미나,최상호,우준희,김양수 대한감염학회 2007 감염과 화학요법 Vol.39 No.3

감염성 대동맥염은 흔하지 않지만 매우 위중한 질병으로 Salmonella so.와 S. aureus가 주된 원인균이다. 아직까지 병원내 감염의 주요 원인균인 Acinetobacter baumannii에 의한 감염성 대동맥염은 보고된 바가 없었다. 저자들은 대동맥 판막 치환술을 시행받은 76세 남자 환자에서 적절한 항생제 투여에도 반복되는 A. baumannii 균혈증의 원인이 감염성 대동맥염으로 진단되었던 1예를 경험하였기에 보고하는 바이다. Infectious aortitis is an uncommon yet, life threatening disease. Early surgical treatment and prolonged antibiotic therapy is crucial to survival. Salmonella sp. and Staphylococcus aureus are the most common organisms isolated. There is no case report of infectious aortitis caused by Acinetobacter baumannii, which has recently emerged as a major cause of health care-associated infections. Here, we describe a 76-year-old male with infectious aortitis who experienced recurrent bacteremia due to A. baumannii in spite of adequate antimicrobial therapy after aortic valve replacement.

전신성 홍반성 루푸스 환자에서 병발된 Coxsackievirus B3 심근염 1예

송봉근,임병관,김민형,신성철,정재홍,김동희,김정환,박건우,고은미,전은석 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.12

어린이 김치 표준화에 대한 연구(1) : 어린이 김치의 담금법 개발 Development of the Preparation of Kimchi for the Children

송영옥,전영수,권명자,빈성미,김은희,문정원,김명 부산대학교 가정대학 1995 家政大學硏究報告 Vol.21 No.-

The purpose of this study is reporting the results of first trial for the standardization of children's kimchi in terms of brining standardization, development for the recipe ad pannel test for the children's kimchi. In order to develop the standard recipe for children's kimchi, our research team have visited kimchi factories, temples and houses located in Pusan and Kyung-Sang Nam Do province. Three kinds of chinese cabbage kimchi (hamyang, haeundae, and jinrae kimchi named by region where we collected) which got the top three highest score in panel testing was selected. The original recipes of these kimchi were sightly modified to prepared the kimchi at laboratory. Among three of them, hamyang kimchi which contained dried anchovy power was selected as a model kimchi for development of the children's kimchi recipe. We find out that the optimal salt concentration of brined cabbage and kimchi for the children's kimchi (sliced style kimchi, approximately 2.5X3cm a piece) that showed the hightest pennel score were approximately 1.5% and 2.0%, respectively. The salt concentration of brined cabbage became 1.5, 1.43, and 1.60% after 60 min at 10% brining solution, 45 min at 12% and 30 min at 15%, respectively. The developed recipe used for the children's kimchi at our team is as follows. The major ingredients used for the preparation of kimchi is brined sliced chinese cabbage (salt concentration is 1.5%) 1kg galic 11g, ginger 5.0g, red pepper powder 20.0g, fermented anchovy juice 25.0g, fermented shrimp juice 5.0g dried anchovy and sea weed extracts 30.0g, anchovy power 2.4g glutinious rice gel 40.0g, starch syrup, 10.0g, and apple juice 22.5g. The total acceptability test of developed children's kimchi (test kimchi) was carried out with 84 of 6th grade student during lunch time at elementary school in Pusan where has a school lunch program. Sixty nine percent of student answered test kimchi is very good, 25% of them said it is fair, and only 6% of students answered they didn't like test kimchil. However, for the kimchi supplied from school at lunch, 52% students answered the kimchi is good, 26% of them said it is fair, and 22% of them said they don't like school supplied kimchi. This result tells us that the test kimchi is better than school supplied kimchi and the test kimchi can be developed further as a children's kimchi.

수도권 지역 대학병원과 재활병원의 인턴물리치료사간 인턴 만족도 비교

강순희,전수진,정민현,정은송,이범승,최용진 韓國交通大學校 2013 한국교통대학교 논문집 Vol.48 No.-

The purpose of this study was to compare internship satisfaction of intern physical therapists working in the university hospitals with that of them working in the rehabilitation hospitals in Seoul metropolitan area. The questionnaire for internship satisfaction survey that amended from vocational interest test [Strong Interest Inventory(SII)] was used to examine satisfaction of intern physical therapists and the questionnaire was used to ask general characteristics, educational and work environment. Thirty nine intern physical therapists working in university hospital and fifty nine intern physical therapists rehabilitation hospital in Seoul metropolitan area responded. Frequency analysis, χ² test and independent t-test were conducted to evaluate differences between groups about variables of internship satisfaction survey, general characteristics, work and educational environments with using the PASW 18.0 statistical program. The results of the study were as follows. There were significant differences of intern physical therapists between university hospitals and rehabilitation hospitals in overall scores of internship satisfaction and scores of all sub-items such as duty, supervision, working condition, work mates and wages. Intern physical therapists working in the university hospitals showed higher satisfaction than that of Intern physical therapists working in the rehabilitation hospitals.

신국제질서와 아·태공동체 구상 논의

송은희 경희대학교 아태지역연구원 1994 아태연구 Vol.1 No.-

The principal purpose of this study is to explain the significance of the concept of an Asian and Pacific Community. Problems arising from various existing approaches will also be addressed. Furthermore, in light of the diverse characteristics that have emerged during the transition towards new international politics and world order, this study aims at constructing a theoretical approach on this region, based on th integration theory. "Regionalism" is becoming a major feature of the new political and economic world order, and formation of regional economic blocs receives worldwide attention in the 1990s. After the decline of "globalism" which was the backbone of the post World War Ⅱ capitalist world, "regionalism" has emerged as an effective instrument in managing the diverse and extensive international community. The European Union which was established in the 1950s was recognized as a successful model in the early 1960s and "regionalism" began to gain popularity. The European Union expects to complete its integration by the end of 1992, and the North American Free Trade Agreement (NAFTA) has been established, which makes a search for a new mechanism for regional integration in the Asian and Pacific region inevitable. There are various views on the nature and scope of an Asian and Pacific Community. The following must be noted when considering these different standpoints. First, the major obstacle in the establishment of such a regional community is the lack of a sense of common bonding among nations in this region. In other words, there is a lack of a "sense of community", which reflects the heterogeneity of this region in its history, culture, religion, language and ethnic background. Second, political and military conflict interrupt the process of establishing an Asian and Pacific Community. The former Soviet Union's advance in this region, Japanese military expansionism, and China's participation in the Asian Pacific Era may bring forth a new form of political and military conflict within this region, rather than solidifying it. Third, the establishment of an Asian and Pacific Community is closely linked to the position of the ASEAN. The ASEAN supports the formation of a community that contributes to the maintenance of its neutrality and cohesion. Fourth, the broad scope of the goals of an Asian and Pacific Community make the basie preparation of its establishment a painstaking and time consuming task. In order to tackle the above-mentioned issues, an atmosphere that ensures the active participation of all nations must be cultivated. This study suggests a partial and local integration model for the gradual integration of this region.

귀출파징탕藥鍼의 抗血栓, 抗炎症, 鎭通 및 抗酸化效果

宋炳基,李京燮,宋銀姬 慶熙大學校韓醫科大學韓醫學硏究所 1999 慶熙韓醫大論文集 Vol.22 No.1

This study was projected to investigate the effects of Kwuichulpajing-tang aqua-acupuncture solution manufactured by water-alcohol method. In vivo, to observe the anticoagulative, antiinflammatory and analgesic effects of Kwuichulpajing-tang aqua-acupuncture at Kwanwon(CV4), the experimental animals were divided into a normal, control and two experimental groups. Each of them had 6 animals. As the normal group was untreated, the control group was injected with normal saline(0.1㎖/100g) at Kwanwon(CV4) s.c., and then injected with induction medicine. One of the experimental groups (Sample I group) was injected with 25.0 ㎎/㎖ Kwuichulpajing-tang aqua-acupuncture solution(0.1㎖/100g) at Kwanwon (CV4) s.c., and then injected with induction medicine. The other experimental group(SampleⅡgroup) was injected with 50.0 ㎎/㎖ Kwuichulpajing-tang aqua-acupuncture solution (0.1㎖/100g) at Kwanwon(CV4) s.c., and then injected with induction medicine. The results of the experimental groups were compared with that of the control group. In vitro, the effects of Kwuichulpajing-tang aqua-acupuncture solution on hyaluronidase activity, hydrolysis of casein by trypsin, heat-induced hemolysis and the antioxidative effect were observed. The results were as follows : 1. The effects of Kwuichulpajing-tang aqua-acupuncture at Kwanwon on the intravascular coagulation in rats induced by endotoxin(0.5㎎/㎏) i.v. were that the blood platelet and white blood cell counts were significantly increased in both experimental groups. the blood fibrinogen content was significantly increased in SampleⅡgroup and the prothrombin, the activated partial thromboplastin and thrombin times were significantly shortened in both experimental groups. 2. The carrageenin-induced mice paw edema was significantly decreased in both experimental groups. 3. The histamine-induced mice paw edema was significantly decreased in both experimental groups. 4. The histamine-induced vascular permeability was significantly decreased in SampleⅡgroup. 5. The writhing syndrome induced by acetic acid was significantly decreased in SampleⅡgroup. 6. The response time of mice on 70℃ heat plate was significantly prolonged in SampleⅡgroup. 7. The hypnotic duration induced by pentobarbital-Na was significantly increased in both experimental groups. 8. Kwuichulpajing-tang aqua-acupuncture solution had antioxidative effect and inhibited hyaluronidase activity, trypsin activity on hydrolysis of casein and heat-induced hemolysis in vitro.

아동기 어린이들의 신체활동 프로그램 참여가 체격 및 운동수행능력에 미치는 영향

송종국,이은희 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6

The aim of the study was to evaluate the effect of a physical activity program on body she and physical performance in preschool children aged 5 years, Subjects consisted of 60 children including 30 children participated in physical activity program and 30 children attending private kindergarten as a control group. Anthropometric characteristics were body height, body weight and chest circumference. Physical performance included sit and reach long jump, shuttle run 20m one foot balance, and leg lift. All statistical analysis were carried out by the SAS computer programs, The results showed that significant increases (p<.001) can be obtained for body height, body weight and chest circumference for both groups between pre and post exercise. However, there were no differences for those variables between exercise group and control group in both pre and post exercise. For physical performance parameters exercise group showed significant increase (p<.001) for sit & reach, long jump, one foot balance and 20m shuttle run between pre and post exercise. Also, significant increase were found for flexibility (p<.01), power (p<.05) and agility (p<.05) in control group, For all variables exercise group have higher mean values than control group in post exercise. This study suggest that participation in physical activity program during childhood can influence positively physical performance.

과산화효소를 이용한 백혈구 측정용 뇨 검사지 제조에 관한 연구

송은영,변시명,김희정,김종완,정태화,이홍수,최인성 THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 1996 Journal of biomedical laboratory sciences Vol.2 No.2

백혈구에 존재하는 과산화 효소를 이용하여 뇨 중 백혈구의 수를 간접적으로 측정하는 새로운 방법의 뇨 검사지를 개발하였다. 과산화 수소원으로서 포도당 산화효소와 포도당을, 색원체로서 tetramethylbenzidine을 처리하여 백혈구 측정용 뇨 검사지를 제조하였으며 검출한계는 10cells/㎕ (5 cells/hpf)이었다. 개발된 백혈구 측정용 뇨 검사지로 뇨를 분석하였을 때 뇨 1/㎕당 10-25cells의 백혈구가 존재할 경우에는 2분내에 연녹색을, 75-250 cells/㎕에서는 녹색을 보였고 500 cells/㎕ 이상에서는 녹청색을 보였다. 172명의 환자뇨를 대상으로 뇨중 백혈구 수치를 현미경 측정 결과와 본 연구에서 개발한 백혈구 측정용 뇨 검사지와 현재 수입 시판 중인 미국의 A사 제품과 B사 제품으로 분석 비교한 결과 좋은 상관관계를 보였다. 이와 같은 평가분석을 통하여 볼 때 본 연구에서 개발한 백혈구 측정용 뇨 검사지는 에스테라아제를 이용한 백혈구 측정용 뇨 검사지와 함께 뇨중 백혈구를 스크리닝 하는데 효과적임을 알 수 있었다. A new test strip to detect leukocytes using the myeloperoxidase in urine was developed. The reagent strip contains tetramethylbenzine, glucose and glucose oxidase. The detection limit was between 10 cells per 1㎕ urine(5 cells/hpf), showing greenish yellow color in the range of 10-25 cells/㎕, green color in the range of 75-250 cells/㎕, greenish blue color in the range of 500 cells/㎕. The result can be obtained within two minute. The performance of the new method was evaluated by comparing the results of microscopic examination and other commercial products. Good correlations were shown between the values obtained by our urine strip and those by other commercial products with 172 urine samples. The results were proven that new methods were useful as primary screening reagents to detect leukocytes in urine.

現代社會에 있어서의 自由에 관한 硏究

宋銀姬 숙명여자대학교 대학원원우회 1985 원우논총 Vol.3 No.-

The principal purpose of this study is to explore the basic nature of the concept of liberty circulated in modern societies. Especially, the study focuses on the theoretical establishment of proper harmony between individual liberty and state power within the context of traditional liberalism. In doing so, it would be valuable to discuss the ideology of liberalism in the pure abstract sence. The idea of freedom won a hold on popular imagination in the seventeenth century and from then on was one of the moving forces in history. In its historical course, the idea of freedom underwent many changes in its meaning. To understand this change process, it is necessary to realize that freedom is a very ambiguous concept. In the modern industrial societies, human beings were confronted with the massive social problems such as public poverty and restriction. In the recent stage, modern liberalism emphasizes equality and justice than liberty. Such modern pathologic phenomena are the background of this study. In this point of view, I believe that the concept of individual liberty may be secured by state power, furthermore, that liberalism will have proper meanings when the individual liberty is protected by institutional arrangements that are constrained by various social forces.