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.

루터의 십자가 신학과 득의

문선희 연세대학교 신과대학 2004 신학논단 Vol.35 No.-

非行靑少年의 行動障碍分類를 위한 理論的 背景의 小考

文宣和,李璟禧 부산대학교 사회과학대학 1990 社會科學論叢 Vol.9 No.1

In helping the child who has problems, measuring method is required in order to identify what the problem is. By the way, the tests of juvenile delinquent have not been made systematically yet. We are aware that the methods of coping with juvenile delinquents will be not so useful unless the bases for treating and correcting them fundamentally are provided. Accordingly, in this study we attempt to consider about tools to measure their adaptive-maladaptive behaviors as the first step of a series of helping process in order that the child can live as a sound citizen and the significance of his problem can be minimized through helping to assess it correctly. Though it defines and classifies differently according to settings which a behavior rises and is evaluated, the adaptive behavior, here, is defined one which can be accepted socially in accordance with his age and development, and can meet the members' expectation in the society. Then, the child who shows anti-sociality, anxiety, regression introvert behavior and passive and autistic tendency, is defined as a maladaptive behavior. By the definition, we referred to some ABS as adaptive-maladaptive measures to diagnose the mental retardation and the emotional/behavioral disorder, and considered the way which those are used in practice and what is asked about each measure. And we investigated all kinds of testing methods being used presently in order to identify and understand their backgrounds, in our Juvenile Justice System. Each setting to be able to apply to the ABS in this process was also considered.

자연치와 복합레진의 색 분포에 관한 연구

김희선,이인복,엄정문 대한치과보존학회 2001 Restorative Dentistry & Endodontics Vol.26 No.2

The structure of current guides is largely illogical and without any rational use of color ordering. The shade guides are generally made of plastic (rather than the actual composite material) and do not accurately depict the true shade, translucency, or opacity of the composite resin after polymerization. To solve this problem, information based on evaluations of natural teeth and material that use the same method and experimental conditions is necessary. The present investigation measured the color of natural maxillary anterior teeth in vivo and compared the results with those of composite resins. 269 Korean subjects were selected for this study. Intact central incisor, lateral incisor, and canine were selected. The clinical crowns were free of caries or restorations. The middle site of the coronal portion on the labial surface of the tooth was measured by Chroma Meter. The five light activated, resin-based materials(Amelogen, Denfil, Elitefil, Spectrum, Z100) were used in this study. Resin composite was condensed into plastic mold with a diameter of 8mm and a thickness of 4mm, pressed between glass plates to flatten the surfaces, and polymerized using a Visilux II visible light-activation unit, The surfaces were polished sequentially on wet sandpaper. Color measurements of each specimen were accomplished by Chroms Meter. A compute program that compares each tooth color with each composite resin color was written and the minimum CIELAB color difference(ΔE*) between tooth and each material was calculated. Under the conditions of this study: 1.Teeth tend to become darker with advancing age. 2.Canines were darker, more yellow, and less green than incisors. 3.The teeth from the women were lighter, more green, and less yellow than the male teeth. 4.In general, composite resins were lighter, more green, and less yellow than teeth. Deficiencies were noted in Hues in YR range. 5.Mean color differences between the five composite resin products and teeth were detectable to the naked eye(ΔE*>1.0). 6.In comparing the mean ΔE* values of materials, Spectrum showed the least followed by Z100, Elitefil, Amelogen, Denfil in increasing order.

경증과 중등증의 신부전을 동반한 진행성 당뇨병성 신병증 환자에서의 ACE 억제제와 안지오텐신Ⅱ 수용체 차단제 병합요법의 단기적 효과

임희정,이선영,박근호,강상용,송준호,이승우,김문재 대한간질학회 2003 대한간질학회지 Vol.9 No.2

피부미용사의 스트레스와 근골격계 자각 증상과의 관련성

이은희,전선복,이무식,김남송,장문정 한국미용학회 2001 한국미용학회지 Vol.7 No.3

The purpose of this study was to examine the relationship of skin beauty artist's stress to musculoskeletal subjective symptom to identify what factors are related to skin beauty artist's musculoskeletal subjective symptom. The subjects in this study were 211 selected skin beauty artists. A survey was conducted from March 11 to 31, 2001, with standardized self-reporting questionnaire to find out the general characteristics, perceived stress level and musculoskeletal subjective symptom. The findings of this study were as below; l. All the skin beauty artists investigated were female. 110 skin beauty artists (52.1%), more than half them, were highschool graduates, 117(55,5%) were unmarried, and the mean career was 52,74 months(four years and four months). The daily mean working hours were 10.61, and the actual daily mean working hours were 7.94. 2. For health habit. 19(9.0%) skin beauty artists were smoker, which indicated that most of them didn't smoke. 136(64.5%) people, more than half them, drank alcohol, and just 72(34.1%) got exercise. 3. In regard to the relationship of general characteristics to stress, the unmarried group was more stressed as they got a score 69.25(SD 12.45), compared to the married group that got 66.30(SD 11.50). The difference between the two group was significant (p<005). The nondrinking group were more stressed out with 69.42(SD 11.50) than the drinking group with 65.87(SD 12.97). The difference between the two was significant(P<0.05). The group that didn't get exercise were more stressed with 70.17(SD 12.11) than the workout group with 64.26(SD 11.27), and the difference between the two was significant(P<0.05). By career, the group that had worked for 34 months or less were more stressed with 70.47(SD 12.38) than the other group that had worked for more than 35 months with 65.87(SD 11.48). And the difference between the two was significant. 4, As for the correlational relationship between musculoskeletal symptom to relevant variables, stress was positively correlated to musculoskeletal symptom and the pain of neck, shoulder, back, arm, hand, wrist, waist and leg. Their stress had a positive correlational relationship with the symptom in every part. The younger people made more complaint of the symptom of shoulder, back and leg, and those who had worked for less period were more stressed out. The findings of this study suggested that there was a relationship between stress and musculoskeletal subjective symptom. To prevent stress and musculoskeletal subjective symptom, there should be an attempt to ease stress. The break time should be offered regularly during working hours, and amicable human relations should be kept. The right health habit should be formed in daily living, and stretching exercise and health care should be done more thoroughly.

당귀잎김치 및 당귀잎첨가 배추김치의 암예방 효과

최선미,길정하,문숙희,박건영 대한암예방학회 2003 Journal of cancer prevention Vol.8 No.3

영유아보육법 개정에 따른 보육시설장 및 보육교사 자격제도 연구

백선희,서문희 한국영유아보육학회 2004 한국영유아보육학 Vol.0 No.39

보육인력의 자질은 영유아보육서비스의 질을 결정하는 주요 요인 중의 하나이다. 최근의 영유아보육법 개정은 영유아보육서비스의 공공성 확보와 질적 향상이 배경이 된 것으로, 따라서 그 주요 요인이 되는 보육교사의 자질 향상과 관련하여 보육교사 자격증 제도의 도입이 새로 포함되어 있다. 법은 자격증제도 도입 등 몇 가지 기본적 사항만 제시하고 있을 뿐 구체적 내용에 대해서는 하위법령에 위임하고 있는 것이 일반적이다. 그러므로 보육인력 자격제도의 완비를 위해서는 하위법령을 구체화하는 방안을 모색하는 것이 필요하다. 본 논문은 보육인력의 전문성을 향상시킬 수 있는 합리적인 자격제도 방안을 모색하는 것을 목적으로 한다. 먼저, 현 자격제도의 주요 문제점으로 첫째, 자격증이 발급되지 않아 사회적 인정 정도가 약하고, 둘째, 보육교사 1급이 되기 위해 필요한 대학 교육내용의 질적 통제가 어렵고, 셋째, 현재의 보육시설장의 자격기준으로는 시설장의 전문성을 확보하기 어렵다는 것 등을 지적하였다. 그리고 모니터링과 정책토론의 방법을 통해, 개정 법률이 위임하는 법적 테두리를 고려하면서 보육인력의 자질 향상을 위한 자격제도 대안을 제시하였다. The quality of child care workers is one of key determinants affecting the quality of child care services. The recent amendment of Child Care Act in Korea was drawn on the idea of both improving the quality of child care service provision and placing more emphasis on public responsibility. Naturally, a part of the amendment includes the introduction of a new certification system of child care workers. In Roman law system where a hierarchy exists among different laws, it is generally done that an upper law delegates the details of its implementation to a lower law such as practice ordinance. So, it is necessary to have Child Care Act supplemented by sub-laws that specifies the details of the implementation measures of the Act. Having these points in mind, this article discusses the problems of the current qualification system of child care workers, and possible alternative system to improve the quality of child care services.

공구형상인자에 따른 공구응력 변화 특성

이영문,손재환,김선일,정희철 한국공작기계학회 2008 한국공작기계학회 춘계학술대회논문집 Vol.2008 No.-

In this study, a series of FE-simulations, using the DEFORM software, on tool stersses of orthogonal cutting are carried out. As cutting input conditions, the tool shape factor such as tool relief angle and the cutting velocity are changed in the analyses. The results reveal that the patterns of stress distribution are same, that is signs of stress are divided at the points, wherever the chips leave the tool. And as the relief angle increases the more sterss concentration occurs at the tool tip.

차아염소산나트륨과 클로르헥시딘의 반응침전물 형성방지를 위한 여러 가지 근관세척 방법의 비교

최문선,박세희,조경모,김진우 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.2

The purpose of this study was to compare the different canal irrigation methods to prevent the formation of precipitate between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Extracted 50 human single-rooted teeth were used. The root canals were instrumented using NiTi rotary file (Profile .04/#40) with 2.5% NaOCl and 17% EDTA as irrigants. Teeth were randomly divided into four experimental groups and one control group as follows; Control group: 2.5% NaOCl only, Group 1: 2.5% NaOCl + 2% CHX, Group 2: 2.5% NaOCl + paper points + 2% CHX, Group 3: 2.5% NaOCl + preparation with one large sized-file + 2% CHX, Group 4: 2.5% NaOCl +95% alcohol+ 2% CHX. The teeth were split in bucco-lingual aspect and the specimens were observed using Field Emission Scanning Electron Microscope. The percentages of remaining debris and patent dentinal tubules were determined. Statistical analysis was performed with one-way analysis of variance (ANOVA). Energy Dispersive x-ray Spectroscopy was used for analyzing the occluded materials in dentinal tubule for elementary analysis. There were no significant differences in percentage of remaining debris and patent tubules between all experimental groups at all levels (p > .05). In elementary analysis, the most occluded materials in dentinal tubule were dentin debris. NaOCl/CHX precipitate was detected in one tooth specimen of Group 1. In conclusion, there were no significant precipitate on root canal, but suspected material was detected on Group 1. The irrigation system used in this study could be prevent the precipitate formation. 이 실험의 목적은 NaOCl과 CHX의 혼합사용 시, 발생하는 침전물의 형성을 막기 위해 두 용액간의 접촉을 줄일 수 있는 여러 가지 방법을 비교하고, 관찰된 침전물의 원소를 분석하는 것이다. 발거된 50개의 단근치를 사용하였으며 2.5% NaOCl을 이용하여 .04 taper ProFile #40까지 근관형성 하였다. 치아는 다음과 같은 근관세척 방법에 따라 4개의 실험군과 1개의 대조군으로 나누었다; 대조군: 2.5% NaOCl, 1군: 2.5% NaOCl + 2% CHX, 2군: 2.5% NaOCl + paper points + 2% CHX, 3군: 2.5% NaOCl + .04/#45 근관확대 + 2% CHX, 4군: 2.5% NaOCl +95% alcohol+ 2% CHX. 근관세척 후 치아를 양분하고 치관부, 중간부, 치근부 세부위로 나누어 전계 방사형 주사 전자현미경을 통하여 잔사 비율, 개방 상아세관 비율, 상아세관 내 물질의 원소분석을 시행하였다. 실험결과, 실험군 사이에 잔사비율과 개방된 상아세관 비율 비교에서 통계학적으로 유의할 만한 차이는 나타나지 않았다. 1 군의 한 시편에서 C의 함유량이 높게 나타났으며 N과 Cl도 함께 검출되어 para-chloraniline으로 추정되며, 1 군의 다른 시편과 나머지 실험군에서는 O, P, C, Ca의 순으로 함유량이 높은 것으로 나타나 수산화인회석으로 추정된다. NaOCl 세척 후 바로 CHX 세척을 한 군에서 PCA로 의심되는 물질이 검출된 바, 두 용액의 직접적인 접촉을 피하기 위해 주의가 필요하며, 본 실험에 사용된 여러 근관 세척방법 이용 시 침전물의 형성을 예방할 수 있을 것이다.