일부 소규모 시계조립 사업장의 상지 누적외상성장애의 유병률

장은철,김현주,권영준,박시복,이수진,송재철 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 단순 반복작업을 하는 시계조립 사업장 근로자를 대상으로 상지 누적외상성장애의 자각증상 유병률과 상지 누적외상성장애 유병률을 파악하고자 하였다. 방 법 : 인구학적 특성, 상지의 자각증상, 사회심리적 요인은 자가 설문지법으로, 인간공학적 특성은 점검표를 이용한 면담법으로 조사하였다. 상지의 자각증상 조사와 사회심리적 요인은 각각, N10SH (1993) 설문지와 Karasek(1979)의 Job strain model을 번역하여 조사하였다. 상지 누적외상성장애 판정은 의사가 작업 현장에서 직접 환자 면담과 이학적 검사를 수행한 후, 연구에서 규정한 증례정의에 의해 수행하였다. 수집된 자료는 x2 teat와 exact test로 단별량 분석을 하였고, 이중 의미있는 변수와 위험 인자로 알려진 변수들로 다중 로지스틱 회귀분석을 시행하였다. 결 과 : 대상자들의 자각증상 유병률은 54.2 %였고, 부위별로는 목 34.9 %, 손/손목 31.3 %, 어깨 30.1 %, 팔/팔꿈치 18.0 %순이었다. 상지 누적외상성장애의 유병률은 45.8 %였고, 근막동통증후군이 26명으로 가장 많았고, De Quervain씨 병 8명, 수부/전완부의 건염 및 건활막영 8명, 수근관 증후군 5명, 이두건염 5명, 척골 신경병증 5명, 내상과 염 4명, 외상과염 2명, 경추 디스크 질환 2명, 흥곽 출구 증후군 1명순으로 나타났다. 단변량 분석시 자각증상 유병률은 작업부서 중 완성 부에서, 상지 누적외상성장애 유병률은 여자와 완성 부에서 통계학적으로 유의하게 높았다. 다중 로지스틱 회귀분석 결과 완성부와 근무긴장도가 높은 군이 상지 누적외상 성장애와 통계학적으로 유의한 결과를 보였다. 결 론 : 이 연구에서 상지 누적외상성장애 유병률은 45.8 %으로서 저강도의 단순 반복작업을 하는 시계조립 사업장 근로자에서도 누적외상성장애의 위험이 있는 것으로 생각된다. 또한, 사회심리적 요인과 작업 부서별 공정 및 환경이 유병률에 영향을 미치는 주요 요인으로 생각되며, 향후 이들에 관한 다양한 연구가 진행되어야 할 것이다. 산업보건 현장에서는 시계조립 사업장과 같이 저 강도의 단순 반복작업을 위주로 하는 사업장에 대한 지속적인 관심과 각 사업장별 위험요인을 파악하여 적절한 예방 및 관리 대책을 세워야 할 것이다. Objectives : The prevalence of cumulative trauma disorders of upper extremities mons watch assembly workers in small-scaled industry was studied. Methods. In 83 workers at five watch assembly factories, symptoms and psychosocial questionnaire, ergonomic Interview, physical examination were conducted. Results : Prevalence of self-reported symptoms was 54.2% and neck 34.9%, wrist/hand 31.3%, shoulder 30.1%, elbow/arm 18.0% by anatomical site. Prevalence of cumulative trauma disorders was 45.8%. Most common disease was myofascial pain syndrome (31.3%). The other diseases were De Quervain disease (9.6%), tenosynovitis/tendinitis at wrist/hand (9.6%), bicipital tendinitis(6.0%), fat. epicondylitis(4.8%), meIn. epicondylitis(2.4%), and cervical disc disease(2.4%). As result of ergonomic interview, repetitiveness was 79(98.8%). There were no differences in the prevalence of self-reported symptoms and cumulative trauma disorders for age, sex, marital status, duration of work In the study, The significant factors of cumulative trauma disorders were occupational task and psychosocial stress in the study. The prevalence of cumulative trauma disorders in high strain group was hlgher (68.4%) than other three groups. The prevalence of self-reported symptoms and cumulative trauma disorders in assembly task was higher (70.0%, 64.0%) than other two tasks. Conclusions : Prevalence of self-reported symptoms was 54.2%, prevalence of cumulative trauma disorders was 45.8% in watch assembly workers. In this study, factor related to self-reported symptoms was occupational task and factors relaxed to cumulative trauma disorders were occupational task and psychosocial stress. This results suggest that differences of ergonomics and environment in occupational task cause differences of prevalence of self-reported symptoms and cumulatlve trauma disorders.

우리 나라 보건관리대행서비스 평가 연구

하은희,조수헌,김선민,주영수,한상환,하미나,권호장,홍윤철,김창엽 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.1

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially in continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions,. Quality in terms of accessibility and continuity highly varied among institutions., To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.

이산화탄소로부터 올레핀 합성을 위한 혼성 촉매와 Fischer-Tropsch 합성 촉매의 비교 연구

이성철,장재훈,서은철,강민철,정석진 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.1

이산화탄소로부터 메탄올을 경유하여 올레핀을 생산하는 연계 공정 대신, 이산화탄소로부터 올레핀을 직접 합성하는 일괄공정을 위하여 두 가지 촉매계를 시험하여 보았다. 즉, 메탄올 합성용 촉매와 메탄올 전환용(Methanol to Olefin process: MTO) 촉매를 혼합하여 구성된 혼성 촉매계와 종래의 Fischer-Tropsch 공정에서 사용되는 철 촉매계를 기반으로 하여 개선된 총매곌르 사용하여 보았다. 일괄 공정 중, 혼성촉매계에서는 Cu/ZnO/Al_2O_3와 Mg-La/ZSM-5로 구성된 혼성촉매가 가장 우수한 이산화탄소 전환 활성을 나타냈으나 구리에 기인한 중간세기 산점의 증대와 강산점의 소멸로 인하여 올레핀의 선택성은 미비하였다. 반면에 종래에 F-T 공정에 사용되는 철 촉매계의 경우 ZSM-5를 담체로 사용하고 특히 알칼리 금속인 K를 조촉매로 사용할 경우 CO_2흡착량을 증가시키게 되며 동시에 촉매 표면에 흡착된 Fe-C종의 결합 강도를 높여 줌으로 인하여 높은 이산화탄소 전환율과 올레핀 선택도를 확보할 수 있었다. One-step conversions of CO_2 into olefins were investigated over conventional Fischer-Tropsch synthesis(FTS) catalyst and the new hybrid catalysts. The hybird catalyst was consisted of methanol synthesis catalyst(Cu/ZnO/Al_2O_3, Cu/ZnO/ZrO_3) and methanol to olefin(MTO) catalyst(Mg-La/ZSM-5). The activity of hybrid catalytic system, which was mixed with Cu/ZnO/Al_2O_3(6:3:1 in weight ratio) and Mg-La/ZSM-5, was superior than others in terms of CO_2 conversion and total hydrocarbon yield, but olefin was not produced significantly. The reason was supposed to be caused by Cu-support interaction, which gives rise to the loss of strong Bro¨nsted acid site and consequently the medium strength acid site production. In contrary to hybrid system, the modified F-T catalytic system showed similar enhanced CO_2 conversion. However, it showed high selectivity to olefin. When ZSM-5 was used as a support for FE-K catalyst system, the selectivity of olefin was found to be increased. The addition of potassium promoters give rise to increase amount of CO_2 uptake on the surface, and the improvement of stability in adsorbed Fe-C species. Consequently, by carefully selecting the support and additives on modified F-T catalyst system, it was possible to obtain the high CO_2 hydrogenation activity as well as high olefin selectivity.

기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

1999년도 전남 지역내 저소득층 주민암 검사 실시에 따른 암유병률 조사연구

선승철,박준영,장판기,이영춘,이은희 한국건강관리협회 2000 건협 Report Vol.3 No.-

결핵의 진단법으로서 중합효소 연쇄반응 검사의 가치

서상철,은상진,김한길,송경은,서장수,최성만,이원길,김재식,김중명 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.1

목적 : 결핵균 동정을 위한 중합효소 연쇄반응을 임상병리검사로서 적용하기 위한 기초 실험으로 분석학적 예민도와 특이도를 알아보고 검토된 조건에 의한 중합효소 연쇄반응을 실제 임상 가검물에 적용하기 위함이다. 재료 및 방법 : Ziehl-Neelsen염색 양성인 객담, 뢰벤스타인-젠센(Loewenstein-Jensen) 배지에서 분리된 결핵균 및 M. tuberculosis H37Rv를 비롯한 항산균 표준균주 11주와 비항산균 10주를 사용하여 2가지 DNA의 분리법, 3set 프라이머, 3종류 중합효소, 2가지 미량 원심시험관 및 Easy-Cycler^R(Ericomp사, 미국)와 수조형으로 검사를 시행하여 DNA 증폭 산물을 비교하였다. 또한 이미 지일-닐슨 염색법에 의한 선별검사에서 음성을 나타낸 객담 53예, 소변 101예, 삼출액 128예, 뇌척수액 54예 등 총 370예의 임상가검물을 대상으로 하여 위에서 검토된 중합효소 연쇄반응 조건으로 검사한 성적과 지일-닐슨 염색법, 배양법 성적과 비교하였다. 결과 : DNA분리방법 2가지와 3가지 중합효소는 분석학적 예민도와 5fg로 나타나 차이를 발견할 수 없었으며, 프라이머 P1, P2쌍은 예민도가 5fg, 프라이머 INS1, INS2쌍과 프라이머 Pt3, Pt6쌍의 예민도는 0.5fg이었다. Easy-Cycler^R가 수조형에 비해 높고, 미량 원심시험관은 Robbins사 제품이 Sarstedt사 제품에 비해 높은 분석학적 예민도를 나타냈다. 프라이머 P1, P2쌍과 프라이머 INS1, INS2와 Pt3, Pt6 2쌍의 프라이머의 특이도에 있어서는 항산균 표준균주 중 M. tuberculosis H37Rv, M. tuberculosis ATCC 27294, M. bovis ATCC 29312의 3주에서 특이 증폭 띠를 관찰할 수 있었다. 그러나 비결핵성 항산균 8주에는 특이 증폭 띠를 나타내지 않았다. 또 비항산균 10주에도 특이 증폭 띠가 관찰되지 않았다. 따라서 Robbins사의 미량 원심시험관과 proteinase-K법에 의한 DNA분리방법에 Easy-Cycler^R를 사용하여 프라이머 INS1, INS2쌍으로 일차 중합효소 연쇄반응을 시행한 후 프라이머 Pt3, Pt6쌍으로 이차중합효소 연쇄반응을 시행하는 방법을 370예의 임상가검물에 시행하였고 지일-닐슨 염색법과 결핵균배양검사도 동시에 시행한 결과 중합효소 연쇄반응 양성은 106예(28.6%), 배양 양성은 27예(7.3%) 및 염색 양성은 18예(4.9%)였으며, 결핵환자는 141명(38.1%)였다. 370예의 임상 가검물로 시행한 중합효소 연쇄반응의 진단학적 예민도와 특이도, 양성결과 예측치 및 음성결과 예측치는 68.8%, 96.1%, 91.5% 및 83.3%로 각각 나타났다. 결론 : 결핵균 동정을 위한 중합효소 연쇄반응은 배양검사에 비해 신속하며, 분석학적인 예민도와 특이도가 뛰어나므로 결핵 진단을 위한 임상병리검사로서 유용하다고 사료됨. In this study, We investigated the optimal conditions of polymerase chain reaction(PCR) assay for the rapid identification of Mycobacterium tuberculosis in clinical specimens as routine laboratory test. So we have compared two DNA isolation methods, 3 polymerases, 2 set of primer, 2 kinds of thermocycler and 2 microtubes. We evaluated two DNA isolation methods, bead-beating method and proteinase-K method, the latter was more sensitive than the former. In comparision of two sets of primers, P1 and P2 primers detecting 123-base pair fragment of IS6110 made from Biosnthesis(U. S. A.) and INS1 and INS2 primers detecting 245-base pair fragment of IS986 showed equally sensitive results ie. 5fg. Specificity of primers were tested and INS1 and INS2 primers gave 245-base pair product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellurae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-positive staphylococcus, coagulase-negative staphylococcus, streptococcus, Esccherichia coli, Serra-tia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinetobacter calcoaceticus, Pseudomonas aerugonosa showed no 245-base pair amplification product. PCR by the P1 and P2 primers showed 123-base pair amplification product from M. tuberculosis H37Rv, M. tuberculosis ATCC 27294 and Mycobacterium bovis ATCC 29312 but not from 8 nontuberculous mycobacterial strains such as M. kansasii ATCC 12478, M. terrae ATCC 15755, M. intracellularae ATCC 13950, M. avium ATCC 25281, M. gordonae ATCC 14470, M. fortuitum ATCC 6841, M. smegmatis ATCC 19420, M. scrofulaceum ATCC 19981. Coagulase-postive staphylococcus, coagulase-negative staphylococcus, streptococcus, Escherichia coli, Serratia marcescens, Klebsiella pneumoniae, Enlerobacter aerogenes, Enterobacter cloacae, Acinelobacler calcoaceticus, Pseudomonas aeruginosa showed no 123-base pair amplification product. In comparision of polymerase, Taq DNA polymerase^R(Promega Co., U. S. A.) was more cost effective than Ampli Tag^R(Perkin-Elmer Cetus, U. S. A.), but these two were equally sensitive and specific in the detection of M. tuberculosis-specific DNA. Tac polymerase (Korea'Biotech, Korea) showed many nonspecific bands. In comparision of thermocycler, Easy-Cycler^R(Ericomp, U. S. A.) was more sensitive than water-bath type and in that of microtubes Robbin's were more sensitive than Sarstedt's PCR results were compared with results of culture for M. tuberculosis and Ziehl-Neelsen stain in 370 clinical specimens that were negative by initial Ziehl-Neelsen stain. There were 27 specimens(7.3%) that were positive for M. tuberculosis by culture, 18(4.9%) specimens that were positive by Ziehl-Neelsen stain, and 106 specimens(28.6%) that were positive for PCR and 141 cases that were positive for tuberculosis. Overall sensitivity, specificity, positive predictive value and negative predictive value were 68.8, 96.1, 91.5 and 83.3% respectively, for PCR; 19.1, 100, 100, and 66.8%, respectively for culture; and 12.8, 100, 100, and 59.0% respectively for Ziehl-Neelsen stain.

자동차 관련직종 근로자의 근골격계 증상 호소율에 관한 연구

이용진,장은철 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

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석면관련 폐질환의 진단에 있어서 흉부고해상도전산화단층촬영검사(HRCT)의 유용성

이현재,손지언,,홍영습,,이영일,예병진,유창훈,정갑열,김상훈,임형준,장은철,김정만,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 석면에 노출된 근로자에서 석면관련 폐질환의 양상을 분석하고 진단에 있어 HRCT의 유용성을 연구하여 석면에 대한 의학적 감시프로그램의 개발에 기여하고자 하였다. 방법: 석면에 직접 노출되는 작업자 68명과 간접 노출되는 작업자 94명 등 총 162명에 대해 OSHA 석면 표준, 의학적 감시 프로그램에 따라 단순 흉부방사선검사, 폐활량검사 및 우리나라 실정에 맞게 일부 수정한 의학적 설문지를 통해 면접조사의 방식으로 환자에 관한 정보를 수집하였으며, 자료의 신뢰성을 확보하기 위하여 면접조사는 1달 이상의 기간을 두고 2차례에 걸쳐 실시된 후 확인, 수정하였다. 또한, 석면관련 폐질환을 확진하기 위하여 HRCT를 추가적으로 실시하였다. 결과: HRCT결과 석면관련 폐질환의 유병율은 162명의 근로자중 17명으로 10.5%였는데, 직접 노출군에서 10명 (14.7%), 간접 노출군에서 7명 (7.4%)이었다. HRCT와 비교할 때 단순 흉부방사선검사의 민감도와 특이도는 각각 70.6%와 98.6%이었고, 양성 예측도와 음성 예측도는 각각 85.7%와 96.6%으로, HRCT는 단순흉부방사선검사에 비해 민감도가 높아 초기 석면관련 폐질환을 진단하는데 효과적이었다. 석면관련 폐질환의 진단에 있어 HRCT와 폐활량검사 사이에 유의한 관련성이 관찰되었다. HRCT 결과 석면관련 폐질환의 유무와 의학적 설문조사 결과의 빈도분석을 실시한 결과, 유의한 변수는 작업기간, 흡연량, 호흡기질환의 과거력, 기침, 호흡곤란이었다. 결론: HRCT는 석면관련 폐질환의 진단에 있어 단순 흉부방사선검사와 비교하여 민감도가 높아 초기 진단에 유용하므로 단순 흉부방사선선검사 결과 석면관련 폐질환소견을 보일 때뿐만 아니라, 정상소견을 보이더라도 폐활량 검사결과와 근무력, 흡연력, 호흡기질환의 과거력, 기침, 호흡곤란 등의 호흡기 증상을 참고하여 HRCT검사를 고려해야 한다. 또한, 본 연구에서 관련성이 없었던 요인들에 대해서도 향후 연관성을 규명하는 광범위한 전향적 연구가 필요하다. Objectives: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. Methods: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveilance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveilance program consists of simple chest x-ray, spirometry and medical questionnarie. Results: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT, HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. Conclusions: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

메이크업 시 사용되는 퍼프의 사용기간에 따른 오염도에 관한 연구

류재기 ; 김은주 ; 장철수 김천대학교 2010 김천대학교 논문집 Vol.31 No.-

The purposes of this study are to investigate the level of bacteriological contamination of puffs which are used most frequently for touch ups during the day as a makeup tool, and to compare the degree of contamination before and after washing puffs with a neutral detergent. A total of 40 powder puffs that were used for six months to three years have been collected since May, 2005. The collected puff samples were cut into the size of lem by a sterilized scissor, and were put into a sterilized test tube that contained 5ml of DW (distilled water). Then the tube was strongly agitated. Supernatants (100ml) con-taining bacteria was applied to TSA (Trypticase Soy Agar), MacConkey agar, and SDA (Sabouraud Dextrose Agar) plates, respectively. The TSA (Trypticase Soy Agar) and MacConkey agar plates were incubated at 37C for 24-48 hours. The SDA (Sabouraud Dextrose Agar) plates were incubated at 28 C for 7-14 days. As a result of the level of contamination of puffs used over a certain period of time, there was no significant difference cxcept aerobic bacteria. Staphylococcus was not detected. Aerobic bacteria was detected from the puffs older than one year and the colony count increased sharply. The puffs used for more than two years had three times more colony count than the one-year old puffs. In particular, out of 10 puffs older than two years, two were found with 500CFU/ml exceeding the limit of microbiology of cos-metics. Also, the puffs older than two years had 31,1% less microbiology after washing with a PH neutral detergent than before washing. Therefore, as the period of using puffs is longer, thorough checks of their hygiene are needed; as the number of using times increase or the length of using times is longer, frequent washing is inevitable. Since this study restrained the number of puffs to 40,7 would be problematic for generalization and a secondary experiment would be necessary for precise identification of cultured germs.

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.