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.

암환자가 지각한 사회적지지, 희망과 삶의 질과의 관계

태영숙,강은실,이명화,박금자 고신대학교 전인간호과학연구소 2002 전인간호과학연구 학술모음집 Vol.- No.-

The Relationship among Percieved Social Support, Hope and Quality of Life of Cancer Patients Tae, Young Sook. Kong, Eun Sil. Lee, Myung Hwa. Park, Geum Ja The purpose of this study was to investigate the relationship among percieved social support, hope and Quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 220 out and in-cancer patients in 5 general hospitals in Pusan The data were collected from July 2 to August 1,2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et. al(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows : 1) The item mean score of quality of life was 6.05±1.16 (range 0-10) .The heighest score of subarea of the quality of life was the spiritual wellbeing area (7.09±1.63) and the lowest score was social wellbeing area(5.53±1.65). The mean score of perceived social support was 52.65±10.32 (최고 1, 최저 80). The mean score of family support was32.71±6.66 (range 1- 40) and the mean score of medical team support was 19.93±5.95 (range 1- 40). The mean score of Hope was 37.02±5.64 (range 1-48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion (F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis (F=3.48, p=0.01), stage of disease (F=13.74, p= 0.00). 3) There was significant correlation between perceived social support(r=0.44, p= 0.000 ; family support: r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p= 0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.

알데히드 탈수소 효소 활성에 미치는 글루타치온의 영향

이은실,문전옥 한국환경독성학회 2001 환경독성보건학회지 Vol.16 No.1

It is known that alcoholics have significantly lower mitochondrial aldehyde dehydrogenase (ALDH)s' activity than do normal subjects or nonalcoholics with liver disease. However, there are only few reports that explain the reasons behind this reduction of ALDHs' activities. In this study, ALDH activity is inhibited by acetaldehyde, a substrate for ALDH. However, the addition of glutathione (GSH) protected ALDH activities against the inhibitory effects of acetaldehyde in vitro. Furthermore, when GSH depletion is induced using diethyl maleate (DEM) in rats by 24% in cytosol and 43% in mitochondria, ALDH activities were also depressed by 31% and 63%, respectively compared to non-treated rats without significant reductions in other hepatic enzymes. These results suggest that ALDHs' activities are closely related to the concentration of acetaldehyde and/or cellular GSH contents. Therefore in alcoholic liver disease, increased productions of acetaldehyde and decreased contents of mitochondrial GSH may involved in the depression of ALDHs' activities.

교육과정 변천에 따른 초등학교 수학 교과서 비(比) 관련 내용 분석

이순주,정은실 晋州敎育大學校 科學敎育硏究院 2006 科學敎育硏究 Vol.29 No.-

본 연구에서는 비(比) 관련 내용이 교수요목기부터 제7차 교육과정까지 초등학교 교과서에 어떻게 반영되었는지에 대해 분석하고 이를 통해 앞으로의 비 관련 내용 지도에 대한 교육적 시사점을 찾아보았다. The present study purposed to analyze how contents related to ratio have been reflected in elementary textbooks from the period of the Syllabus(Gyosuyomok) to the 7th Curriculum, and to find their educational implications for contents related to ratio in the future. The results of analyzing contents related to ratio by curriculum are as follows. In the aspect of changes in teaching contents and order, the period of the Syllabus covered five contents but with the development of curriculum, all of the 10 contents were taught. In the aspect of changes in teaching methods, in the period of the Syllabus and the 1^(st) and 2^(nd) Curriculums, concepts and procedures were explained using situations in everyday life, but in the 3^(rd) and 4^(th) Curriculums, the use of life situations decreased. In the 5^(th), 6^(th) and 7^(th) Curriculums, mathematical situations were neglected and only mathematical elements were applied and life situations were used. The methods of presenting learning contents developed from 'dialogue' in the period of the Syllabus and the 1^(st) Curriculum to 'simple explanation' in the 2^(nd) Curriculum, 'task suggestion' in the 3^(rd)~6^(th) Curriculums and 'activity instruction' in the 7^(th) Curriculum. Based on the result of textbook analysis, we find a number of educational implications as follows. First, it is necessary to introduce earlier contents related to ratio, which are currently presented in the 6^(th)-year class. Because the sense of ratio is formed in the early stage of children's development, programs for intuitive understanding of ratio should be developed and applied from low grades. Second, research should be made on desirable order of teaching in consideration of students' understanding level. Third, specific life situations and learning materials should be presented to students so that they can make proportional reasoning actively. In order to get out of teaching through presenting simple life situations, practicing outward expressions of ratio and emphasizing algorithms, realistic life situations containing various elements should be presented.

영아의 혀에 발생한 유아조직 1례

이희정,윤은실,최준혁,최광해 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out Sometimes, tongue lesions are present with dyspnea, dysphagia, dyarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination After excision of tongue mass, she had no problem with swallowing and breathing.

분자 유전학적 검사로 진단된 Ornithine Transcarbamylase Deficiency 1 예

이은실 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

Ornithine transcarbamylase (OTC) deficiency is the most common inborn error of urea cycle metabolism; it is inherited in an X-linked manner. The OTC catalyzes the third step of the urea cycle, the conversion of ornithine and carbamyl phosphate to citrulline. Deficiency of OTC leads to the accumulation of ammonia, causing neurological deficits. In most affected hemizygote males, OTC deficiency manifests as hyperammonemic coma that often leads to death in the newborn period, and those who recover from the coma may be neurologically impaired due to the sequelae of the hyperammonemic encephalopathy, In some, late-onset manifestations develop. We report a male neonate with early onset OT deficiency that had apnea and was comatous. On mutation analysis using DNA sequencing after polymerase chain reaction (PCR) amplification of the 10 exons, deletions of 10 bases in codon 285, causing a frame shift was detected in exon 8. The mother and a sister were diagnosed as female carriers. Therefore, genetic counseling and the risk assessment could be provided to the family.

고등학생의 스트레스와 의복의 규범적 동조 및 의복만족도에 관한 연구

이명희,이은실 한국의류학회 2000 한국의류학회지 Vol.24 No.2

The purpose of this study was to examine the influence of stress, body satisfaction, academic record, and demographic variables on the normative conformity toward clothing and clothing satisfaction of high school students. The subjects were 389 high school students(boys: 169, girls: 220) in Seoul, Korea. The normative conformity toward clothing measured by the degree of wearing of unsuitable clothes for school clothing and private clothing norm of students. The school clothing was influenced by allowance, gender, stress of home fife, academic record(-), mothers education(R^=.270). The private clothes was influenced by allowance, gender, stress of home life, body satisfaction, and geographical region (R^2=.200). The clothing satisfaction was influenced by body satisfaction, gender, allowance, geographical region, and stress of home life(-) (R^2=.325). The present findings provide that stress of home life, gender, and allowance had effect on the normative conformity toward clothing, and the higher the stress of home life, the lower the degree of clothing satisfaction.

생활중심 수학보고서 쓰기가 수학학업성취 및 수학적 성향에 미치는 영향

이승운,정은실 진주교육대학교 초등교육연구소 2005 科學敎育硏究 Vol.28 No.-

생활중심 수학보고서 쓰기 활동이 현재 학생들이 가지고 있는 수학의 가치에 대한 인식 변화와 수학적 태도, 그리고 수학학업성취도에 어떠한 영향을 주는지 알아보기 위하여 생활중심 수학보고서 양식을 구안하고, 생활중심 수학보고서 쓰기 활동이 수학학업성취에 미치는 효과를 분석하며, 이 활동이 학생의 수학적 성향에 미치는 효과를 분석하였다. 연구 결과 생활중심 수학보고서 쓰기 활동이 학생들의 수학학업성취도 향상과 수학의 가치에 대한 인식 및 태도에 긍정적인 변화를 준다는 것을 알 수 있었다. The purpose of this study is to investigate what effect life-focused mathematical journal writing activity has on the change of recognition which children have about the value of mathematics at present, mathematical attitude, and the degree of mathematics learning achievement. For the purpose of this study, we design a journal writing form of life-focused mathematics. And we analyze the effect of life-focused mathematical journal writing activity on mathematics learning achievement and children's mathematical disposition. We used nonequivalent control group pretest-posttest design to investigate the effect of life-focused mathematical journal writing activity on mathematics learning achievement and mathematical disposition, used SPSS 10.1 program to arrange the results of the pretest-posttest on mathematics learning achievement and of the pretest-posttest on the mathematical disposition to verify the effect of life-focused mathematical journal writing, and analyzed what difference there is between the experimental group and the control group by performing t-test. As a result, we have come to know that life-focused mathematical journal writing activity has a positive effect on the children's mathematics learning achievement, the recognition on the value of mathematics, and mathematical attitude.

齒槽膿漏 治療劑에 關하여

李恩實 梨花女子大學校 藥學硏究所 1960 梨花藥學硏究 Vol.- No.2

다치 논리 회로를 이용한 32 × 32 Modified Booth 승산기

이은실,김정범 강원대학교 정보통신연구소 2002 정보통신논문지 Vol.6 No.-

Current mode CMOS multiple-valued logic circuits have various applications in digital signal processing and computing. This paper proposes new multiple-valued current mode CMOS integrated circuits for high-density arithmetic systems. The proposed 32×32 modified Booth multiplier using Radix-4 algorithm give the improved operation speed by using the elimination method of sign-bit extension at the most upper bit of each row. This circuit is simulated with HSPICE under 0.35㎛ CMOS standard technology, 10㎂ unit current, and 3.3V VDD voltage. The simulation results shows the satisfying characteristics.