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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.
협동 미술활동 프로그램을 통한 발달지체유아의 사회성 증진 연구
고선희,정계숙 부산대학교 영유아보육연구소 2006 영유아보육연구 Vol.12 No.-
The purpose of this study was to examine whether a cooperative art activities program improved social skills of the preschooler with developmental delays. Four selected preschoolers with developmental delays. They were selected by using interviews, Social Maturity Test and Korean ABACUS. A 25-sessions program was conducted. The finding of the study were as follows: First, as a result of the program the score of social ability of the preschoolers with developmental delays increased. Second, as a result of the program the frequency of interaction-target behavior of the preschoolers with developmental delays increased during free-play class. Third, a cooperative art activities program allowed the preschoolers with developmental delays to make more attempts to get in touch with the preschoolers, and positive attempts, such as communicating through gesture, commenting. Fourth, a cooperative art activities program encouraged the preschoolers with developmental delays to react to the attempts of the preschoolers in a more positive manner, and negative reaction was the wane. In conclusion, the program developed for this study has been shown to have a positive effect on the social ability and social interaction in the preschoolers with developmental delays not only during the program, but also after the program.
고광선,양희재 여수대학교 1996 論文集 Vol.10 No.-
Korea is a good example for the developing corporations beacuse of its rapid economic growth, and now is the 21th largest trading country in the world. Hower, the majority of Korea corporations are facing rapid changes of nations and international business environments, especially trade environments and the restriction of the environmental pollution. In this situation, for preparation on the influence of the new protection and sustainable competition advantage, Korea companies have to be prepared for the future. The results of this thesis are as foolows: ① Firms should consider environment to bo the most important factor on competitive advantage in their business. ② The enterprises should establish the company strategies that could be adaptable systematically. ③ In orders to correspond both to the enviromental restriction to betterment quality of life, all parties should do their best by having the high level of environment consciousness.
임신여성을 제외한 성인에서의 B군 연쇄구균 감염에 관한 임상적 고찰
고경식,권선희,안우석,이원욱,김구엽,서환조 대한감염학회 1995 감염 Vol.27 No.4
목적:B군 연쇄구균은 최근 보고에 의하면 만성 기저질환(당뇨병, 악성종양등)이 있는 성인에서 감염빈도 및 사망률, 이환율이 증가하고 있는 추세이며 그 중요성이 대두되고 있다. 이에 저자들은 B군 연쇄구균 감염의 임상양상, 기저질환(위험인자)을 알아보고, B군 연쇄구균 항균제 감수성등을 규명하고자 하였다. 방법:1986년 1월부터 1993년 12월까지 경희대학교 부속병원에서 B군 연쇄구균이 배양된 274예를 대상으로 의무기록지를 검토하였다. 결과: 1) 전체 연구대상은 274예로 98예(35.8%)가 남자였고, 176예(64.2%)가 여자였다. 이들의 연령분포를 보면 신생아군에서 감염이 많이 발생하였다 이후 감소추세를 보이다가 20대 이상에서 다시 증가 하는 추세를 보였다. 2) 감염 양상은 274명중 명확한 감염이 156명(56.9%), 추정감염이 55명(20.1%), 비감염이 63명(23.0%)이었다. 임신을 제외한 18세 이상의 성인은 231명으로 남자가 83명, 여자가 148명이었고 남여 비율은 1:1.78이었다. 이중 133예(57.6%)에서 명확한 감염이었고, 46명(19.9%)에서 추정 감염, 52명(22.5%)에서 비감염이었다. 명확한 감염환자 133명중 31명(23.3%)이 병원내 감염이였다. 3) 18세 이상의 성인 231명에서 Group B Streptococcus가 분리 동정된 감염 부위는 자궁 경부 77예(33.3%), 요 73예(31.6%), 객담및 상기도 39예(16.9%), 농 24예(10.4%)등이었다. 4) 명확한 감염을 가지고 있었던 성인 133명의 임상양상은 요로 감염 37명(28%), 자궁 경부염 37명(28%), 피부, 연조직 감염 23명(17%), 폐렴 10명(8%), 패혈증 8명(6%)등이었다. 5) 명확한 감염을 가지고 있었던 성인 133명중 92명(69%)에서 한가지 이상의 만성 기저질환이 있었으며, 이중 당뇨병 32%, 뇌 혈관 질환 21%, 고혈압 19%, 신부전 12%, 악성종양 5%등을 차지하였다. 6) 항균제 감수성 검사(251예)에서 penicillin 98.4%, cephalothin 99.6%, cefamandol 98.8%, erythromycin 96.0%, clindamycin 89.4%, oxacillin 88.8%, lincomycin 87.8%, methicillin 86.8%, minocycline 49.4%, trimethoprim-sulfamethoxazole 15.5%의 감수성을 보였다. 7) 명확한 성인 감염 133명중 6명(4.5%)이 사망하였다. 결론:B군 연쇄구균은 만성 기저질환이 있는 성인에서 감염 빈도가 높고, 치명적인 결과를 초래할수 있으므로 감염 예방 및 조기 발견, 적절한 항균제 감수성 검사에 따라 조기 치료로 사망률을 줄여야 할것으로 생각된다. Background: Several reports have suggested that the incidence of diseases caused by Group B streptococcus is increasing in nonpregnant adults, particularly those with serious underlying diseases. The objectives of this study were to define the clinical manifestations, underlying conditions(risk factors) of definite group B streptococcal diseases in nonpregnant adults and to obtain antimicrobial sensitivity of these infections. Methods: We analyzed the records of 274 cases of the Group B streptococcus isolated in Kyung-Hee University hospital between 1986 and 1993. Results: 1) Total Group B streptococcal isolates were 274 cases : Of these cases, 7 percent were 1 month of age or younger, 3 percent were older than 1 month but younger than 18 years of age, and 91 percent were 18 or older. 2) Men and nonpregnant women accounted for 87 percent (n=231) : 133 cases (57.6%) with definite infection, 46 cases(19.9%) with possible infection, and 52 cases(22.5%) with no infection. 31 cases of 133 (23.3%) nonpregnant adult with definite infection apeared to have acquired the disease nosocomially. 3) In the 133 nonpregnant adult patients, the most common clinical diagnosis were urinary tract infection(28%), and cervicitis(28%). 4) In the 133 nonpregnant adult patients, the underlying diseases or conditions were diabetes mellitus(32%), cerebrovascular accident(21%), hypertension(19%), renal failure(12%), and malignant neoplasm(5%), Sixty-nine percent of the cases had one or more underlying diseases. 5) In the antimicrobial sensitivity tests, 98.4% of isolates were sensitive to penicillin, 99.6% to cephalothin, 98,8% to cefamandol, 96.0% to erythromycin, 89.4% to clindamycin, and 49.4% to minocycline. 6) The case mortality rate was 4.5%(6 of 133). Conclusion:We found group B streptococcal infection to be a significant and apparently increasing cause of definite diseases in nonprognant adults, particularly in those with serious underlying diseases. Recognizing these infections early in the groups with serious underlying diseases will be helpful in lowering mortality.
고경식,권선희,김병준,김구엽,서환조 대한감염학회 1995 감염 Vol.27 No.5
목 적 : 최근 칸디다혈증의 발생율이 매우 증가하여 병원 감염의 중요한 원인으로 대두되고 있다. 이에 저자등은 칸디다혈증에 대한 임상적 특성을 알아보기위하여 다음과 같이 연구하였다. 방 법 : 1988년 1월부터 1993년 12월까지 경희대학부속병원에서 발생하였던 병원성 칸디다혈증 61예를 대상으로 의무기록지를 검토하였다. 결 과 : 1) 연도별 발생 빈도는 1988년 부터 1933년까지 각각 2예, 7예, 9예, 11예, 15예, 17예로 증가하였으며, 최근에는 non-albicans 균주에 의한 감염이 증가하고 있었다. 2) 연령분포는 4-83세였으며 평균연령은 51.0±17.4세였고, 남자 32예, 여자 29예였다. 50대와 60대가 57.3%로 가장 많았다. 3) 균주별 발생빈도는 C. albicans 30예, C. tropicalis 13예, C. parapsilosis 10예, C. glabrata 6예, C. guilliermondii 1예, C. krusei 1예로서 C. albicans가 가장 많았다. 4) 기저질환으로 뇌혈관계질환이 25예(41%)로 가장 많았으며, 외과적질환 11예(18%), 고형악성종양 10예(16.4%), 혈액종양질환 9예(14.8%), 기타 내과적질환 6예(9.8%)였다. 5) 균주간 선행인자는 비슷하였으나, C. albicans와 C. tropicalis에서는 수술을 시행받은 예가 많았고, C. parapsilosis는 정주 영양 공급을 받은 경우가 많았다. 6) Amphotericin B 치료군(20예)과 fluconazole 치료군(11예) 사이에 예후에서 유의한 차이는 없었다. 7) 총 61예중 28예에서 사망하여 사망율은 45.9%였으며 정형외과적 수술을 시행받은 경우(83.3%)와 C. glabrata인 경우 사망율이 가장 높았다(83.3%). 결 론 : 칸디다 혈증은 중요한 병원 감염으로 대두되고 있으며 최근에는 non-albicans 진균주에 의한 병원성 칸디다 혈증의 발생율이 증가하는 추세이다. Background : The aim of this study is to determine the annual occurrence of nosocomial candidemia, the relation between Candida species and underlying illness, the relation bewteen Candida species and predisposing factors, and also to compare between the outcome of candidemia of the amphotericin B treatment group and that of the fluconazole treatment group. Methods : We reviewed medical records of 61 cases with nosocomial candidemia between 1988 and 1993 in Kyung Hee University Hospital retrospectively. Results : Two cases occurred in 1988, 7 in 1989, 9 in 1990, 11 in 1991, 15 in 1992, and 17 in 1993. The incidence of candidemia by non-albicans species has increased during this period and accounted for 64.7% in 1993. The infecting candida species were C. albicans(30 cases, 49.2%), C. tropicalis(13 cases, 21.3%), C. parapsilosis(10 cases, 16.4%), C. glabrata(6 cases, 9.8%), C. guilliermondii(1 case, 1.8%), and C. krusei(1 case, 1.8%). The most common underlying disease was cerebrovascular disease(41%) followed by surgical disease(18%), solid cancer(16.4%), hematological malignancies(14.8%), and other medical illness. There were no significant differences between the amphotericin B treatment group(n=20) and the fluconazole treatment group(n=11) in mortality. Overall mortality was 45.9%. The highest mortality was in patients with previous orthopaedic surgery(83.3%) and with C. glabrata candidemia(83.3%). Conclusion : Candidemia emerged as an important hospital infection and candidemia caused by non-albicans species has significantly increased in recent years.
장애인 생활시설의 후원자원 개발을 위한 전략적 마케팅 기획 사례연구 : J기관을 중심으로 Focused on J Institution
고선정,김성희 한국장애인재활협회 2004 재활복지 Vol.8 No.1
본 연구는 장애인생활시설의 후원자 개발을 위한 전략적 마케팅 기획과정(Strategic Marketing Planning Process)에 따른 사례연구를 하고자 함이다. 최근 사회복지시설은 후원자원 개발의 필요성이 제기되고 있으나 담당인력의 마케팅 기법에 관한 지식과 기술이 미숙한 단계에 있다. 특히 작은 규모의 생활시설은 자원개발의 필요성에도 불구하고, 후원자원 개발을 위한 마케팅 전략을 수립하는데 어려움을 겪고 있다. 이를 위해 장애인생활시설(J기관)의 후원자개발 사례를 종합하여, 전략적 마케팅 기획과정에 초점을 맞추어 조직을 분석하고, 그 내용을 토대로 포트폴리오 기획을 통해 핵심 마케팅 전략을 수립하였다. 특히 조직적 차원에서 마케팅 전략을 수립하기 위해 Andreasen과 Kotler(2003)가 제시하고 있는 기본들을 사용하였다. J기관의 조직분석 결과, 도서지역이라는 지리적 특수성은 자원개발을 하는데 저해요인이 되고 있었으나, 기관의 약점을 강점으로 활용하기 위한 기회요인(시설의 개방)을 찾고, 후원자개발을 위한 조직문화를 형성하고 있음을 볼 수 있었다. 특히 마케팅믹스에 의한 자원개발 전략을 7가지 요소로 구분하여 최적의 상태에서 자원개발을 하기 위한 방안을 모색하였다. 따라서 본 연구는 생활시설의 담당인력이 자원개발 업무수행에 어려움을 겪고 있는점을 감안할 때, 단일기관의 사례를 제시함으로써 생활시설의 자원개발에 따른 실천적 접근방법을 모색하는데 그 의미가 있겠다. This is a case study on the process of strategic marketing planning to develop sponsors of residential institutions for people with disability. Recently social welfare institutions are raising the necessity of developing sponsoring resources but persons in charge of relevant affairs lack knowledge and skills in marketing. In particular, small-sized residential institutions have difficulties in establishing marketing strategic for the development of sponsoring resources despite their keen necessity of resource development. Thus this study examined a case of sponsor development by an residential institution for people with disability(J Institution), analyzing the organization focused on the process of strategic marketing planning. In addition, based on the findings, it established a key marketing strategy through portfolio planning. Particularly to establish a marketing strategy in an organizational dimension, this study used a basic frame proposed by Andreasen & Kotler(2003). According to the result of analyzing J Institution, its geographical characteristic, namely, its being at an island was a factor hindering resource development but the institution had developed organizational culture for finding opportunities (openness in residential institution) to utilize its weakness as a strength and developing sponsors. In particular, it divided its resource development strategy based on marketing mix into seven elements, and looked for resource development plans under the optimal condition. Thus, considering difficulties that persons in charge of resource development at residential institutions for the disabled have in performing their job, this study is meaningful in that it looked for practical approaches for the institutions to develop resources by suggesting the case of an institution.
박선희,고영수 漢陽大學校 韓國生活科學硏究所 1992 韓國 生活 科學 硏究 Vol.- No.10
우리나라에서 식용으로 잘 이용되고 있지 않은 값싼 가래의 권장을 위하여 호두와 가래의 general components, minerals, amino acids, triglycerides, fatty acids, sterols 및 tocopherols을 각각 AOAC방법, spectrograph법, amino acid auto analyzer법 thinchrograph법, gas chromatograph법, thin layer chromatograph법 등을 이용하여 분석하고 비교하여 다음과 같은 결과를 얻었다. 호두는 71.86%의 crude fat를 함유하며, 17.81%의 crude protein을 함유하는데 비해, 가래는 59.47%의 crude fat를 함유하며, crude protein은 호두 보다 휠씬 많은 30.79%를 함유하였다. Mineral의 경우에는 P가 호두보다 가래에 2배가량 많았고, amino acid는 호두의 경우, glutamic acid, arginine순으로 함유되어 있었고, 가래는 glutamic acid, aspartic acid순으로 함유되어 있었다. 호두와 가래의 물리화학적 성질에 있어서 I.V. 는 각각 141과 161로 모두 건성유에 속하며, S.V., A.V., R.I.는 거의 유사했다. Total lipid중 triglyceride는 호두와 가래에 94∼97%를 이루었으며 호두에는 trilinolein이, 가래는 triliolein이 각각 많았다. Fatty acid에서는 호두에 59.95%, 가래에 69.17%를 이루는 것이 essential fatty acid인 linoleic acid이었고, oleic acid도 각각 22.17% 및 18.99%를 함유했다. Sterol은 호두에 95.34%, 가래에 93.49%의 β-sitosterol을 함유하고 있었으며 소량의 campesterol을 함유하였다. Tocopherol의 경우에는 호두와 가래 두 경우 모두 α-, δ- 및 γ-tocopherol을 함유하고 있었다. This study was conducted to investigate the possible use of wild walnut as a supplement for walnut. The chemical compositon of general components including minerals, amino acids, total lipids, triglycerides, fatty acids, sterols, and tocopherols were analyzed by AOAC methods, spectrographic methods, amino acid auto analyzer, thinchrographic methods, GLC and TLC, respectively. The results are as follows : 1.Crude fat content of walnut(71.86%) was higher than that of wild walnut(59.47%), while crude protein content of walnut(17.81%) lower than that of wild walnut(30.79%). Remaining components were almost the same in these two nuts, 2.Potassium was most abundant mineral in these two nuts, even though the level in wild walnut was twice as great as that in walnut. 3.The content of glutamic acid was the highest among amino acids in both nuts. Walnut had ARG. > ASP. > VAL. > ASP. in decreasing proportion while wild walnut a had ARG. > ASP. > PHE. in decreasing levels. 4.Among the physical and chemical characteristics of walnut and wild walnut oil yielded, iodine value was 141 and 161 individually, so it was known that both were drying oil. The content of triglyceride in total lipid contained more than 94% in common. Trilinolenin was the major triglyceride in walnut while trilinolein in wild walnut. 5.Linoleic acid (walnut 59.5%, wild walnut : 69.17%) was most prominent in both nuts and oleic acid (22.17%, 18.99%) and linolenic acid (8.9%, 8.30%) were followed. 6.β-Sitosterol was the predominant sterol in two nuts detected and campesterol was found in small amounts in both them. 7.Both nuts had α-, δ- and γ-tocopherol, which are natural antioxidants.
강국희,김혜란,고애경,김경민,최선규 성균관대학교 생명과학자원연구소 1994 生命資源科學硏究 Vol.1 No.2
We have investigated the distribution of bacteria in kimbab and its materials. The total bactria counts were over 3×10 exp(6)/g(n=30) when the kimbabs were delivered to restaurant and it exceeded the prieliminary legal level 1 × 10 exp(6)/g even though it should be negative for coliforms. In order to look into the cause of bacterial contamination in kimbabs, we examined the content materials of kimbabs. The bacterial counts were founded 10^4-10^8/g for Kim, 10^4-10^8/g for sausage, 10^4-10^6/g for spinach, 10^3-10^7/g for carrot, and 10^3-10^6/g for danmugi, respectively. From these results it could be concluded that the bacterial contamination in Kimbabs are due to kim, spinach, carrot, and sausage. Therefore, so as to reduce the bacterial contamination for kimbab, the sanitary manufacture and storage of kim and the refrigeration of content materials should be went abreast.
노선희,고영수 漢陽大學校 韓國生活科學硏究所 1996 韓國 生活 科學 硏究 Vol.- No.14
This study was performed to investigate the seasonal changes in the chemical composition of Korean oysters(Crassostrea gigas). The fresh oysters from Sept. to Decenm. harvested were freeze-dried and stored at -20℃ for analysis. The results showed that fatty acids, cholesterol amino acids, and trace metals Total fat and eicosa-pentaenoic acid content increased from September to October and then decreased till December. While most of fatty acids composition was not much changed. Cholesterol content was highest in September and then deceased to the lowest level in December. Glutamic acid, alanine and glycine were found as the major amino acids and relatively large amount of taurin was also determined. These amino acids, which affects the tasty of oysters, showed a gradual increase till December.