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.

하지 분절 각도에 따른 수의 등척성 수축(MVIC)시 근전도 비교

김정자,이민형,김연정,채원식,한윤수,권선옥 한국운동역학회 2005 한국운동역학회지 Vol.15 No.1

J. J. KIM, M. H. LEE, Y. J. KIM, W. S. CHAE, Y. S. HAN, O. KWON. Comparison of the maximum EMG levels recorded in maximum effort isometric contractions at five different knee flexion angles. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 197-206, 2005. The purpose of this study was to quantify the maximum EMG levels and determine if there are differences in these EMG levels with respect to different knee flexion angles. Eight university students with no known musculoskeletal disorders were recruited as the participants. The maximum voluntary isometric knee extensions and flexions were taken from each participant sat on the isokinetic exercise machine (Cybex 340) at five different knee flexion angles (10?30?50?70? 90?. After surface electrodes were attached to rectus femoris, vastus medialis, vastus laterlis, biceps femoris, and semitendinosus, maximum EMG levels at five different knee flexion angles were measured. The results showed that there was no significant difference in maximum EMG levels among five different knee flexion angles. Although there was no significant difference in EMG levels and were some variations among different knee flexion angles, the EMG signals of quadriceps in extension and biceps femoris in flexion were the greatest at 30? It seems that different joint angles or relative locations of body segments might affect the magnitude of EMG levels. Because the maximum EMG levels could change with a different knee flexion angle, an attempt should be made to more accurately measure these values. If then, %MVIC measure provides more reliable data and is most appropriate for EMG normalization.

PT조건하 V_2O_5에 의한 Alcohol의 산화

강선희,김미련,김선자,김현옥,노복자,이기화,이정숙 曉星女子大學校 藥學大學 學生會 1988 曉星藥誌 Vol.4 No.-

2, 3; 5,6-di-O-isopropylidene-α-D -mannofuranose(ManA) were oxidized to their cor-responding 2, 3;5,6-di-O-isoprolylidene-α-D-manno-1.4-lactone(ManB) using calcium chlorite as oxidant in a phase transfer catalysis system. But identified results were not obvious. V_2O_5 catalzed oxidation of primary and secondary alcohols to aldehydes and ketones respectively at alkali conditions under Solod-Liquid phase transfer conditions. This reaction affords good overall yields of products without formation of undersirable.

간호 지식관리시스템 개발

민효숙,문원희,김미자,김선미,황윤신,황관옥,심희숙 충남대학교 간호과학연구소 2006 충남대 간호학술지 Vol.9 No.1

The purpose of this study were to develop Knowledge Management System for the nurse and to identify its effectiveness. The program was developed in development of the contents and programing. And the system was operated to 85 nurse for three weeks. Data collection were performed during the period of May 1, 2005 to December 30, 2005. The data was collected from 85 nurses using questionnaires. In order to ascertain the validity of clinical application of the system, Prior experience of the computer mediated communication, user satisfaction and utilization were analyzed. The instruments for the study were satisfaction(Kim, 2000), utilization(Kim, 2002). The collected data were analysed by descriptive statistics, using SPSS WIN 11.0 program. The results showed average score which is the satisfaction(6.09) showed middle satisfaction scores. It is concluded that if Nursing Knowledge Management System is operated considering all the above factors, It wound be one of the best qualified continuing clinical method for nurses.

백서 대장암의 동종면역효과에 관한 연구 : Effect of Cancer Bearing Rat Serum

김형일,박애자,장선택 중앙대학교 의과대학 의과학연구소 1988 中央醫大誌 Vol.13 No.2

In recent years, there has been much interests in identification and characterization of numerous tumor relating substances including ectopic hormones, oncofetal antigens, or abnormal enzymes for the diagnosis and monitoring of malignant tumors. But, practically so called cancer antigen, such as AFP, CEA, or TPA, which has been never used toward manufacturing anti-cancer antibody, while only used to compete the cancer tissue type specificity. Nowadays, cancer antigen must be actually applied in the field of cancer treatment by means of the mediator or inducer for anti-cancer antibody formation. This study researched the alloimmunization effect of the serum components obtained from cancer developing animals, chemical carcinogen (NG: N-methyl-N'-nitroso-N-nitrosoguanidine) induced colon adenocarcinoma model, in 216 male rats, and gained following results: 1. In cancer producing rats, the CRP levels were maintained evenly high values althrough the experimental period, but serum TPA was gradually increased along sequential studies, while βCG and LDH were increased in early acute phase and sooner decreased in late phase. 2. The individuals, those were alloimmunized by the serum acquired from cancer bearing rats, represented significantly high cancer rejection rate, especially in the group which was infused the serum of conspicuously high TPA concentration. 3. In the long survivers and cancer resistance group, could observed neither high βCG level nor increased LDH value, however the early deaths revealed extremely higher βCG and LDH levels in contrast of relatively lower TPA concentration. 4. So, there was able to confirm the fact that not only cancer rejection antigenicity was presented in the serum of cancer developing individuals, but also could gained prominent allommunization effect utilizing such serum of high occurring TPA believing one of immunologic cancer rejectives by itself or mediation of antibody inducing effects.

퍼지 PID제어기를 이용한 직류 전동기의 속도제어에 관한 연구

김동희,박순규,김자룡 진주여자전문대학 1994 論文集 Vol.17 No.-

본 논문은 직류서보 전동기 시스템의 퍼지논리를 이용한 PID제어의 한 기법이다. 이러한 제어기법은 재래식 조정기법(ITAE table)을 이용하여 정상적인 제어기의 변수를 조정한 다음 퍼지제어 행렬을 사용하여 시스템이 동작하는 동안 작은 이득값의 변화를 결정함으로서 전동기의 속도제어 시스템의 정상상태오차와 과도응답의 성능을 향상시킬 수 있으리라 기대된다. 이러한 시스템은 마이크로프로세서를 이용함으로서 쉽게 실현할 수 있다. This paper present an approach to use fuzzy logic PID control of DC servo control system. This approach assumes that available nominal controller parameter settings through some classical tuning technique (ITAE table). By using an appropriate fuzzy matrix(which is 3- separate Look-up Table), we determine small changes on these gain values during the system operation, and these lead to improved performance of the transient and steady behavior of the motor speed control system, this achieved at the expense of some small extra computational effort, which can be very easily undertaken by a microprocessor.

청소년기 학생의 학교 근린환경 이용과 불건전 행동 유형

김윤자,박선희 한국 가정과 교육 학회 2000 한국가정과교육학회지 Vol.12 No.1

The purpose of this study was to investigate the correlations between the school neighborhood environment and adolescents' behaviors. A questionnare was distributed to 221 high school students from June 27, 1997 to July 16, 1997 in chonju. In this study SAS package was used. The statistical methods such as frequency, mean, analysis of variance, correlation analysis, multiple regression analysis and T-Test were applied. The result of this study were as follows. 1) The school neighborhood environment of B high school included much more problematic places than A high school in 20 minutes distance on foot. So B high school students visited problematic places more frequently than A high school students(p<.05). 2) Both of A high school students and B high school students didn't be satisfied about the school neighborhood environment. The degree of satisfacton for school environment of A high school student was higher than that of B.(p<.001). The number of benefit facilities, the degree of cleanness, and the safety from automobiles positively influenced the satisfation for school neighbor envirionment, while the number and visiting of harm facilities negatively satisfation. 3) The problematic behaviors of B high school students was higher than A high school students(p<.05).

급성 임파성 백혈병의 말초혈액 검사소견

김성집,안경남,조무자,김춘식,심상인,김선무 대한임상병리사협회 2001 대한임상병리사회지 Vol.21 No.1

한과 중 유과의 제조방법 개선연구

이선임,김경자 東亞大學校附設 生活科學硏究所 2004 생활과학연구 논문집 Vol.12 No.-

The purpose of this study is the new expansion method research using sand, salt and charcoal except expansion using oil. The Yukwa base has been expanded by the oil traditionally, but the Yukwa base expanded by oil felt oily and smelled bad during storage. We studied the new expansion method compared with the oil expansion method and the proper condition of the new expansion method using sand, salt and charcoal. 1. To find the most expansion temperature, we studied the Yukwa base,s expansion degree from 120℃ to 200℃ using the sand bath. The Yukwa base,s surface broke and was the dark browning during expansion at 200℃. The Yukwa base,s didn't break and was good browning during expansion at 160℃. The Yukwa base,s contracted, adhered sand, and didn't appear the browning during expansion at 120℃. 2. When the Yukwa base was expanded at 200℃ by the salt expansion method, the Yukwa base was expanded fast but became dark browning. At 150-160℃ of salt bath, the Yukwa base expanded very well, was stable and became good browning but tasted salty. 3. The Yukwa base has long time until the Yukwa base was expanded at 90℃, The Yukwa base was expanded properly and good browning at 110-120℃ for 2 minutes. 4. The Yukwa base was expanded in first fry(110-120℃, 1 minute), and then the Yukwa base was stable and good browning in second fry(170-180℃, 1 minute) 5. The Yukwa base was made of glutinous rice, raw crude rice wine and bean water by K,s preparation. We studied the Yukwa base expansion degree using sand, salt and charcoal. The Yukwa base was the most expansion by the expansion method using edible oil. The Yukwa base by expansion method using sand and salt was smaller than the Yukwa base by expansion method using oil. The cross section of the Yukwa base by expansion method using sand was showed that the hole of cross section was constant, and surface was thin. The Yukwa base by expansion method using sand was high score in the tenderness and crispness of sensory evaluation. The Yukwa base by expansion method using salt was salty taste because of salt. 6. The Yukwa base was made of glutinous rice, clear rice wine and bean water by Y,s and H,s preparation, respectively. The Yukwa base by expansion method using sand was lower in the expansion rate compared with the Yukwa base by expansion method using oil. But the Yukwa base by expansion method using sand was high scores in the tenderness and crispness of the sensory evaluation. If we use sanitary sand and make good in Yukwa processing, The Yukwa base by expansion method using sand was good food without oily and the storage period was longer than the Yukwa base by expansion method using edible oil.

마우스 골수세포의 액체배양에서의 세포화학적 염색성에 관한 연구

김현태,박애자,장선택 중앙대학교 의과대학 의과학연구소 1988 中央醫大誌 Vol.13 No.4

The mouse bone marrow cells were cultured in liquid culture system to investigate the correlation of cytochemical changes and the number of colony forming unit granulocyte/macrophage(CFU-GM) and colony-forming unit megakaryocyte(CFU-Meg) colonies with cell maturation and platelet formation. The following results are obtained; 1. Total colony counts are markedly increased during 4-6 days of culture and reach the maximum number by 7th day (262.33 ± 192.33/ml). The number of cells are increased in each colonies without increase of total colony number after 5 days. 2. The mean ratio of acetylcholinesterase positive megakaryocyte colonies are 13.70 ± 7.04% of total colonies formed with no remarkable changes during 9 days culture period. The number of megakaryocyte colonies reach maximum level by 7th day (31.37 ± 25.73/ml), while that of nonmegakaryocytic colonies reach maximum level by 9th day (230.51 ± 81.90/m1). 3. Platelet count in medium are 5,000 ± 3,490/ml with no remarkable changes during 9 days of culture periods. 4. In acetylcholinesterase positive megakaryocytic colonies, the PAS stain show weak positive in few megakaryocyte by 3rd day, however about 40% of megakaryocytes show rather strong positivity by 7th day. The positivity of non-specific esterase and acid phosphatase are less than 10% until 9th flay of culture. Specific esterase positivity was not found during 9 days period of culture. 5. Non-specific esterase and acid phosphatase stain show lower positivies (11%, 5%) than PAS and specific esterase stain (21%, 55%) in non megakaryocyte colonies. In summary, the number of CFU-GM and CPU-Meg colonies in liquid culture are increased gradually and reached maximum by 7th day, forming large colonies from 5th days on In megakaryocytic colonies, no evidence of platelet formation were observed during 9 days period of culture. It is suggesed that the majority of CFU -GM colonies in liquid culture are mixed colonies according to the cytochemical stainabilities.