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.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

약제 내성 폐렴구균의 비율이 높은 지역에서 발생한 하기도 감염 치료에 대한 Levofloxacin의 효능 및 안정성

조황래,오원섭,김춘관,김연숙,정숙인,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

목적 : Levofloxacin은 지역성 호흡기 감염의 흔한 원인인 폐렴구균과 같은 그람 양성균뿐만 아니라, 그람 음성균, atypical organisms에 대해서도 넓은 항균 스펙트럼을 갖는 항균제로 알려져 있다. MDRSP의 빈도가 증가하고 있는 국내에서의 지역성 호흡기 감염에 대한 levofloxacin의 유효성과 안전성을 평가하기 위해 계획하였다. 방법 : 본 임상시험은 전향적 방법으로 2000년 1월부터 2001년 4월까지 삼성서울병원에 내원한 지역사회 획득 폐렴, 만성 기관지염에 병발된 급성 세균성 감염 환자 60명을 대상으로 하였다. 투여량 및 투여방법은 Levofloxacin 500㎎을 하루에 한번씩 12.6일(±3.3일)간 투여 하여 임상적으로 호전된 경우, 경구제로 전환하였으며(500㎎ q 24hrs), 신기능 장애시(Ccr 20-50㎖/min) 주사 및 경구제 500㎎을 48시간 간격을 두고 투여하였다. 임상효과, 미생물학적 평가, 및 부작용을 관찰하였다. 결과 : 총 60명의 환자가 시험을 완료 하였고, 결핵환자로 판명된 3명과 NK/T cell lymphoma로 확인된 1명, 투약 후 피부발진 발생으로 2일만에 중단된 환자 1명을 제외하고 55명을 평가하였다. 증상의 치료 및 개선을 임상적 유효성이 있는 경우로 하였을 때 55예 중 49예(89%)에서 만족할 만한 결과를 얻었다. 미생물학적 평가에서 10예중 10예(100%) 모두에서 미생물학적 소실을 보였다. 부작용으로는 간염 4예, 피부 발진 1예로 모두 5예(9%)가 발생 하였다. 결론 : 약제 내성 폐렴구균의 빈도가 증가하고 있는 국내에서의 지역성 호흡기 감염에 대하여 levofloxacin은 비교적 효과적이고 안전한 치료 방법이라 할 수 있다. Background: To evaluate the efficacy and safety of levofloxacin in the treatment of lower respiratory infections in the area with high prevalence of multidrug-resistant Streptococcus pneumoniae(MDBSP) Methods: Outpatients of over 18 years old with a confirmed diagnosis of a community acquired pneumonia and an acute bacterial exacerbation of chronic bronchitis were enrolled. Patients were treated with parenteral levofloxacin(500㎎ once a day) followed by oral levofloxacin(500㎎ once a day) for about 2weeks and evaluated. Results: Total number of 60 patients received levofloxacin for a mean of 12.6days. Successful clinical response(cured and improved) was 89.1%(49/55) of patients. Microbiologic eradication rate was achieved in 100% of patients whose pathogens were isolated. Hepatitis was developed in 4 cases and drug eruption occurred in I case. Conclusion: A once a day of 500㎎ of levofloxacin for lower respiratory infections developed in the region of high prevalence of MDRSP was effective and safe.

한국형 노인우울검사(Korean Form of Geriatric Depression Scale : KGDS) 표준화에 대한 예비연구

정인과,곽동일,조숙행,이현수 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.2

본 연구는 한국형 노인우울검사(KGDS) 표준화에 대한 예비연구로 GDS를 포함한 기존의 성인용 우울검사(BDI, MMPI-D, SDS, CES-D)에서 일련의 통계적 과정을 거쳐 한국 노인의 우울양상을 잘 반영하는 것으로 판단되는 문항 40개를 추출한 뒤 신뢰도와 타당도를 검증하였다. 연구대상은 60세 이상의 노인 175명으로. 이들 중 우울장애 진단을 받은 81명(남자 15명, 여자 66명)이 우울 환자군에. 우울장애진단이 배제된 94명(남자 33명. 여자 61명)이 대조군에 할당되었다. KGDS의 신뢰도를 검증한 결과, Cronbach의 α계수는 .88, 반분신뢰도는 .79로서 만족스러운 수준이었고 두 집단의 평균의 차이를 검증해본 결과 α=.001수준에서 유의하였다(환자군 평균 23.40±8.13,대조군 평균 12.50±8.82. t=9.76) KGDS의 구성타당도와 내적 구조를 파악하기 위해 실시한 요인분석에서는 비관적 사고 및 불행감(Negative thinking and Unhappiness feeling), 정서적 불편감(Emotional discomfort). 인지기능 저하(Cognitive dysfunction), 기력쇠퇴(Decreased vitality), 신체적 약화 및 건강염려증가(Physical weakening and inclosed somatic concern) 사회적 철수 및 흥미상실(Social withdrawal and loss of interest) 등 총 6개의 구성요인이 밝혀졌고 총 설명변량은 51.2%였다. 마지막으로 KGDS의 판별력과 최적 절단점수를 확인하기 위해 판별분석 및 민감도. 특이도의 지표를 구하여본 결과 전체판별률은 76.7%이었고 최적 절단점수는 16점이 제안되었으며 고전적인 백분위점수분포를 추가적으로 고려하여 16∼22점 사이는 경계선수준 및 정도의 우울증, 23∼25점 사이는 중도의 우울증, 26점 이상은 심도의 우울증으로 분류할 수 있을 것으로 기대되었다. 결론적으로. 노인 우울증에 대한 기존 검사들의 낮은 진단변별력을 개선시키고자 새로이 만든 한국형 노인우울검사(KGDS)는 GDS를 포함한 기존 검사들에 비해 진단변별력이 10%이상 향상되었을 뿐 아니라 신뢰도, 타당도도 만족스러운 수준을 보여 노인우울 진단용 검사로 유용하게 쓰일 수 있을 것으로 여겨진다. 마지막으로 피험자 선정과 관련된 문제점을 짚어보았고 추후 연구에서 문항의 수와 내용을 좀더 압축할 필요성에 대해 논의해 보았다. The purpose of this study was to construct Korean Geriatric Depression Scale(KGDS) items and test the reliability and validity of KGDS. Total 151 items from GDS, BDI, SDS, MMPI-D, and K-CES-D were administered to 81 depressed elderly and 75 elderly control groups. Sixty-four preliminary items which have discrimination power between depression and control groups were selected. Then by correlational analysis considering adjusted item-total correlation, 40 items were finally chosen to construct KGDS. The values of Cronbach's αand split-half reliability were 0.88 and 0.79, respectively. The differences of means was signified at α= .001 level(patients group mean = 23.40±8.13, control group mean= 12.50 ± 8.82,t=9.76). The result of factor analysis showed that KGDS had six factors. They were labeled negative thinking and unhappiness feeling(factor 1), emotional discomfort(factor 2), cognitive dysfunction(factor 3), decreased vitality(factor 4), physical weakening and inclosed somatic concern(factor 5), social withdrawal and loss of interest(factor 6), which represent depressive features of the elderly in thought, emotional, cognitive, physical, and social aspects. The total percentage of variance of the 6 factors was 51.2%. The result of discrimination analysis showed that hit ratio of KGDS was 76.7%, and the score of 16 was suggested as the optimal cut-off score. Additionally, by using percentile score distribution of control(normal) group, it is suggested that the score of 16-22 represents borderline or mild depression, the score of 23-25 are moderate depression, and greater than the score of 26 severe depression. Conclusively, KGDS not only improves diagnostic discrimination power 10% more than other depression scales including GDS, but also show sufficient reliability and validity, thus can be used far evaluation of elderly depression. Finally, some issues relevant to sample selection and the necessity of concising content and items of KGDS are discussed.

올리고당을 첨가한 송화다식의 물리적 특성

조은자,황지희,문정숙 誠信女子大學校 生活文化硏究所 2003 生活文化硏究 Vol.17 No.-

The present study also investigated possible use of oligosaccharides in Dasik making, as a low caloric and healthy replacement of honey(HON), isomalto-oligosaccha ride(IOS) and fructo-oligosaccharide(FOS) were subjected to a series of tests where they were substiduted for a half or all of honey supplemented in pine pollen Dasik. The treatments were, 100%HON(SI), 100%IOS(S2), 100%FOS(S3), 50%IOS+50%HON(S4), 50%FOS+50%HON(S5), Syrup100%(S6), Sensory and physical characteristics of the Dasik supplemented with various amounts of the oligosaccharides and honey were compared using various methods. The results of the study are summarized as follow: 1. Isomalto-oligosaccharide(23%) had the highest Water activity while Ash ranked the highest position in Honey(0.13%), Fructo-oligosaccharide(2.8poise) had the highest viscosity and pH. 2. Water activity rate in pine pollen Dasik including 100% of honey ranged from 0.50 to 0.56, and Water activity in pine pollen Dasik including oligosaccharide ranged from 0.54 to 0.67. All kinds pine pollen Dasik showed low water activity rate of limitation growth compated to those in yeast or mold during the storage period of six days. 3. The pH of pine pollen Dasik including 100% of honey ranged 3.90 4.06 while that of pine pollen Dasik including oligosaccharide range 3.97 4.11. 4. Total plate number derived from the storage of the pine pollen Dasik added with 100% of honey was 2.1×10^1 1.9×10^3 CFU/g, and that of the pine pollen Dasik added with 100% of oligosaccharide was equal to 2.1×10^1 1.9×10^3 CFU/g. However, the pine pollen Dasik, made up of 50% of honey and 50% of oligosaccharide, had total plate number of 1.2×10^1 2.0×10^2 depending on storage period which was remarkably lower than others. 5. In an actual manufacturing day, the more oligosaccharide was added, the higher result with high brightness was derived. As the storage period became longer, all brightness(L value) and yellowness(b value) decreased, and redness(a value) increased gradually. Color in storing pine pollen Dasik in cold temperature changed less than that in room temperature. 6. Hardness and adhesiveness of Taxture characteristics while storing pine pollen Dasik in cold temperature increased more steadily than that in room temperature. Furthermore, pine pollen Dasik including oligosaccharide revealed low Taxture characteristics 7. Sensory evaluation in terms of appearance of all pine pollen Dasik did not show difference in manufacturing day, but as the storage period increased, score about elasticity and hardness of pine pollen Dasik increased gradually. However, pine pollen Dasik with syrup added decreased remarkably. score ablut adhesiveness increased higher on three days before a manufacturing day. Especially, pine pollen Dasik with combining 50% of honey and 50% of Fructo-oligosaccharide positioned high in overall quallity and score during the entire storing period.

중학교 가정 교과 중 식습관 단원에 실천적 문제 해결과정을 적용한 수업 연구

조호정,안숙자 한국 가정과 교육 학회 2000 한국가정과교육학회지 Vol.12 No.2

The Purpose of this study is (1) to develop the teaching plan based on Practical Problems solving on the area of food habits in home economics class and (2) to investigate the participation of teaching. the attitude of teaching method and food life. The subject of this study was two classes consisted of 66 students(male 26, female 40, 33 for each class) who are the first grade of middle school. The comparison group was taught by lecturing, while the experiment group by cooperative learning. The period of this experiment was three weeks: from June 7th to June 23th. 1999. The experiment was conducted through 5 classes. First of all students identify the problem of food habits. and seek and evaluate information. Students evaluate actions and potential consequence and select the best actions and then students take action and reflect on decision and evaluate action. The statistical method for the study was a paired T-test. The results of this study are as follows : 1.After experiment. the participation of teaching(P<.05) and the attitude of teaching method(p<.01) in the experiment grouts showed a statistically significant difference. Therefore, the students in the class based on the practical problems solving took an active part in teaching. 2.The practical problems solving is more effective than the lecturing in doing guide the positive attitude of teaching. 3.Through the experiment, the attitude of food life in the experiment group showed a statistically significant difference(p〈 05) . Therefore, the practical problems solving is more effective than the lecturing in changing Positive attitude of food life.

쌀가루 혼합빵의 관능적 품질

조숙자,정은희 서원대학교 응용과학연구소 1996 응용과학연구 Vol.5 No.1

The sensory quality and the baking property of blends containing 10-50% of rice flour with wheat flour were analyzed by QDA. As sensory characteristics, color, air cell size, air cell distribution, flavor, softness, chewiness and overall quality were evaluated. Bread could be made successfully even using up to 50% rice flour. The color, flavor, softness and chewiness were increased in rice-wheat bread especially using 10∼30% of rice flour, but in case of using 40∼50% of rice flour those characteristics were not significantly different from those of wheat bread. The size of air cell in 10∼30% rice-wheat bread was not significantly different but in 40∼50% rice-wheat bread it was increased. The distribution of air cell was more even in 10∼30% rice-wheat bread than in wheat bread, but not in 40∼50%rice-wheat bread. The overall quality of rice-wheat bread was shown to be better in 10∼30% rice-wheat bread than in wheat bread.

흰쥐 대뇌피질에서의 Cholecystokinin Octapeptide의 分布

황정한,조희중,김은희,박매자,배용철,홍해숙,주강 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.4

흰쥐 대뇌피질에서 cholecystokinin octapeptide(CCK-8)의 분포를 관찰하기 위하여 간접면역형 광법을 행하여 관찰해 본 결과 다음의 많은 부위에서 CCK-8양성세포 및 양성섬유를 관찰할 수 있었다. 신피질: CCK-8양성세포는 주로 제2, 3층에서, 양성섬유는 제2, 3 그리고 6층에서 저밀도를 나타내었다. 후구: 전후핵에서 많은 CCK-8양성세포 및 양성섬유를 관찰하였다. 이상엽 및 후내야: 양성세포는 주로 제2층에서 관찰되었으며 양성섬유는 제2층에서 중밀도 제3층에서 저밀도로 관찰되었다. 해마체: 많은 양성세포 및 고밀도의 양성섬유가 원추세포층에서 관찰되었다. In order to investigate the distribution of immunoreactive cholecystokinin octapeptide (CCK-8) containing neurons in the cerebral cortex of the rat, brains of the rats were processed for indirect immunofluorescent technique. The results obtained were as follows. Neocortex; CCK-8 immunoreactive cell bodies were found in layer Ⅱ and Ⅲ and immunoreactive axon terminals were heaviest in layers Ⅱ, Ⅲ and Ⅵ. Olfactory bulb; The anterior olfactory nucleus contained numerous CCK-8 immunoreactive cell bodies and a moderate density of immunoreactive axon terminals. Piriform and entorrhinal cortex; CCK-8 immunoreactive neurons and axon terminals were observed in layer Ⅱ and Ⅲ. However, they were more frequent in layer Ⅱ. Hippocampus; CCK-8 immunoreactive cell bodies and axon terminals were found in pyramidal layer.

보육과 현장중심 교육과정 개발 : DACUM법을 중심으로 Based on the DACUM Method

김정신,노은호,이행숙,정해은,조희진 한국영유아보육학회 2004 한국영유아보육학 Vol.0 No.36

The quality of childhood educare teacher is the most important element in evaluation of the quality of childhood educare. However, the current curricula for the childhood educare in colleges are operated individually without a standard curriculum and there are many problems in the certification system of childhood educare teacher. So, it is hard to discuss about the specialty of the childhood educare teachers. Hence, an immediate development of a standard curriculum which fully reflect the needs of the field is necessary to meet the demand of the times and to enhance the quality of childhood educare service by producing qualified teachers. To fulfill the aforementioned needs, the procedure of the DACUM Method which is useful in developing vocational training course is used in this study. And based on the results, a field centered curriculum of the Dept. Child Care and Education is developed by the job analysis of the childhood educare teachers and by collecting the needs of the field. Educare planning and activities, development and evaluation of the educare program, consultation and education of the family, utilization of the regional resources, and after-class guidance of the children were found to be the principal jobs of the childhood educare teachers.

熱處理 條件에 따른 PET 織物의 減量加工에 關한 硏究

배정숙,조환,허정순,조용석 대구대학교 산업기술연구소 1985 産業技術硏究 Vol.4 No.-

This study has been undertaken to see the variation of the weight loss, dyeing property, and the tensile strength of the polyethylene terephthalate (PET) fabrics under the influence of the heat setting during the finishing of the fabrics. The fabrics were heat set for 40,80 and 120 seconds, then alkali treated with 5%, caustic soda solution for 40 minutes on temperature of 80℃, and then dyed with blue and red disperse for 30 minutes of the temperature of 130℃, Using these treated materials, color differences and tensile strength were measured. The results were as follows; 1. The weight loss of PET fabrics increased as the heat setting temperature was elevated. 2. weight loss of PET fabrics decreased as heat setting time increased on the temperature over 220℃ 3. The dyeing property of PET fabrics became stable on the temperature below 180℃ not influenced by heat setting time. 4. The tensile strength decreased as the weight loss increased. Consequently, the temperature influences greatly on the weight loss and the dyeing property during the finishing of PET fabrics.