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.

보육료 차등지원제도의 도입 방향에 관한 연구

백선희 한국영유아보육학회 2004 한국영유아보육학 Vol.0 No.36

This article is about directions of introduction for a Sliding system of Child care Benefits(SCB). In recently, governments and research institutions proposed the SCB for socialization of child rearing. These proposals focused on an income level as criterion of the SCB. But this article concerned about necessity the other criteria in addition to the income. For strengthening of the public nature in the child care, it is needed enlargement of government's responsibility and equitable redistribution in the child care finance. So, the SCB should have both that mentioned above, as basic principles. This article assert on adding some criteria like parents's social-economic activities in relation to objectives of the child care policy, and the extent of burden when parents rear an infant or disabled children or more than two children in relation to social child care need. And this presents some preconditions of the SCB.

빈곤여성 자활의 사회적 인프라로서의 아동보육사업의 과제

백선희 한국영유아보육학회 2002 한국영유아보육학 Vol.0 No.30

This article is about the relation between the child care services and the self-support policy for the poor. The initiative function of the child care policy leads to economical independence of the poor women with young children. Although the direction of the latest child care policy proceeds to assure for quality of services, it is very important to secure social-economic participation of the poor working mother. The public assistance changed under the productive welfare ideology in the D.J. administration brings out the importance of child care services as a social infrastructure. It is required for all the beneficiaries with labour ability to participate in work programs, i.e. job search, job training and a public work. In spite of some criticisms towards the forced labor, the work programs also have some positive functions, such as offering jobs, developing their human resources through job training and increasing income. However, the most poor women with young children, even though they want to participate in such programs, are often unable to participate in those because of the burden of rearing their children. In this situation, the child care services are able to play an important key. This article distinctly shows importance of the child care policy as a social infrastructure for the poor women's economical independence, and proposes the tasks of the child care policy in connection with the self-support policy.

이하선 종양에 관한 임상적 연구

백승,오희균,박홍주,유선열,김원재 전남대학교 치의학연구소 2002 구강과학 Vol.14 No.3

This is a clinical study on 113 patients, who were treated for parotid tumors at Chonnam National University Hospital over a period of 5 years from January 1996 to December 2000. The results were as follow, 1. The mean ages were 42.6 years old (12~73 years) for benign parotid tumor patients and 43.9 years old (2~74 years) for malignant patients. 2. The ratio of male to female was 1:2 in malignant parotid tumors, but there was no difference in sex distribution of benign tumor. 3. There was no difference in mean mass size and duration of illness between benign and nalignant tumor patients. 4. The combined use of fine needle aspiration biopsy and computed tomograph was common as the diagnostic method of parotid tumor 5. The parotid tumors were commonly located in the superficial lobe(69%). 6. The ratio of benign and malignant tumors was 4:1. The most common benign tumor was pleomorphic adenoma (72% of benign tumor), followed by Warthin's tumor and monomorphic adenoma. The most common malignant tumor was rnucoeplderrnoid carcinoma(45% of malignant tumor). followed by adenoid cystic carnoma. carcinoma ex pleomorphic adenoma, and adenocarcinoma. 7. The most common operations were superficial parotidectomy (72%) for benign parotid tumor and total parotidectomy (45%) for malignant tumor 8. The most common postoperative complication was temporary facial nerve weakness (82%), followed by Frey's syndrome (14%) and permanent facial palsy (4%). 9. Postoperative radiation therapy was done in 12 patients and the mean radiation dose was 5550±620cGy. 10. Of 113 cases. tumor recurrence developed in 12 cases (10%). These results suggest that the successful management of parotid gland tumors needs adequate surgical treatment on the basis of knowledge of parotid gland anatomy and preoperative diagnosis.

銀杏葉의 家兎 皮膚 接觸性炎症 誘發 毒性物質에 關한 硏究

白秉杰,金秉洙,金善熙,安丙浚 충남대학교 약학대학 의약품개발연구소 1991 藥學論文集 Vol.7 No.-

Gingko biloba is one of the oldest trees on earth. It can be traced 300 million years or more into past. In recent years, this tree has become increasingly popular because of its longevity. Amount of comsumption of Gingko leaves in Korea is increased to produce drugs for blood circulating system's disorder. The workers who work at the company of product drug with Gingko leaves complain pruritus at belt position of west, however toxic substance from extracts of Gingko biloba was carried out to determine what kind of the toxic substance from extract could induce a contact dermatitis by means of histopathological study. Dried leaves of Korean G. biloba were exhaustively extracted with chloroform. The aqueous chloroform residue was extracted with hexane. After evaporation, the hexane extract was passed through a silica gel column chromatography, it was separated into 9 fractions by means of gradient solvent(benzene: acetone/ 98~93:2~7%). The 4th and 7th fraction were idendified as bilibol and gingkolic acid by silica gel thin layer chromatography and NMR spectrophotometer. The 4th and 7th fractions of Korean Gingko leaves have an irritant substances which can be induced ear swelling and increased thickness of stratum cornium of rabbit ear exposed with the fractions (3 time/3 day, 100μl of 50mg/ml ethyl alcohol). In the 4th fraction, the substance have induced the surface of ear to swell and mass of unknown cell like inflammatory cell were infiltrated within the stratum corneum, and the 7th fraction have the surface of ear to loss the hairs, and sebaceous gland and follicle of hair were infiltrated with inflammatory cells, and other fractions at all did not induced a certain contact dermatitis and also Deutschen drug of Gingko (named as Gerigeron) have induced the contact dermatitis such as dematitis of Korean Gingko extract.

영유아보육법 개정에 따른 보육시설장 및 보육교사 자격제도 연구

백선희,서문희 한국영유아보육학회 2004 한국영유아보육학 Vol.0 No.39

보육인력의 자질은 영유아보육서비스의 질을 결정하는 주요 요인 중의 하나이다. 최근의 영유아보육법 개정은 영유아보육서비스의 공공성 확보와 질적 향상이 배경이 된 것으로, 따라서 그 주요 요인이 되는 보육교사의 자질 향상과 관련하여 보육교사 자격증 제도의 도입이 새로 포함되어 있다. 법은 자격증제도 도입 등 몇 가지 기본적 사항만 제시하고 있을 뿐 구체적 내용에 대해서는 하위법령에 위임하고 있는 것이 일반적이다. 그러므로 보육인력 자격제도의 완비를 위해서는 하위법령을 구체화하는 방안을 모색하는 것이 필요하다. 본 논문은 보육인력의 전문성을 향상시킬 수 있는 합리적인 자격제도 방안을 모색하는 것을 목적으로 한다. 먼저, 현 자격제도의 주요 문제점으로 첫째, 자격증이 발급되지 않아 사회적 인정 정도가 약하고, 둘째, 보육교사 1급이 되기 위해 필요한 대학 교육내용의 질적 통제가 어렵고, 셋째, 현재의 보육시설장의 자격기준으로는 시설장의 전문성을 확보하기 어렵다는 것 등을 지적하였다. 그리고 모니터링과 정책토론의 방법을 통해, 개정 법률이 위임하는 법적 테두리를 고려하면서 보육인력의 자질 향상을 위한 자격제도 대안을 제시하였다. The quality of child care workers is one of key determinants affecting the quality of child care services. The recent amendment of Child Care Act in Korea was drawn on the idea of both improving the quality of child care service provision and placing more emphasis on public responsibility. Naturally, a part of the amendment includes the introduction of a new certification system of child care workers. In Roman law system where a hierarchy exists among different laws, it is generally done that an upper law delegates the details of its implementation to a lower law such as practice ordinance. So, it is necessary to have Child Care Act supplemented by sub-laws that specifies the details of the implementation measures of the Act. Having these points in mind, this article discusses the problems of the current qualification system of child care workers, and possible alternative system to improve the quality of child care services.

대전광역시지정무형문화재 기록화 방안 연구

백주연,김순희 충남대학교 충청문화연구소 2010 충청문화연구 Vol.4 No.-

사회복지 이념적 모형을 통해 본 김대중 정부의 아동보육정책 평가

백선희 한국영유아보육학회 2003 한국영유아보육학 Vol.0 No.33

The purpose of this study is to evaluate on the child care policy of the Kim Dae-Jung administration(1998-2002). This article classified welfare ideologies into residual welfare, corporate welfare and institutional welfare models. Perspectives on the child care policy is different each other: poverty policy, labour policy for women, child welfare policy. Generally, Child care policy has characteristics of human development(child development) and economic investment(Women's participating in labour market). That seems to be response to the productive welfare of DJ welfarism. But government did not adopt the child care as a crucial policy. As evaluating on subjects, objects, methods, deliverly systems and finances in the child care policy, this article describes that DJ's child care policy is located between residual welfare and corporate welfare.

우리나라 1900년대 문헌에 나타난 주식류 변화에 관한 고찰

백선희,안빈,이강자 동아시아식생활학회 2004 동아시아식생활학회지 Vol.14 No.6

This study reviewed the main-meals in 1900's Korean cook books. Boiled rice, gruel and thin gruel were mainly made of rice. As the additional ingredients, miscellaneous cereals, vegetables, potatoes, seafoods, meats and eggs were used to substitute for rice and to improve of preference. we observed some sort of main-meats were diminished and/or disappeared, changed its side ingredients to obtain foods easily, and also its cooking style has been gradually gelling to simplify.

이하선 종양에 관한 임상적 연구

백승,하주원,오희균,유선열,김원재 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.5

This is clinical study on 113 patients who were treated for parotid tumors at Chonnam National University Hospital over a period of 5 years from January 1996 to December 2000. The results were as follows ; The mean ages were 42.6 years old (12∼73 years) for benign parotid tumor patients and 43.9 years old (2∼74 years) for malignant patients. The ratio of male to female was 1:2 in malignant parotid tumors, but there was no difference in benign tumors. There was no difference in mean mass size and duration of illness between benign and malignant tumor patients. The combined usage of fine needle aspiration biopsy and computed tomogram was common as the diagnostic methods of parotid tumor. The parotid tumors were commonly located in the superficial lobe (69%). The ratio of benign and malignant tumors was 4:1. The most common benign tumor was pleomorphic adenoma (72% of benign tumor), followed by Warthin's tumor and monomorphic adenoma. The most common malignant tumor was mucoepidermoid carcinoma (45% of malignant tumor), followed by adenoid cystic carnoma, carcinoma ex pleomorphic adenoma, and adenocarcinoma. The most common operations were superficial parotidectomy (72%) for benign parotid tumor and total parotidectomy (45%) for malignant tumor. The most common postoperative complication was temporary facial nerve weakness (82%), followed by Frey's syndrome (14%) and permanent facial palsy (4%). Postoperative radiation therapy was done in 12 patients (60%) and the mean radiation dose was 5550±620 cGy. Of 113 cases, tumor recurrence developed in 12 cases (10%). These results suggest that the successful management of parotid gland tumors needs adequate surgical treatment on the basis of knowledge of parotid gland anatomy and preoperative diagnosis.