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.

협력중심 장애유아 통합교육 교사지원 프로그램에 참여한 유아통합학급 교사의 협력교수 수행과정에서 나타난 변화 탐색

양진희(Yang Jin-Hee) 한국열린유아교육학회 2011 열린유아교육연구 Vol.16 No.2

본 연구의 목적은 성공적인 장애유아 통합교육 실천을 위한 협력중심 장애유아 통합교육 교사지원 프로그램을 경험한 유아통합학급 교사의 협력교수 수행과정에서 나타난 변화를 탐색하기 위한 것이었다. 연구 참여자는 유아통합학급 교사 6명이었으며, 15주 동안 협력교수 교사교육 프로그램에 참여하였다. 본 연구의 결과는 다음과 같다. 첫째, 협력교수 교사교육에 지원한 유아통합학급 교사들은 협력교수가 이루어지고 있지 않았으나, 협력교수의 필요성과 그 중요성을 인식하고 있었다. 또한 협력교수가 성공적인 장애유아 통합교육 실천을 위한 전제조건이라는 점에 동의하고 있었다. 둘째, 협력교수 교사교육에 참여한 유아통합학급 교사들은 협력교수 수행을 시도함으로써 장애유아 통합교육을 성공적으로 이끌려는 의지를 보였다. 유아통합학급 교사의 협력교수 수행은 통합학급 교사로서의 교육철학과 신념, 역할과 책임, 전문성 발달과 향상, 협력과 소통 등으로 세분화 되어 나타났으며, 각각이 긍정적으로 변화되었다. 본 연구는 유아통합학급 교사들의 협력교수 수행은 교사지원 프로그램에 따라 긍정적으로 변화될 수 있다는 점과 성공적인 장애유아 통합교육의 실천은 유아통합학급 교사들의 협력적 체계 구축이 우선되어야 한다는 점을 시사한다. The purpose of this study was to observe the changes of early childhood inclusive classroom teachers' co-teaching performance in a teacher support program for collaborative inclusive education. A teacher support program for collaborative inclusive education developed by Yang jin-hee(2008) was used in this study. This study was conducted with the collaboration of the team of 6 co-teachers including general and special education teachers for the period of 15 weeks. The materials were collected through the in-depth interviews of co-teachers related to the changes in co-teaching performance. The collected materials were classified and arranged by the purposes. The result of this study were as follows: Frist, the philosophy and belief on co-teaching performance of co-teachers in early childhood inclusive classroom was changed to mutual confidence and trust between the co-teachers. The co-teachers shared communication techniques on overall aspects about co-teaching. Second, the thought on role and the responsibility of co-teachers in early childhood inclusive classroom was changed to the designation of the role and the establishment of the limit of responsibility. The co-teachers shared the method of trouble-shooting on overall aspects about co-teaching. This study discussed the important supporting systems that are responsive to the requests of instructors while co-teaching with co-teachers.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

숙명여자대학교 학위예복 디자인 개발에 관한 연구

양숙희,손휘순,박진영,양희영,위혜정 숙명여자대학교 건강·생활과학연구소 2004 生活科學硏究誌 Vol.- No.21

Academic costume is a ceremonial dress represented authority and formality. This indicates a degree in a viewpoint of personality, and symbolizes academic authority and well matched social responsibility. Besides, it emblematizes separately university's identity and tradition, and could be utilized useful culturaltools visualized national culture and tradition. That is to say, academic costume is most effect visual medium, which symbolizes our subjective culture and academic authority and phase. Accordingly, creative academic costume's development is a link of active and positive efforts to be satisfied with various needs of spearhead information society in 21C. Academic costume designing development had been progressed a public opinion survey, theoretical examination, and research on the actual condition through various actual materials. Based on the above examination, this study performs designing development of a bachelor, master, and doctor's academic costumes. Designing development of academic costumes intend to be enlarged and developed academic costume's function as a symbolic cultural tool, which includes Sookmyung women's spirit as a beginningof the racial education. Moreover, this aims at active utilizing of academic costumes as a symbolic medium expressed Sookmyung Women's University's identity, which intends to realization of the racial education establishing women's education, racial identity, and subjectivity, and represents educational objectives planning to the ruling women's bringing up.

지능형 도로 LED 라인조명 시스템

양진영,김원식,김진희,박찬원 江原大學校 産業技術硏究所 2009 産業技術硏究 Vol.29 No.B

This paper presents the development of smart road line lamp system consisting light control device. It can perform the individual power control or partial on/off control of a LED lamp by control center and can detect the error of the LEDs by current sensing . Also, the ability to control the brightness and period of on/off by detecting the car's existence. This light control circuit consists of road line lamp unit device. It can give a lot of solutions when the server, which controls the whole system, is operated through CDMA(Code-Division Multiple Access) network

(Zn,Cd)S:Ag 형광체의 발광특성에 관한 연구 : I. Flux 변화에 의한 고찰

양동익,신영진,윤희중 全北大學校 科學敎育硏究所 1980 과학과 과학교육 논문지 Vol.5 No.-

The photoluminescent(Zn, Cd)S: Ag phosphors are prepared by firing at 750℃, 850℃, 950℃ and 1050℃ in N_2 gas of atmospheric pressure for an hour. They are doped with(1) an activator Ag_2S(2) both an activator Ag_2S and each different flux; NaCl, NH_4C1, NH_4Br. The crystal structure of(Zn, Cd)S: Ag phosphors powder is the mixed phase of cubic and hexagonal. The photoluminescent cells are made with these phosphors and their emission spectra are measured at room temperature after these materials are excited with 3650A˚ (3.4eV) light. All these fluxes are found out to help the doping of the impurity energy level. The following results are also observed about (Zn, Cd)S: Ag phosphors. (1) Sufficient concentration of flux is enough with10^-2mole/mole(Zn, Cd)S. (2) (Zn, Cd)S: Ag phosphors with flux NH_4Br is stronger intensity than that of the orthers. (3) Variation of PL intensity of (Zn, Cd)S: Ag phosphors against gr molecule of flux seems to increase with logarithmic function like.

部分 補强된 얇은판 보의 橫挫屈 近似解析法에 관한 硏究

梁會眞 호남대학교 1997 호남대학교 학술논문집 Vol.18 No.4

In this study, to investigate the reinforcement efficiency of lateral bucking of partially reinforced beam with web stiffener approximate analysis method is used to evaluate the reinforcement efficiency of web stiddener according to it's the location. To verify suggested approximate analysis method for lateral buckling of partially reinforced beam with web stiffener it's numerical results are compared with results by extended fininte element method for lateral buckling. The results of this study are as follow. 1.The effective location of web stiffener for reinforcement of lateral bucking is govered by the support condition of beams. It is the most effective that web stiffener located both ends for both ends simply supported beam, and in the case of both ends fixed beam, the web stiffener placed L/4 from both ends. 2.The error of the approximate analysis method that is compared with extended finite element method is increased according to the effectiveness of reinforcement. Both ends simply supported case, maximum error is 34% for analysis model No.(MD-2-B), and both ends fixed case maximum error is 16% for model No.(MD-2-D). 3.In approximate analysis method, it is considered that the increment of stiffness by web stiffener is overestimated. So, to reduce error in approximate analysis method, it is necessary that to apply reduction factor to the stiffness of web stiffener used in this study.

建築物의 構造的 破壞分析 시스템에 관한 考察

梁會眞 호남대학교 1990 호남대학교 학술논문집 Vol.11 No.2

According to recent analysis result which was made in switzerland to deter-mine the causes of failure, although a part of the failures are due to accepted risk, most of the failures are the result of human errors. Most of the failures observed are obviously the results of incomplete safety concepts which at present as applied in structural engineering are restricted to taking into account only the damageing influence. The influence of man is not or only scarcely considered. Therefore, the failure occurence cannot be essentially reduced. The application of an improved safety concept should be able to reduce similar failures in the future. The new overall safty concept should consider not only the damaging influences, but also strategies against human errors. In this study, based on the experance of an analysis done in Switzerland, a system for a detailed analysis of structural failures fitted to this new overall satfy concept is presented.

측뇌실내 수막종 : 임상분석 및 수술접근법 Clinical Analysis and Surgical Approach

양희진,김동규,정희원,이현구,김현집,조병규,최길수,한대희 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

The authors present six cases of lateral ventricle meningiomas treated at Seoul National University Hospital between 1979 and 1991. These six cases of lateral ventricular meningiomas constitute 1.8 percent of all intracranial meningiomas and 16.7 percent of mass lesions of the lateral ventricle. The mean age was 29 years ranging from 11 to 50 years, younger than that or intracranial meningiomas with a statistical significance(p<0.01). Four of the patients were women and two were men. All cases were located in the trigonal area. The most common clinical symptoms and signs were related to increased intracranial pressure such as headache, nausea and vomiting. Based on the clinical presentation and radiological features(CT. MRI and angiography), correct preoperative diagnosis was possible in five cases. Gross total removal of the tumor was achieved in all cases. There was no operative mortality. A temporal gyrus approach was used in five cases with good surgical results. The benefits and drawbacks of each surgical approach for meningiomas of the lateral ventricle is discussed with review of pertinent literatures.