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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.

      • KCI등재

        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

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        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.

      • 서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

        김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

        Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

      • 전문대학 간호과 통합교과과정 개발에 관한 연구

        김영희,김정수,김정애,방숙명,배경진,이애경,장은정,정안순,주미경,최나영 경복대학 1998 京福論叢 Vol.2 No.-

        교과과정의 조직은 체계적이고 뜻이 있는 순서로 학생들을 가르치기 위해 지식을 어떻게 조직화할 것인지와, 과목들 사이에서 공통된 내용은 통합시켜 중첩되는 일이 없도록 조정할 필요가 있다. 이에 현재 본 대학 간호과에서 운영되었던 97학년도의 17개 전공과목들의 교과과정의 내용을 비교, 분석하여 중복을 줄이며 순차적 지식의 습득을 도모하는 새로운 통합교과과정의 틀을 개발, 제시함으로써 보다 나은 전문직 간호교육이 이루어지도록 하고자 하였다. Most curricula are considered how to teach the student in systematic and meaningful orders. And it is necessary to coordinate the duplicate contents in major subjects in nursing. So this study was designed to set up a new comprehensive curriculum through comparing and ananlyzing each seventeen major subjects in Nursing Department of Kyung-Bok College. Therefore, the purpose of this study is to present the new comprehensive curricula for promoting the efficiency and effectiveness in diploma degree course of nursing education.

      • 중증 재생불량성 빈혈 환자에서 신우신염에 대한 광범위항생제치료 중에 속발한 Saccharomyces cerevisiae 진균감염 1예

        김철희,이정호,이정찬,강정현,곽상혁,배광봉,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

        Most patients with aplastic anemia who do not respond to immunosuppressive treatment or are not candidates for bone marrow transplantation die of infection or bleeding. The neutropenia in acute leukemia, aplastic anemia, or occurring subsequently to chemotherapy and bone marrow transplantation increases susceptibility to infection. In general, the number of infectious episodes correlate with the degree and duration of neutropenia. Global immunosuppression produced by conditioning for bone marrow transplantation or graft-versus-host disease, is associated with unusual bacterial and fungal pathogens, or serious viral and protozoan infections. In addition, repeated treatment with broad-spectrum antibiotics is associated with the emergence of resistant organisms and fungal diseases because of the altered microbial microenvironment of the host. The incidence of invasive fungal infection caused by Saccharomycetes eerevisiae in immunosuppressed patients is very rare, compared with that of infection by candida or aspcrgillus species. Cases of Saccharomycetes cerevisiae fungemia occurring in the course of treatment with broad-spectrum antibiotics are reported in patients with extensive burn or with prosthetic valve endocarditis. We experienced a case of urinary tract infection by Saccharomycetes cerevisiae in a 27-year old female patient with severe aplastic anemia. We report the case with a review of relevant literatures.

      • KCI등재

        한국 기혼여성의 일상적 삶의 질 향상에 관한 연구 (3) : 한국 기혼여성의 삶의 질 향상을 위한 프로그램 개발 연구 Development of A Program for the Enhancement of Korean Married Women's Quality of Life

        김정자,최순,김선희,정영숙,김경연,심혜숙,문소정 부산대학교 여성연구소 1999 여성학연구 Vol.9 No.1

        The purpose of this study was to develop a program for the enhancement of Korean married women's quality of life(LQ) based on the results of the first year study(1996) and the second year research(1998). In order to construct a program, a psycological type test was conducted to 505 women and four preliminary programs were carried out focusing on self-esteem, understanding of one's own personality dynamics, efficient communication, positive emotion, social belongingness and expressions of feelings of unfinished business. For the final program, Jung's theory of psychological type(MBTI), Satir's family therapy approach and psychodrama were applied. An experimental and a control group were designed consisting 16 women for each group. The program was carried out for 6 weeks for the experimental group. The result of treatment were as follows: l)There was a difference statistically in LQ related to family harmony, self-achievement and improvement of relationship with in-laws. 2)There was a statistical change in psychological factors of expression of feelings, self-esttem, communication, and positive emotions. 3) The program participants self reports indicate that the program was effective for the reconstruction of family relationship, self-understanding, group coherence, and instillation of hope. The reports also shows that the program was effective for the perceptual changes in parent-child, wife-husband and siblings' relationships. In conclusion, the program developed for the enhancement of Korean married women's life quality(LQ) based on the Jung's psychological type theory, Satir's family therapy approach and psychodrama was effective for the improvement of LQ.

      • 일부 자동차 공장 근로자들의 職業的 特性과 社會 心理的 Stress의 相關性 硏究

        김성삼,홍지우,한현정,최희석,권소희,정해경,김삼태,송용선,이기남 한국전통의학연구소 2004 한국전통의학지 Vol.14 No.1

        〈Objective〉 This study were carried out to study to assess the relationship between job characteristics, general characteristics, health behaviors, and psychosocial distress and suggested the preventive oriental medicine approaches in occupational health area. 〈Methods〉 We measured job characteristics(job demand, job control, jop insecurity) by The Karasek's Job Content Questionnaire, health behaviors(smoking, drinking, exercise, coffee), general characteristics at work by a self-administered questionnaire. Psycho social distress was measured by PWI(Psychosocial Well-being Index), a 18-item self- administered instrument. 370 data for research were collected through the process of oriental health examination with questionnaire in workplace. Statistical analysis was done by t test, oneway ANOVA, and hierarchical multiple regression analysis with SPSSWIN (version 10.0) 〈Results〉 Among the 152 respondents, the prevalence of high job strain was 27%(41 persons). The Odds ratio of high job strain was 3.11(95 2.12~4.11), and those of passive group and active group were 2.01(95 0.83~2.76) and 1.80(95 0.83~2.76), respectively. Our results supported the association between psychosocial distress and job strain. 〈Conclusion〉 The odds ratio of high strain isolated group(high strain group+low social support) was 3.59(95 2.05 5.13), but the odds ratio of high strain collective group was 1.32(95 0.23 2.41). Social support at work was modifing factor of the association between psycho social distress and job strain. Therefore we reviewed the evidence that economic depression was associated with psycho social distress in this study, and that the strength of the social support was important in maintain health.

      • KCI등재

        공주대학교 천문대 16인치 반사망원경의 원격 제어 시스템 구축

        김희수,김칠영,정정인,김종헌,김혁,장비호 한국지구과학회 2003 韓國地球科學會誌 Vol.24 No.5

        본 연구에서는 공주대학 천문대 16인치 반사망원경의 원격 제어 시스템을 구축하였다. 이 시스템은 닫힌 루프 시스템이다. 전자제어부는 한국천문연구원에서 개발한 TCS-196를 활용했고. 기계부는 직접 개발하였다. 이 원격제어 망원경의 마운트 모델링 후 얻은 지향정밀도는 시간각 방향에서는 ±5O", 적위 방향에서 ±40"이며, 추적 정밀도도 약 1"/min정도였다. 이러한 예비관측 결과는 본 시스템이 천문학 연구 및 교육에 적당함을 의미한다. We developed a remote control system for the 16″ reflecting telescope at KNUO(Kongju National University Observatory). This system is a close loop system. The electronic control part used TCS-196 of the Korea Astronomy Observatory, the mechanical part was developed directly in this research. The pointing accuracy of this system was ±50″ in the hour angle direction, ±40″ in the declination direction after mount modeling. The tracking accuracy was about 17min. This pilot test result means that this system is suitable for research or education of astronomical fields.

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