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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.
김승일,김은희 조선대학교 사범대학 부설 교과교육연구소 2001 敎科敎育硏究 Vol.4 No.1
For a long time music has imporeant functions in our life. There are music from the broadcast everyday, fellowship among friends, meeting and recreational places and it enrich and refresh our life. We can not image drama and mivie without music. Music can manipulate tension and relax and can infiuence our conception. If misic in life has more objective function, misic therapy has more subjective function. Music therapy can be processed depend on human's behavior. This therapy is related to emotional effect not a acknowledgement effect to patient. Mental Retardation Children have very exclusive behavior in their society and hardly adapt themselves to their circumstance and his difficulties are somewhat different in the individual cases and they are needed a treatment on purpose. This thesis includes first, the definition and history of music therapy and its process to become a professional subject and its situation of several countries. Second, the conception and definition of Mental Retardation Children and music therapy and its effect. Third, there are some programs of misic therapy and variety ways of music therapy which can be applied in the field.
민희홍,신승철,서현석,김은주,김호선 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.2
School dental clinic programs is the most active and effective programs to prevent the oral disease for school-children and it is one of the recommended programs by the advanced and welfare countries. In Korea, 15 primary schools have been established the school dental clinics in 1999 as one of the public oral health programs supported by the Ministry of Health and Welfares, and expanded more every year. 11 school dental clinics among 15 were participated for 2-years evaluation project. Such items as the structure, the process, the supply of dental services, the promotion of the health level and the community supports were evaluated through the standardization by governmental suggestions. Average score for 2-years evaluation was estimated as 81.35% as considerably good remark. In detail, score 4.74 for the structure, 22.10 for the process, 19.77 for supply of dental services, 26.22 for promotion of the oral health level and 8.53 for the community supports were calculated. In conclusion, school dental clinic programs in Korea were evaluated considerably good and they should be extended to all primary schools as possible.
완전 포상기태 이후 발생한 지속성 융모질환의 치료경험 2례.
이진희,류은석,김윤숙,김종수,최승도,선우재근,배동한 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1
Persistent tumor develops in approximately 20% of patients with a complete mole, and chemotherapy is required to achieve remission. Following evacuation of hydatidiform mole, careful hCG monitoring is mandatory since it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. In carefully selected patients in whom the risk of developing gestational trophoblastic disease is significant or when the availability of hCG testing is suboptimal, chemoprophylaxis has been shown to decrease the risk of gestational trophoblastic tumor. We report here two cases of patient, 16-year-old and 45-year-old women who experienced unusual course after the evacuation of a complete mole and markedly elevated serum β-hCG levels. The patient developed persistent gestational trophoblastic disease and were successfully treated with EMA-CO and hysterectomy.
김창희,양승순,김연자,손연정,유미애,송주은 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4
Purpose: The purpose of this study was to construct and test a structural equation model of nurses' turnover intention. Method: The participants were 716 nurses at 4 university hospitals. Data were collected by a self-report questionnaire in 2008 and analyzed using SPSS 12.0 and AMOS 4.0 Win program. Results: The fit indices of modified model were x²=285.928(p<.001),x²/df=1.958GFI=0.964, RMSEA=0.037, AGFI=0.944, NFI=0.947, NNFI=0.961, CFI=0.973, PNFI=0.658 and showed high compatibility with the empirical data. In the final model, job stress and satisfaction were found to have significant direct effects on nurses' turnover intention, while organizational culture and emotional labor were very important factors to have indirect effects on turnover intention via job stress and satisfaction. Nurses' turnover intention was accounted for 41.2% of covariance by these factors. Conclusions: Comprehensive nursing interventions for decreasing nurses' turnover intention should be focused on reducing job stress and increasing job satisfaction. Also, Nursing strategy for enhancing positive organizational culture and decreasing emotional labor would be helpful for decreasing nurses' turnover intention, too. Further studies are needed to prospectively conduct to verify these causal relationships with larger sample.