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.

Vancomycin-Resistant Enterococci (VRE) 빈도, 검사법 및 감염관리 대책에 관한 전국 병원 설문조사

정희진,김우주,최선주,이경원,최강원,박승철 대한감염학회 2001 감염 Vol.33 No.2

Background : Vancomcyin-resistant enterococci (VRE) have been an important nosocomial pathogen in the 1990s. Recently, VRE have become an emerging nosocomial pathogen in Korea, but there have been no nationwide study about the status of VRE in Korea. This nationwide questionnaire survey was aimed to determine the prevalence of VRE, the appropriateness of detection method fur VRE, and to evaluate the infection control program in hospitals of various size in Korea. Methods : During 4 weeks (September 1 to October 1, 1999), a questionnaire surveillance study was conducted. We had sent the questionnaire to 200 large hospitals in Korea, which were distributed nationwide. Questionnaire included the prevalence of VRE within the hospital, the detection method for VRE, method of enterococci isolation, antibiotics-susceptibility test and infection control method of VRE. Results : The response rate to questionnaire was 42%. The species identification of enterococci was capable in 62.3% but the accurate enterococcal speciation were capable in 18%. Appropriate antibiotic-sus-ceptibility test were produced only in 6.5%. Total 746 VRE were detected in 42 hospitals during 1-year despite of low sensitivity of detection methods. VRE was noted in 54.4% of hospitals at least. The isolation programme of VRE infected patients was presented in 20.3%, regular surveillance of VRE in high-risk pop ulation was produced only in 16.5%. Conclusion : The prevalence of enterococci among microorganisms isolated from clinical specimens were increased up to 27.7% in Korea. VRE has been emerged in many big cities as well as in Seoul. The microbiological methods that include the speciation of enterococcal isolates, antimicrobial susceptibility test, and VRE detection appeared to be inappropriate in many hospitals. And, proper control and prevention methods were presented in a few hospitals. Education and training about accurate detection of VRE as well as proper infection control programs for VRE are urgently needed. (Korean J Infect Dis 33:78~87, 2001)

일개 대학병원근무자들에서의 인플루엔자 예방 접종 순응도 관련요인

정희진,손장욱,최선주,엄중식,우흥정,천병철,김우주,박승철 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : 병원근무자에서의 인플루엔자 예방 접종은 병원내에서 인플루엔자 전파를 막기위한 수단으로 적극 권장되고 있으나 매년 인플루엔자 백신을 접종하는 병원근무자들은 소수에 지나지 않는다. 본 연구는 병원근무자들에서의 인플루엔자 예방 접종률을 향상시키기 위한 목적으로 첫째, 백신 접종자에서의 인플루엔자 백신 접종 계기를 알아보고 둘째, 인플루엔자 백신접종의 장애요인을 분석하여 그 문제점을 해결하는데에 목표가 있다. 재료 및 방법 : 서울 1개 대학병원의 병원종사자들을 대상으로 1999년 10월 1개월에 걸쳐 인플루엔자 예방 접종을 하도록 한 후 2000년 3월에 접종군과 비접종군을 대상으로 구조화된 설문지를 이용한 설문조사를 실시하였다. 백신 접종군을 대상으로 백신접종의 동기(que to action), 비접종군을 대상으로는 접종에의 장애요인(barrier) 등을 조사하였다. 이 외에도 양군을 대상으로 인플루엔자에 대한 지식 척도, 인플루엔자 백신으로 기대되는 효과(benefit)등에 대한 설문조사를 시행한 후 정답률을 조사하였다. 결과 : 1) 설문 조사에 응한 총 수는 309명으로 간호사가 60% 이상이었다. 백신접종군은 평균연령, 평균 근무연수가 비접정군에 비하여 유의하게 길었으나 성별, 직종별 분포는 양 군간 차이가 없었다. 2) 인플루엔자 예방 접종의 필요성에 대한 지식정도에 있어 접종군의 934%가 그 필요성을 잘 인식하여 비접종군의 779%보다 유의하게 높았으나 예방 접종이 필요한 구체적 이유에 대한 정확한 이해는 접종군 113%, 비접종군 119%에 불과하였다. 3) 인플루엔자 예방 접종을 받은 의료인들의 행동계기는 ‘감염관리실의 홍보’와 ‘주위사람들의 권유’에 의한 경우가 26.9%, 21.6%로 가장 많았고 본인이나 가족, 친구들을 통한 일종의 감지된 위협 때문에 접종한 경우 31명(186%)의 순이었다. 4) 비접종자들에서 예방 접종을 시행치 않은 가장 흔한 이유는 ‘업무에 바쁘고 시간이 없어서’라는 항목이었으며(37.3%) 특히 의사 집단에서는 이러한 이유가 68.8%로서 압도적으로 많았다. 간호사나 기타 직종에 종사하는 직원들의 경우는 자신의 건강에 대한 확신이 30%내외에 달하였고 예방 접종 자체의 효과에 의문을 갖는 경우도 직종에 따라 6.3-29.7%에 달하였다. 결론 : 병원근무자에서 인플루엔자 예방 접종률을 향상시키기 위해서는 백신 접종의 장애물(효과의 의문, 부작용)을 효과적으로 제거하고 인플루엔자 백신의 필요성과 효과를 인식시키기 위한 교육과 함께 시간, 공간상의 제약을 배제할 수 있는 접근성의 문제를 해결하여야 할 것으로 사료된다. Background : In spite of yearly recalls, influenza immunization rate among healthcare workers (HCWs) remained low in Korea University Guro Hospital. This study was conducted to identify the causes of non-compliance against influenza immunization and to analyze the barrier factors for the immunization. Materials & Methods : Questionnaires were distributed in March of 2000 at Korea University Guro Hospital. We evaluated factors associated with acceptance of influenza vaccination and opinions regarding influenza prevention (knowledge about influenza vaccination efficacy, que to action in vaccinee, perceptible benefit, barrier to vaccination). Results : 309 completed questionnaires from HCWs were returned. Mean age and mean duration of work in hospital were higher and longer among vaccinee than non-vaccinee. Even though the necessity of influenza vaccination among HCWs were accepted well in vaccinee compared to nonvaccinee, the accurate reasons for vaccination were not quite understood among HCWs regardless of compliance. Vaccine campaign (30.8%) and advise from doctors (24.7%) were important for the promotion of vaccination among vaccinee. However, major reason for non-compliance among nursing staff and was mis-confidence that their bodies' self defense mechanisms would ward off infection (33.5%) and 'too busy to get injection' for doctors (65%). Conclusion : We conclude that regular education about perceptible benefits and wrong concerns about influenza vaccination among HCW's and easy accessibility to vaccination were important determinants to improve the influenza vaccination. On-site availability of a vaccination-nurse also proved to be important.

水邊環境造成에 관한 硏究

李熙榮,丁仙吉 서울市立大學校 1994 論文集 Vol.28 No.-

The Water is very important resource to man. The riverain and view which are concern with water are important co-ownership resource to territory. We hold consciousness which is keep up and bring up water, and put in practice it. The plan which is make riverain-space, is realization of harmony between the use of water and closed water, detecte of riverain-space, a specific character of territory, which is base on the historical culture of territory with wholesome ecosystem, execute creativity. The improvement of riverain-environment is resuscitate natural sapce which is concern with water, inhabit variety microorganisms, animals and plants, play to conservative function of water quality, integrite and create beautiful riverain with natural disposition of consideration of ecology.

장애인 교육권 보장을 위한 특수교육법률 고찰

강경희,안병주,이선재,황정보,김청아 朝鮮大學校 社會科學硏究所 2007 社會科學硏究 Vol.28 No.2

폐병변의 경피적 흡인생검술

박청희,김선영,서광선 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.1

Over a period' of recent 2 years and 10 months, 47 patients who had localzied pulmonary lesions, but were not diagnosed pathologically through bronchoscopy, transbronchial biopsy, and sputum examination, underwent percutaneous aspiration biopsy using 22G Wescott needle under the fluoroscopy. The diagnostic accuracy was 85%. Malignant lesions were 32 cases, benign were 8 cases, and 7 cases were negative. Eleven of all 47 patients developed pneumothorax and one of them required treatment. Two of 11 pneumothorax patients also showed pleural effusion. Small amount of hemoptysis developed in 7 petients. The method, problems, and complications are discussed. Nowadays, percutaneus aspiration biopsy appears to be the procedure of choice in the pulmonary lesions, especially peripherally localized.

A Study on Dietary Intake and Vitamin and Mineral Supplement Use by Korean College Students Attending Web Class

Cheong, Sun-Hee,Kim, Jin-Sook,Lee, Mi-Young,Lee, Jeong-Hee,Chang, Kyung-Ja The Korean Nutrition Society 2001 Nutritional Sciences Vol.4 No.2

The Purpose of this study was to investigate the dietary intake of nutrients and the use of vitamin and mineral supplements by Korean college students attending Web class and the socioeconomic, dietary and health-related factors involved. The subjects were 137 male and 115 female students amending a health and nutrition-related Web class at a cycler university. This cross-sectional survey was conducted by self-administered questionnaire and the data were analyzed by SAS and SPSS PC package programs. Nutrient intake data collected using three-day recall method were analyzed by the Computer Aided Nutritional Analysis Program. Average intake by male students of most nutrients except energy, vitamin B$_2$ and calcium and intake by female students of those except energy, vitamin $B_2$, calcium and iron was higher than Korean RDA. Nutrient intake of male students was significantly influenced by the mother s job, skipping meals, exercise, vitamin and mineral supplement use, flood supplement use and self-evaluated anemia. Skipping meals and flood supplement use significantly influenced the nutrient intake of female students. A total of 47.4% of male students and 53.9% of female students were vitamin and mineral supplement users. In female students, socioeconomic characteristics such as the father s education level and household income were significantly different between vitamin and mineral supplement users and non-users. In both male and female students, there were significant differences in cross analysis between vitamin and mineral supplement use and flood supplement use. As for the self-reported health status of male and female students, vitamin and mineral supplement users perceived their health status to be worse compared to non-users. Therefore, nutrition education via the Internet is necessary in order to encourage college students to practice optimal nutrition strategies, including maintaining well-balanced diets by choosing various floods wisely.

Spirulina Prevents Atherosclerosis by Reducing Hypercholesterolemia in Rabbits Fed a High-Cholesterol Diet

CHEONG, Sun Hee,KIM, Mi Yeon,SOK, Dai-Eun,HWANG, Seock-Yeon,KIM, Jin Hee,KIM, Hye Ran,LEE, Jeung Hee,KIM, Yun-Bae,KIM, Mee Ree Center for Academic Publications Japan 2010 JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY Vol.56 No.1

<P>The anti-atherogenic effects of spirulina (<I>Spirulina platensis</I>) were investigated in the New Zealand White (NZW) rabbit model. The animal had hypercholesterolemia induced by being fed a high cholesterol diet (HCD) containing 0.5% cholesterol for 4 wk, and then fed a HCD supplemented with 1 or 5% spirulina (SP1 or SP5) for an additional 8 wk. Spirulina supplementation lowered intimal surface of the aorta by 32.2 to 48.3%, compared to HCD. Serum triglyceride (TG) and total cholesterol (TC) significantly were reduced in SP groups. After 8 wk, serum low density lipoprotein cholesterol (LDL-C) remarkably decreased by 26.4% in SP1 and 41.2% in SP5, compared to HCD. On the other hand, high density lipoprotein cholesterol (HDL-C) was markedly increased in SP1 and SP5 compared with that in the HCD group from 2 to 8 wk. These results suggest that spirulina intake can cause the reduction of hypercholesterolemic atherosclerosis, associated with a decrease in levels of serum TC, TG and LDL-C, and an elevation of HDL-C level. Spirulina may, therefore, be beneficial in preventing atherosclerosis and reducing risk factors for cardiovascular diseases.</P>

[P10-11] Preventive Effect of Fermented Milk Supplement with Tomato (Lycopersion Esculentum) on Bone Loss in Ovariectomized Rats

Sun Hee Cheong,Kyung Ja Chang 한국식품영양과학회 2006 한국식품영양과학회 학술대회발표집 Vol.2006 No.10

Studies on Self-Perceived Health and Appearance, Health-Related Lifestyles and Dietary Behaviors of Korean College Students Attending Web Class

Cheong, Sun-Hee,Kim, Jin-Sook,Lee, Mi-Young,Lee, Jeong-Hee,Chang, Kyung-Ja Korean Society of Community Nutrition 2001 Journal of community nutrition Vol.3 No.2

The purpose of this study was to investigate self-perception and practices of health and appearance, health-related lifestyles and dietary behaviors of college students(137 male, 115 female) attending web class via the Internet. This cross-sectional survey was conducted by a self-administered questionnaire and data was analyzed by SPSS program. The average height, weight and BMI of the male and female college students were 174.4cm, 67.8kg, 22.3kg/㎡ and 162.3cm, 52.1kg, 19.8kg/㎡, respectively. Male collage students perceived their health statuses significantly better compared to female students. As for self-evaluation of anemia, female college students perceived significantly more anemia symptoms compared to male college students. Female college students perceived their body image to be obese compared to male college students. Underweight college students perceived significantly less healthy statuses, more anemia symptoms, and worse hair conditions compared to other college students. The rate of male students who exercise was significantly higher compared to that of female students. Male students reported significantly more smoking and drinking of alcohol compared to female students. The rate of female college students skipping meals was significantly higher than that of male college students. Frequency of eating out in female college students was significantly higher compared to that in male students. These results may provide some basic information in developing a nutrition education program for Korean college students using Internet.