신생아 호홉곤란증후군에서 Surfactant 투여군과 대조군의 임상적 비교관찰

오연균 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We performed a randomized clinical trial comparing intratracheal administration of surfactant with assisted ventilatiory treatment with mechanical ventilation alone for treatment of neonatal respiratory distress syndrome. Twenty two premature infants with respiratory distress syndrome were randomly assigned to surfactant-treated or control group. Thirteen infants (mean gestational age: 29.3±1.8weeks, mean birth weight: l,424±227.3gm) were given surfactant-TA. and nine infants received intermittent mandatory ventilation only. The results were as follows: 1) We investigated the severity of respiratory distress syndrome by grading .which were severe, intermediate and minimal, at each point. Intermediate and severe categories were more rapidly changed to minimal in the surfactant-treated group than the control. Especially, those were improved at the 24 hours after surfactant administration significantly(46.2 vs 0%) (p<0.05). 2) Within 6 to 96hours of replacement of surfactant, there were significantly improved oxygenation with decreased FiO2 and increased a/APO2 and diminished the need for respiratory support with decreased Ⅵ index and mean airway pressure in the surfactant-treated group than the control(p<0.05∼0.005). 3) A decrease in the need for respiratory support was also reflected by a shortening of the total duration in assisted ventilation(6.7 vs 11.5days), supplemental oxygen(17.5 vs 32.25days)and high supplemental oxygen over 40%(3.0 vs 4.7days) in the surfactant-treated group. 4) In the surfactant-treated group, sepsis, IVH, PDA and NEC occured more often, and pneumothorax, pulmonary interstitial emphysema, bronchopulmonary dysplasia and apnea occured less. But, the difference of these complications were not significant. 5) Infants in the surfactant-treated group had decreased mortality, but it was not significant. And, the major causes of death were pulmonary hemorrhage and sepsis in both groups, but there was no significant difference between two groups. We concluded that replacement of surfactant is effective therapy that can improve the pulmonary function with diminution the need for oxygen and respiratory support.

韓國人에서 血友病 B 遺傳子(血液凝固因子 Ⅸ)의 構造 및 制限酵素 Dde Ⅰ, MnI Ⅰ 切片길이 多形性에 關한 分子 遺傳學的 考察

이풍연,전봉균,이정민,권오병,권무식 성균관대학교 생명과학자원연구소 1996 生命資源科學硏究 Vol.2 No.2

Hemophilia B, a human chromosome X-linked recessive disease, is a bleeding disorder resulting from defect or abnormality in blood coagulation factor IX. DNA-based prenatal diagnosis or carrier detection for hemophilia B in Korean has been developed by analyzing restriction fragment length polymorphisms(RFLPs). Two polymorphisms( Dde I and Mnl I) were investigated as follow. Genomic DNAs were extracted from blood of 50 females at the age of twenty. The primers were chemically synthesized by the method of phosphoamidite. Mnl I primers were derived from exon 6, while Dde I primers, from the flanking sequences of intron 1 of the factor IX gene. Genomic DNAs were amplified with Mnl I primers to generate 405 nts long fragments in all cases. They were digested with Mnl I to analyze the polymorphic site on agarose gel. No MnlI polymorphic site was found in all cases. Also, the genomic DNAs were amplified with Dde I primers to generate ca. 320 nts long fragments in all cases. These results are not correlated with those obtained from the Caucasian. It suggests that Korean could exhibit different patterns of Dde I and Mnl I polymorphisms in the gene for blood coagulation factor IX. Direct sequencing of the polymorpic sites will confirm the above sugestion.

극소 저체중 출생아의 발생빈도 및 근 치료 성적

강순애,오연균 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

목적: 신생아 집중치료의 발달로 국내 3 차 대형병원에서는 극소 저체중 출생아 뿐만 아니라 초극소 저체중 출생아에서도 괄목 할만한 생존율의 향상을 보이고 있다. 따라서 본원에서의 극소 저체중 출생아의 빈도, 생존율, 이환율 등 집중치료 결과를 비교 분석 해보고 더욱 향상된 치료가 될 수 있도록 도움을 얻고자 본 연구를 시행하였다. 방법: 2000년 1월부터 2006년 12월까지 만 7년까지 원광대학교 병원 신생아 집중치료실에 입원한 1,500g 미만의 극소 저출생 체중아 205명을 대상으로 의무기록을 조사하여 후향적으로 결과를 분석하였다. 결과: 극소 저출생 체중아의 발생빈도는 4.2%였다. 생존율은 75.0%로 타병원의 80% 이상의 높은 생존율에 비해 다소 낮았다. 1,250g 이상은 92.6%로 타병원과 비슷한 높은 생존율을 보였으나 750g 미만은 18.2%로 낮은 생존율을 보였다. 29주 이상은 80% 이상의 높은 생존율을 보였으나 25-26주는 38.9%로 낮았으며 24주 이하는 한명도 생존하지 못하였다. 주요 합병증은 호흡곤란 증후군이 75.0%로 가장 많았으며, 뇌출혈 31.7%, 동맥관 개존증 29.3%, 미숙아 망막증 28.8%, 패혈증 27.3%, 만성폐질환 23.4%의 순이었다. 사망 시기는 3일 이내가 47.1%로 가장 많았고 7일 이내에 2/3 이상인 70.6%가 사망하였다. 주 사망 원인은 생후 3일 이내에는 호흡곤란 증후군(23.5%), 생후 4-7일에는 폐출혈(9.8%), 생후 8-27일에는 패혈증(16.7%) 이었다. 평균 입원 기간은 57.7±26.0일 이었다. 결론: 최근 극소 저체중 출생아 특히 초극소 저체중 출생아의 증가를 보이고 있는 시점에서 시행된 본 연구를 통해 신생아 집중치료로 향상을 보이던 생존율이 최근 감소를 보이고 있음을 알 수 있었다. 향후 저체중 출생아의 향상을 위해서는 전문적 치료와 간호, 그리고 폐출혈, 패혈증 등의 합병증 저하를 위한 노력이 적극적으로 요구된다. Purpose: The survival rate of very low birth weight infants(VLBWI) has improved by advanced neonatal intensive care in level III hospital. We performed this study to evaluate the outcome including incidence, survival rate, mortality and morbidity of VLBWI and to get a help on more advanced care in neonatal intensive care unit(NICU). Methods: The retrospective review of medical records was analysed for 205 VLBWI(<1,500g) who were admitted to the NICU of Wonkwang University Hospital from January 2000 to December 2006. Results: The incidence of VLBWI was 4.2%. Overall survival rate was 75.0% and which was lower than other hospital. By birth weight, survival rate was 92.6% in over 1,250g which was higher same as other large hospital, however it was 18.2% in below 750g which was lower than others. By gestational age, survival rate was higher over 80% in over 29 weeks, however which was lower 38.9% in 25-26 weeks and there is no lived in below 24 weeks. Common morbidities were respiratory distress syndrome(RDS) 75%, intraventricular hemorrhage 31.7%, patent ductus arteriosus 29.3%, retinopathy of prematurity 28.8% in the order of frequency. Most common time of death was within 3days 47.1%, and 70.6% died within 7 days. Major cause of death was RDS 23.5% within 3 days, pulmonary hemorrhage 9.8% in 4-7 days, and sepsis 16.7% in 8-27 days. Mean admission duration was 57.7±26.0 days. Conclusion: Survival rate of VLBWI was much improved, but recently decreased a little. So, much efforts must be made with a skillful therapy and nursing care and to reduce a complications for increasing their survival rates.

한국인에서 혈액응고인자 IX 유전자의 제한효소 절편길이 다형성에 관한 연구

전봉균,이풍연,권오병,이정민,안주미,권무식 성균관대학교 생명과학자원연구소 1995 生命資源科學硏究 Vol.2 No.1

DNA-based prenatal diagnosis or carrier detection for hemophilia B in Korean has been developed by RFLPs. The polymorphisms were Taq I and Xmn I . Genomic DNAs were extracted from the blood of 56 females and 10 males at the age of twenty. The PCR primers were chemically synthesized by the method of phosphoramidite. Taq I-59 & -39 derived from flanking sequences of intron 4 generate 163nt fragment. And, Xmn 1-59 & -39, derived from the flanking sequences of intron 3 allow amplification 222nt fragment. Using Polymerase chain reaction(PCR) method, each segment(intron 3-Xmn I, intron 4-Taq I) was amplified with each primers and the genomic DNA as template. The amplified DNA fragments were treated with an appropriate restriction enzyme. The Xmn I polymorphism of the factor IX gene was detected on agarose gel as segments of 154 and 68nt, respectively. The heterozygote frequency, calculated from the allele frequencies (0.025/0.975) in intron 3-Xmn I polymorphism, was 4.8%. In case of intron 4-Taq I polymorphism, there is no polymorphic site. So that the heterozygote frequency calculated from the allele frequencies (0.0/1.0) in intron 4-Taq I polymorphism, was 0%. Thus, the two intragenic polymorphisms predicted to be informative was 4.8% in this study. The results are not correlated with those obtained from the Caucasian. It suggests that Korean exhibit different patterns of Xmn I and Taq I polymorphism in the human coagulation factor IX gene.

인공호흡기로 치료한 신생아 파상풍 2례

이순길,오재화,오연균 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

We report 2 cases of neonatal tetanus treated with intermittent positive ventilation(IPPV) combined with neuromuscular blockade and high dose diazepam Duration of mechanical ventilation was ranged from 11 days in case 1 to 19 days in case 2. Muscle relaxation and sedation were achieved by continuous intravenous infusion of high dose diazepam(15-30㎎/㎏/day) and difficult ventilation due to muscle rigidity was removed by Mioblock® . If spasm was severe and frequent, additional bolus injection of Diazepam and Chlorpromazine were administered. Pneumonia with atelectasis were complicated in both cases, but cleared up with susceptible antibiotics and vigorous physiotherapy. We thought that severe neonatal tetanus was best treated by IPPV with Mioblock® and high dose Diazepam. A brief review of the related literature is given.

폐렴구균 감염증에서 항생제 내성의 임상적 의미 : Asian Network for Surveillance of Resistant Pathogens(ANSORP) Study

정숙인,기현균,손준성,고관수,김나영,장현하,오원섭,백경란,이남용,김신우,이혁,--,송재훈 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 전 세계적으로 폐렴구균의 페니실린을 포함한 β-lactam과 마크로라이드 및 퀴놀론 계열의 항생제에 대한 내성이 급격히 증가하여 임상적으로 문제가 되고 있으나, 시험관내 내성이 실제 임상적 예후에 미치는 영향에 대해서는 아직까지 논란이 되고 있다. 본 연구는 폐렴구균의 항생제 내성률이 높은 아시아 지역에서 항생제 내성이 폐렴구균 감염증의 임상경과에 미치는 영향을 평가하기 위하여 시행되었다. 방법 : ANSORP에서 주관한 전향적 임상 연구로서 1999년 11월부터 2001년 8월까지 아시아 지역 11개국의 14개 기관에서 진단된 침습성 폐럼구균 감염증 환자를 대상으로 내성 균주 감염의 위험요인, 임상양상, 예후 등의 임상적 분석을 시행하였다. 결과 : 총 646명 환자의 평균연령은 30.1세(6일-89세)였고, 이전 3개월 내에 항생제 사용력이 있는 환자는 159명(32.4%)이었다. 질환별로는 폐렴이 377예(58.4%)로 가장 많았고, 중이염 67예, 뇌수막염 66예(10.2%), 일차성 균혈증 65예(10.1%)였다. 총 646균주 중 347균주(53.7%)가 페니실린 비감수성(중등도 내성 23.1%, 고도 내성 23.1%)이었고, 페니실린에 대한 MIC_(90)은 0.03㎍/mL에서 4㎍/mL까지의 분포를 보였다. 페니실린 비감수성 균주에 의한 감염증과 차이가 없었다. 페니실린 내성 폐렴구균 폐렴에 의한 사망률은 페니실린 감수성 폐렴구균 폐렴에 의한 사망률과 차이가 없었다(p=0.846). Erythromycin에 대한 고도 내성을 보이는 균주의 비율이 매우 높았으나, 실제 임상상이나 치사율에는 영향을 미치지 않았다(p=0.092). 페니실린 비감수성 폐렴구균에 의한 뇌수막염의 치사률도 감수성 균주에 의한 사망률과 차이가 없었다(p=0.059). 결론 : 본 연구의 결과 페니실린 및 베타 락탐 제제에 대한 시험관 내성은 폐렴구균 폐렴이나 뇌수막염의 임상상이나 치사율에 영향을 미치지 않는 것으로 확인되었다. 이는 내성의 정도와 연관될 것으로 생각되므로, 향후 고도 내성 균주가 증가할 때 추가 검증을 요한다. 아울러 macrolide 및 퀴놀론계 항생제 내성의 임상적 의미에 대한 후속 연구가 필요할 것으로 사료된다. Background : Despite the widespread emergence of antimicrobial resistance among pneumococcal strains worldwide, clinical implications of in vitro resistance still remain an open question. To evaluate the clinical impact of pneumococcal resistance in Asian countries where the prevalence of pneumococcal resistance was reported to be highest in the world, ANSORP has performed a prospective, multinational surveillance study with cases with invasive pneumococcal diseases in Asian countries. Methods : In vitro susceptibility of pneumococcal isolates was determined by broth microdilution tests with 16 antimicrobial agents. All enrolled cases of pneumococcal infections were analyzed with regard to demographic data, clinical features, risk factors and mortality. Results : A total of 646 patients with pneumococcal infections were enrolled from 14 centers in 12 countries between the period from November 1999 to August 2001. Pneumonia (58.4%) was the most common clinical disease followed by bacteremia (33.4%), otitis media (10.4%), and meningitis (10.2%). Among 646 isolates, 347 (53.7%) were penicillin non-susceptible (intermediate 23.1%, resistant 30.7%). MIG_(90)s for penicillin ranged from 0.03 (India) to 4.0 ㎍/mL (Korea, Taiwan, Vietnam, and Hong Kong). Overall mortality from pneumococcal diseases by penicillin non-susceptible strains was not different from that by susceptible strains. Pneumococcal pneumonia caused by penicillin- or erythromycin-resistant strains showed similar mortality, severity of illness, or complications to that by susceptible strains. Mortality from pneumococcal meningitis caused by penicillin non-susceptible strains was also similar to that by susceptible strains. Conclusion : Data suggest that current situation of in vitro resistance to penicillin or macrolides may not affect the mortality from pneumococal pneumonia or meningitis caused by antibiotic-resistant strains.

배추(Brassica campestris L. var. pekinensis Makino)의 cDNA library 구축 및 상동성 비교

안주미,권오병,전봉균,이풍연,이정민,권무식 성균관대학교 생명과학자원연구소 1995 生命資源科學硏究 Vol.2 No.1

Expressed sequence tag(EST) has a good value to discover a new gene or to study its structure. Some 20 ESTs were generated to obtain new genetic resources of chinese cabbage(Brassian campestris L. var. pekinensis Makino). Poly A+ RNAs were isolated from 10-day-old seedlings grown at 25℃ under the day light. cDNA gene bank was constructed using λ ZAP /cDNA synthesis /Giga Pack Gold Packing kit. About a million clones were able to obtain from the library. All the clones examined so far had insert DNAs. Nucleotide compositions of randomly selected clones were determined by the Sanger mthod. The DNA sequences were compared with those deposited in the GenePept and GenBank database to figure out nucleotide homologies. Two ESTs showed significant similarities to the enlisted sequences. They are chloroplast GADPH subunit of Arabidopsis thaliana and carbonic anhydrase of A. thaliana. The full DNA sequences of the two clones are being determined. The cDNA gene bank constructed. in this experiment will being used to isolate more genes induced by the light in the plant.

최근 10년간 원광의대병원에서 시행한 소아 심장혈관 수술의 임상적 고찰

윤향석,정수미,최두영,오광수,오연균,김종덕,양현웅,이삼윤,김형곤,최종범,최순호,노병석 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We reviewed 10 years experiences of the clinical aspects and early postoperative results in 544 pediatric patients(age less than 16 years old). Among them. 529 cases had the congenital heart diseases, and 15 had the acquired diseases. Open heart surgery was performed in 413 patients. 115 cases were treated with non-open heart surgery. 16 with interventional catheterization. Annual increase of the cardiac patients was not significant in recent 10 years, except slight increase in 1994. The mean age of the study patients had been evidently changed to younger year by year. Total mortality rate of the open heart surgery was 6.4%. The cyanotic congenital heart diseases were high in early postoperative mortality by 25.7%, whereas 4% in acyanotic group. The age group less than one month was most highest in surgical mortality(66.7%). There were no deaths in patients with patent ductus arteriosus(103 cases), atrial septal defect(83 cases) or pulmonary stenosis(17 cases). Among 220 patients with ventricular septal defects(VSD). 10(4.5%) were died early postoperatively. In cyanotic group, the patients with pulmonary atresia with ventricular septal defects(PAVSD), transposition of the great arteries(TGA), interrupted aortic arch(IAA), complex cardiac anomalies with isomerism seemed to be most susceptible to an early death.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

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.