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.

간호교육 성과 측정 도구의 탐색

이향련 ( Lee Hyang Yeon1 ),오가실 ( Oh Ka Sil2 ),안양희 ( Ahn Yang Heui3 ),이숙자 ( Lee Sook Ja4 ),김인자 ( Kim Inja5 ) 경희대학교 동서의학연구소 2010 동서간호학연구지 Vol.16 No.1

간호학과 졸업생들의 간호교육 성과 측정 도구를 규명하기 위하여 시행한 본 연구에서는 의사소통, 전문직관, 지도력, 비판적 사고를 측정하는 도구들을 탐색하여 타당도와 신뢰도를 규명하였다. 의사소통 능력을 측정한 지지적 의사소통 능력 측정 도구의 경우 신뢰도가 Cronbach’s=.78로 비교적 신뢰도가 좋은 것으로 나타났다. 또한 타당도에서는 수렴타당도로 본의사소통 능력과의 상관계수가 .24 (p<.001), 구성타당도로 본집단타당도에서는 다른 학년에 비하여 4학년의 평균점수가 유의하게 높아 의사소통을 측정하는 도구로 활용할 가치가 있다고 판단하였다. 아직 이 도구를 사용한 논문을 찾을 수 없었으나 대인관계를 손상시키지 않으면서 정확하고 정직하게 의사를 전달하면서, 문제를 해결하는 동안 의사소통하는 사람간의 긍정적인 관계를 보존하는 것을 측정하는(Whetten & Cameron, (1998) 본 도구는 인간관계를 중요시하는 간호학의 전인적 간호를 증진시키는 특징이 포함되어 있어 간호학 교육 성과를 측정하는 도구로 활용할 가치가 있다. 또한 수렴타당도를 측정하기 위하여 선택한 의사소통 측정도구보다 문항수가 적어 효율성도 높다. 지금까지 간호학생을 대상으로 의사소통을 측정한 연구들도 면접을 통한 질적인 자료로 측정하거나(LeBlanc et al., 2009), 연구자들이 개발한 도구(Rosenzweig et al., 2008; Yoo & Yoo, 2001)로 측정하고 있어 효율적이면서 객관적인 도구로써 유용할 것으로 생각한다.전문직관은 신뢰도가 Cronbach’s a=.87로 매우 높게 나타났다. 수렴타당도로 본 Yeun 등(2005)이 개발한 간호전문직관과의 상관계수도 .23으로 유의하였고, 구성타당도를 보기위한 집단 비교법에서는 4학년의 점수가 가장 높았으나 유의하게 차이가 있는 학년은 2학년으로 나타나 간호학 교육 성과도구로 채택하는데 큰 문제가 없는 것으로 판단하였다. 항목이 19개로 구성되어 있어 효율성 측면에서 볼 때 Yeun 등(2005)의 도구보다 활용성이 높다. 특히 주위 다른 사람들과 비교하여 자신의 태도를 측정하고 있어 일반적인 간호사에 대한 의견을 묻는 Yeun등(2005)의 도구에 비하여 개인적인 전문직관을 더 민감하게 측정할 것으로 생각한다. 지도력은 신뢰도가 Cronbach’s α=.94로 가장 높았으며 수렴타당도로 본 지도력 도구와의 상관계수도 .16으로 통계적으로 유의하였다. 구성타당도로 본 집단비교에서는 4학년의 점수가 가장 높았으나 유의한 차이가 있는 학년은 2학년이었다. 문항수가 40문항으로 다소 긴 편이어서 효율성이 떨어지기는 하나 간호 실무에서 4년제 학부 학생의 지도력 특성을 측정하기 위해 개발된 도구라는 점에서 활용할 가치가 있다. 비판적 사고를 측정하기 위하여 선택한 Yoon (2004)의 도구는 신뢰도가 Cronbach’s α=.87로 상당히 높은 편이고, 집단비교법에서도 4학년이 다른 학년에 비하여 유의하게 높아 구성타당도도 만족할 만한 수준이었다. 그런데 본 연구자들이 개발한 비판적 사고 기술 도구와의 상관관계가 유의하지 않아 수렴 타당도가 인정되지 않았다. 이는 몇 가지로 해석할 수 있는데 첫째는 비판적 사고 기술과 비판적 사고 성향이 다를 수 있다는 것이다. 즉 Yoon (2004)의 도구는 비판적 사고 성향을 측정하는 도구이고 연구자들이 개발한 도구는 비판적 사고 기술을 측정하는 도구이기 때문이었던 것으로 보인다, 이러한 해석은 비판적 사고 기술과 사고 성향 간에는 유의한 상관관계가 없다는연구 결과가 뒷받침한다(Raymond, Rachel, & Jenny, 2002). 그러나 두 개념간에 상관관계가 있다는 연구결과도 있어(Profetto-Mcgrath, 2003) 이 두 개념 간의 관계에 대한 심층적인 연구가 더 필요하다. 두 번째는 비판적 사고 성향을 측정하는 Yoon (2004)의 도구는 정답이 존재하지 않으나 비판적 사고 기술을 측정하는 도구는 정답이 있는 도구인데 자료를 수집할때 이를 설명하지 않고 측정하여 두 도구의 상관관계가 없는 것으로 나올 가능성도 배제할 수 없다. 성향을 측정하는 것과 달리 정답이 있다고 하는 경우는 본인의 생각과 다르더라도 비판적 사고 기술에 해당하는 내용을 선택할 수 있으나 정답이 없다고 생각하는 경우는 설령 비판적 사고 기술에 해당하는 내용이라고 판단하더라도 본인의 성향과는 다르기 때문에 다른 내용을 선택할 수 있기 때문이다. 또한 성향과 기술이라는 특성이 다른 측면을 측정하는 과정에서 성향은 Likert 척도로 기술은 이분법으로 측정한 것도 상관관계를 떨어뜨린 이유로 보인다. 세 번째는 Yoon (2004)의 도구는 이미 몇 연구에서 사용하여 왔으나 아직도 더 검증이 필요하고, 본 연구자들이 개발한 도구도 신뢰도가 낮아 신뢰도와 타당도를 높이기 위한 작업이 더 필요함을 나타낸다고도 볼 수 있다. 현재 가장 많이 사용하는 도구인 Facione과 Facione (1994)이 개발한 California Critical Thinking Disposition Inventory (CCTDI)를 활용하는 방법도 있으나 75문항으로 긴 편이어서 효율성이 떨어지고 사용하기 위하여 많은 비용을 지불하여야 하므로 비경제적인 측면이 있다. 결론적으로 본 연구에서 규명한 네 도구는 신뢰도와 타당도가 비교적 높게 나타나 간호교육기관에서 사용할 수 있을 것으로 판단하였다. 비판적 사고 측정 도구는 수렴 타당도가 낮게 나와 비판적 기술과 성향을 구분하여 측정하여야 한다고 판단하였다. Purpose: The purpose of this study was to identify and evaluate outcome measurement scales of nursing education such as communication, professionalism, leadership, and critical thinking. Methods: A methodological study design was used to evaluate the reliability and validity of the scales. Survey was done to the students (n=407) enrolled in baccalaureate nursing schools. Using convenience sampling method, we tried to include all grades of students. Internal consistency, convergent validity and group comparison were used to evaluate the reliability and validity of the scales. Results: All scales were reliable and valid. Only convergent validity of the scale to measure critical thinking was relatively low. It suggested that critical thinking skill and disposition might be measured separately. Also it was inefficient to measure the nursing education outcomes with separate scales. Conclusions: It is recommended to develop a new integrative scale to measure nursing education outcomes. Also it is necessary to set the norm of nursing students to evaluate nursing education outcomes for the quality control of nursing education.

무용활동이 정신지체아의 사회적응행동 및 표현력에 미치는 영향

이창섭,강연실 충남대학교 체육과학연구소 2006 體育科學硏究誌 Vol.23 No.1

This study was performed to investigate the effect of dance activity program on social adaptive behavior such as self-supporting skill, social-emotional behavior and cognitive ability and the expression skills such as emotion skills of the mentally retarded. For this purpose of the study, we selected 20 mentally-retarded children in middle schools and they were divided into 2 groups, a dance program participating group(n=10) and control group(n=10), during 22-week periods. The dance activity program which was designed to participate twice per week and practice during 60 minutes in 22 weeks. With this process of program, we obtained some significant results and drew a conclusion. First, dance activity program have some positive effect on the improvement of self-supporting skill, social-emotional behavior and cognitive ability of those children. Second, dance activity program have some positive effect on the improvement of emotion expression skills, movement expression skills and speech expression skills of those children. In general terms of this study, it would be possible to suggest that dance activity has some positive functions to improve the social adaptive behavior and expression skills of the mentally-retarded children. Considering the above advantageous effects, dance activity program for the mentally retarded could be significantly effective in improving their physical fitness, leading to mental rest and increasing social ability, so it could be considered as one of the effective ways for the rehabilitation and the treatment of mentally retarded persons.

수직점프 수행시 두 발의 동시· 비동시 스텝에 따른 운동학적 특성 분석

윤희중,이연종,이경식,유실,정남주 韓國體育大學校附屬 體育科學硏究所 1997 韓國體育大學校附屬 體育科學硏究所論文集 Vol.16 No.1

The purpose of this study is to quantify the differences between synchronous and asynchronous step during vertical jump. The subjects of this study were 3 males college students. And 2 S-VHS vedio cameras were used for the data collection. The Direct Linear Transformation (DLT) method was employed to obtain 3-D position coordinates of 21 landmarks. And the following conclusions were drawn ; 1. Synchronous step was faster in approach velocity than asynchronous step. 2. Asynchronous step was smaller in knee flexion angle than synchronous step. 3. Synchronous step was faster in angular velocity at knee flexion than asynchronous step and asynchronous step was faster in angular velocity at knee extention. 4. Asynchronous step was higher in take-off height and loss height than synchronous step. 5. Synchronous step was higher in flight height top height and reach height than asynchronous step.

여성은행원에서의 스트레스 관련요인

정경태,장성실,이강숙,이연경,이동배 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.1

We surveyed 343 female bank clerks to find out associations between stress and a variety of factors including general, menstruation and reproductive characteristics of the participants. Unmarried women composed the majority of younger, lower income and lower education groups than married did. They also showed higher, though not significantly higher, scores for psychosocial well being index(PWI) and the first three items of the stress survey. And married women scored slightly higher only in the fourth item of the stress survey. Among the subgroups of married and unmarried women, many factors contributed to a higher stress score in two or more items of the stress survey: in unmarried women, lower education level, little physical exercise, and large family inhabitants, in contrast married women, higher monthly income and greater working hours were related to higher stress scores. According to the menstruation factors, subgroups with dysmenorrhea or irregular cycle and scanty bleeding volume in unmarried women and subgroups with dysmenorrhea kin married women showed higher stress scores in PWI. In married women, the proportion of those who have been pregnant was 77.2% and the proportion of those who have experienced spontaneous abortion was 24.1%. Those who have ever experienced two or more spontaneous abortion showed hgher, though not statistically significantly higher, scores for PWI. In conclusion, dysmenorrhea was associated with high stress score in two groups. And the other factors related to higher score of PWI were different between unmarred and married women, which should be considered in a management plan for mental health promotion.

Anti-angiogenic and Anti-tumor Activities of 2′-Hydroxy-4′-methoxychalcone

Lee, Yeon Sil,Lim, Soon Sung,Shin, Kuk Hyun,Kim, Yeong Shik,Ohuchi, Kazuo,Jung, Sang Hoon Pharmaceutical Society of Japan 2006 Biological & pharmaceutical bulletin Vol.29 No.5

<P>In the present study, we evaluated the <I>in vitro</I> and <I>in vivo</I> anti-angiogenic and anti-tumor activities of 2′-hydroxy-4′-methoxychalcone (HMC). HMC decreased angiogenesis in both chick embryos in the chorioallantoic membrane assay and basic fibroblast growth factor (bFGF)-induced vessel formation in the mouse Matrigel plug assay. This compound also reduced the proliferation of calf pulmonary arterial endothelial cells and was found to possess relatively weak gelatinase/collagenase inhibitory activity <I>in vitro</I>. HMC, when administered subcutaneously at the dose of 30 mg/kg for 20 d to mice implanted with murine Lewis lung carcinoma, caused a significant inhibition of tumor volume by 27.2%. Intraperitoneal (i.p.) treatment at the same dosage for 10 d to ICR mice bearing sarcoma 180 caused a significant suppression in tumor weight by 33.7%. Taken together, out data demonstrate that the anti-angiogenic activities of HMC might be due to anti-proliferative activity under inhibition of the induction of COX-2 enzyme. Furthermore, the results suggest that the potent anti-angiogenic activity of HMC seems to be the possible mechanism of action in these animal models of solid tumors.</P>

Inhibitory Effects of Isorhamnetin-3-<i>O</i>-β-<small>D</small>-glucoside from <i>Salicornia herbacea</i> on Rat Lens Aldose Reductase and Sorbitol Accumulation in Streptozotocin-Induced Diabetic Rat Tissues

Lee, Yeon Sil,Lee, Sanghyun,Lee, Hye Seung,Kim, Bak-Kwang,Ohuchi, Kazuo,Shin, Kuk Hyun Pharmaceutical Society of Japan 2005 Biological & pharmaceutical bulletin Vol.28 No.5

<P>The inhibitory effects of compounds from <I>Salicornia herbacea</I> (Chenopodiaceae) on rat lens aldose reductase (RLAR) and sorbitol accumulation in streptozotocin-induced diabetic rat tissues were investigated. The various fractions from the MeOH extract of <I>S. herbacea</I> were tested for their effects on RLAR <I>in vitro</I>. Among them, the EtOAc fraction was found to exhibit a potent RLAR inhibition (IC<SUB>50</SUB>=0.75 μg/ml), from which an active principle as a potent AR inhibitor was isolated and its chemical structure was elucidated as isorhamnetin-3-<I>O</I>-β-<SMALL>D</SMALL>-glucoside (1) by spectral analysis. Compound 1 exhibited a potent RLAR inhibition <I>in vitro</I>, its IC<SUB>50</SUB> being 1.4 μ<SMALL>M</SMALL>. Compound 1, when administered orally at 25 mg/kg in streptozotocin (STZ)-induced diabetic rats, caused not only a significant inhibition of serum glucose concentration but also sorbitol accumulation in the lenses, red blood cells (RBC), and sciatic nerves. These results indicate that compound 1 from <I>S. herbacea</I> is a leading compound for further study as a new drug for the prevention and/or treatment of diabetes and its complications.</P>

Inhibitory Effect of Populoside from the Bark of Populus nigra on Aldose Reductase

( Yeon Sil Lee ),( Soon Sung Lim ),( Il Jun Kang ),( Jin Kyu Kim ),( Cheng Bi Cui ),( Jae Yong Lee ),( Young Soo Bae ) 한국응용생명화학회 2010 Applied Biological Chemistry (Appl Biol Chem) Vol.53 No.6

Bark extract of Populus nigra was examined as a possible inhibitor of aldose reductase, a key enzyme involved in diabetic complications. The aqueous acetone extract of P. nigra was subjected to gel filtration chromatography to produce an active compound, populoside, which inhibited aldose reductase with 50% inhibitory value of 18.55 μM in a non-competitive manner. Populoside also inhibited sorbitol accumulation by 48.84% at 50 μM. These results suggested that the P. nigraderived component populoside has the potential to be used in the treatment of diabetic complications.

Clinical Characteristics of False-Positive Lymph Node on Chest CT or PET-CT Confirmed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer

Lee, Jongmin,Kim, Young Kyoon,Seo, Ye Young,Choi, Eun Kyoung,Lee, Dong Soo,Kim, Yeon Sil,Hong, Sook Hee,Kang, Jin Hyoung,Lee, Kyo Young,Park, Jae Kil,Sung, Sook Whan,Kim, Hyun Bin,Park, Mi Sun,Yim, Hy The Korean Academy of Tuberculosis and Respiratory 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and $^{18}F$-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. Methods: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. Results: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ${\geq}65$, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. Conclusion: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

Inhibitory Effect of Populoside from the Bark of Populus nigra on Aldose Reductase

Lee, Yeon-Sil,Cui, Cheng-Bi,Kim, Jin-Kyu,Bae, Young-Soo,Lee, Jae-Yong,Kang, Il-Jun,Lim, Soon-Sung The Korean Society for Applied Biological Chemistr 2010 Applied Biological Chemistry (Appl Biol Chem) Vol.53 No.6

Bark extract of Populus nigra was examined as a possible inhibitor of aldose reductase, a key enzyme involved in diabetic complications. The aqueous acetone extract of P. nigra was subjected to gel filtration chromatography to produce an active compound, populoside, which inhibited aldose reductase with 50% inhibitory value of $18.55\;{\mu}M$ in a non-competitive manner. Populoside also inhibited sorbitol accumulation by 48.84% at $50\;{\mu}M$. These results suggested that the P. nigra-derived component populoside has the potential to be used in the treatment of diabetic complications.