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.

유성견에서 periodontal distraction에 의한 급속 치아견인 시 치수 및 치주조직의 변화에 관한 연구

이종진,홍현실,채종문,조진형,김상철 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.5

유성견에서 periodontal distraction 과정을 통해 급속 견인 후에 치수와 치주조직의 변화를 평가하였다. 유성견의 상악 제2소구치를 발거하고 제3소구치 근심의 치간골을 부분 제거하였다. 견인장치는 6일 동안 하루에 2번씩 견인하고, 강화기 동안 0주, 1주, 3주, 5주, 7주, 9주에 치수와 치주조직의 변화를 임상적, 방사선학적, 조직학적, 면역조직화화학적으로 관찰하였다. 신장된 치주인대 내에서 견인 직후부터 4주까지 활발한 골밀도 증가를 보였으며, 특히 2-3주 사이에서 가장 활발하였다. 강화기 0주에 압박측 치조골의 흡수 및 파골세포 출현, 염증세포 침윤이 가장 많이 관찰되었고 1주의 신장측 치주인대에서 특징적인 골형성을 보이기 시작하였다. 신생골 형성은 1주와 3주에 가장 많이 관찰되었으며 9주에는 성숙골로의 대치 및 치주인대의 재생으로 대조군과 차이가 없었다. 실험군의 calcitonin gene-related peptide의 발현은 치수, 치주인대 내의 염증 부위에서 나타났으며 0주, 1주에 압박측 치주인대에서 증가하였다가 5주 이후에는 감소하여 대조군과 차이가 없었다. 이상과 같은 소견은 periodontal distraction에 의한 급속 치아 이동이 정상적인 골 재형성 과정을 도모하는 새로운 치아이동 방법이 될 수 있음을 시사한다. Objective: The aim of this study was to evaluate pulp and periodontal changes following rapid tooth retraction by periodontal distraction after bone undermining surgery in young adult dogs. Methods: After extraction of second premolars, the interseptal bone mesial to the upper 3rd premolar was undermined. After activating the distraction appliance at 0.5 mm/day for six days, the dogs were sacrificed at 0, 1, 3, 5, 7, and 9 weeks during the consolidation period. Tissue changes of periodontium and pulp were evaluated radiologically, histologically, and immunohistochemically. Results: Digital subtraction radiography showed active bone formation in the stretched periodontal ligament from 0 - 4 weeks. Resorption of the alveolar bone, appearance of osteoclasts, and infiltration of inflammatory cells were observed just after the activation period at the pressure side, and distinctive bone formation was seen in the tension side of the periodontal ligament from 1 week. New bone formation was active at 1 - 3 weeks. The expression of calcitonin gene-related peptide in the experimental group was increased at the alveolar bone and pulp, and periodontal ligament at the pressure side from 0 - 1 week, and it decreased after 5 weeks to become similar to that of the control group. Conclusions: The results showed that rapid tooth movement using periodontal distraction can be new form of orthodontic tooth movement for accelerating normal bone formation.

연삭의 채터 발생과 연삭 숫돌 수명의 연관성에 대한 실험적 고찰

이상태,이재환,정윤교,김재실 한국공작기계학회 2002 한국생산제조학회지 Vol.11 No.5

The chatter to raise grinding operating is reduce the precision and the quality. In this study, In reply to AE signal and the normal force generated in the grinding operating were measured (1) the amplitude in the mathematical model of the normal force is the form as to transform an exponential (2) the chatter growth is minus point of an exponent. (3) From the observed wheel aspect after the chatter growth, it was to investigated the concern of the chatter growth and the wheel life.

SHS법에 의한 TiC-Al₂O₃계 세라믹스의 합성 및 소결특성

이형복,김성수,편무실,최덕배 明知大學校 産業技術硏究所 1991 産業技術硏究所論文集 Vol.10 No.-

TiC-Al₂O₃ system powders were prepared by the self-propagating high temperature synthesis method from the mixture of metal titanium, carbon and alumina powder, Powder and sintering characterization of TiC-Al₂O₃ system were investigated. TiC-15wt% Al₂O₃ compacts sintered by hoy-pressing under the pressure of 20MPa at 1850 for 90 minutes showed 3-point bending strength of 724Mpa, ?? of ??????, hardness of 2450㎏/㎟ and relative density of 97%. The combustion mode of combustion wave showed steady-state up to 15wt% Al₂O₃, spin above 20wt% Al₂O₃ also combustion velocity was decreased with increasing of Al₂O₃ contents.

하악 이부확장 시 하악골 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구

이도훈,홍현실,채종문,조진형,김상철 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.1

하악 이부확장에서 골 절단선의 위치 및 종류와 견인 장치의 종류에 따른 차이를 알아보고자 삼차원 유한요소법으로 하악골의 이동 양상 및 응력 분포를 조사하였다. 골 견인장치의 종류로는 치아 의존형과 골 의존형, 혼합형, 30˚ 기울여 위치한 치아 의존형의 4가지를, 골절단 위치와 방법으로 하악 중절치 간 수직절단과 하악 정중이부를 관통하는 계단식 골절단 등의 2가지를 설정하였다. 연구 결과, 골절단의 위치 및 방법과 견인장치의 종류에 관계없이 과두를 포함한 하악골의 모든 부위에서 외측방 변위를 보였으며 상하적이나 전후방적 변위는 적은 양이었으나 방향에 있어 군간에 차이를 보였다. 치아 의존형 장치에 의한 골절단면 이개 양태는 V형이었으나 골 의존형 장치는 역V형이고 혼합형 장치는 평행하게 확장되었다. 골 의존형 장치에 의한 하악각의 외측 변위량이 다른 장치에 비해 컸다. 30˚ 기울여 위치한 치아 의존형에서의 변위는 측방적, 전후방적 면에서 좌우 차이가 인정되었다. Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type 30˚ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the 30˚ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.

암환자의 영적건강 측정도구의 신뢰도, 타당도 연구

이원희,김명실,김상희 성인간호학회 2001 성인간호학회지 Vol.13 No.2

Spiritual health is an important indicator in the quality of life of patients with canter. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descrtptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows : 1. The reliability score was examined using Cronbach's α and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named : ① Peace of mind (19.1% of variance), ② Hope (9.7%), ③ Self-esteem (6.4%), ④ Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24∼ .42. 4. SHI was identified as multidimension, that is ① The relationship with GOD, as absolute being, ② the relationship with ethers, ③ the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings : 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.

농업의 특성을 고려한 자유무역 일반균형효과 분석모형의 체계

김충실,이상호 한국농업정책학회, 한국축산경영학회 2000 농업경영정책연구 Vol.27 No.3

The main purpose of this study is to construct Multiregional General Equilibrium Model which is generally used to analyze general equilibrium effects of trade liberalization and changes in various international or national economic variables like as Free Trade Agreement, WTO new Round, and changes of price, exchange rate, and tariff rate. This multiregional general equilibrium model handles the multilateral trade liberalization and various kinds of policy shocks. Especially, this model emphasizes the speciality of agricultural demand and production system. Key words : 아밍턴 함수(Armington Function), 불변전환탄력성 함수(CET Function), 다국간 일반균형모형(Multiregional General Equilibrium), 소비체계(Demand System), 생산체계(Production System)

재가노인의 일상생활동작수행의 의존성과 생활만족에 관한 연구

홍춘실,김현리,이상화 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.1

This study was conducted to analyse the correlation between the ADL dependency and life satisfaction. Data were collected from the 102 home resident eldery who have no dementia by cognition test. The age distribution f subjects were 65 years and over The data were collected from January 16th to February 15th, 1997. The instruments used for this study were a survey of general characteristics(10 items), physical function(15 items), life satisfaction(20 items). The data were analysed by using an SPSS program and included percentage, t-test, ANOVA & Pearson correlation coefficient. The result of the study are summarized as follows: 1. The mean of ADL dependency score was 5..912 in a possible range of 15 to 60 when 15 indicates high dependency and 60 incicates low dependency. 2. The mean of life satisfaction score was 20.363 in a possible range of 0 to 40 when 0 indicates low life satisfaction and 50 indicates high life satisfaction. 3. The relationship between ADL dependency and life satisfaction for old people in home proved to be of statistically highly negative correlation(r=-.2553 P=.01). 5. General characteristics related to life satisfaction was educational status, household status, economic status, personality, perception of health(P<0.05). In conclusion, it was identified that ADL dependency is the important variable influencing the life satisfaction of the elderly. Therefore, more efforts are needed to decreased the ADL dependency of the elderly to enhance life satisfaction of the elderly.

도서영역에서의 동화책에 기초한 통합적 수·과학활동의 제공이 유아의 상호작용에 미치는 효과

심성경,김영실,이선경 圓光大學校 1995 論文集 Vol.30 No.1

This study is to look into the effect of literature-based activities on children's peer interaction around literature. For the study, experiments were conducted over the period of nine weeks, with one class each from two kindergartens in Seoul as subjects. The experimental group was induced to literature-related activities based on the children's book, and their base-line response was video-taped twice and treatment three times out of seven. The control group was presented with only books, and their base-line response was video-taped twice and treatment once. These taped materials have been analyzed in accordance with an observation system specifically designed for this study. The analysis was made in terms of the number of children who interacted. The analysis has found that literature-based activities increase children's peer interaction around literature. It has also found that the interaction is chiefly peer collaboration, mostly between two children.

GIS를 이용한 지역농업 특성 분석과 정책방향

김충실,이상호 韓國農業政策學會 1999 농업경영정책연구 Vol.26 No.1