다시 나타난 절지동물에 의한 피부질환Ⅱ : 이

심서보,배기수 대한의사협회 2011 대한의사협회지 Vol.54 No.5

The aim of this article is to provide guidelines to diagnosis and therapeutics for HLI in Korea. Head lice infestation (HLI) caused by Pediculus humanus capitis is still common in Korean children in spite of an improvement since the 1980s in the country’s economic status and the concepts of hygiene. HLI is troublesome and, if not treated, can lead to secondary bacterial infection as a result of scratching of the irritated scalp induced by an inflammatory reaction to injected saliva or anticoagulant. In addition, HLI causes social and psychological problems as well as physical symptoms. Confirmation of the HLI depends on identification of adult lice,nymphs, or viable nits. Nits are more commonly found at the nape of the neck and retroauricular areas. The differential diagnosis includes hair casts, dandruff, and debris by hair spray. Few chemical shampoos such as those containing lindane or pyrethrin are currently available in Korea. Although HLI is an important public health issue in Korea, little information is available on HLI. Medical doctors, school nurses, and teachers should be acquainted with HLI for the successful control of this disease, which is distressing a number of children covertly.

Effectiveness of Mass Drug Administration on Neglected Tropical Diseases in Schoolchildren in Zanzibar, Tanzania

김주영,심서보,정은주,임한종,채종일,Duk-Young Min,엄기선,Khalfan A. Mohammed,Iddi S. Khamis,용태순 대한기생충학ㆍ열대의학회 2020 The Korean Journal of Parasitology Vol.58 No.2

Soil-transmitted helminths and Schistosoma haematobium affect more than 3 billion people globally and mainly occur in sub-Saharan Africa. The present study assessed the overall infection status of a 1716-student cohort of schoolchildren in Zanzibar and applied mass drug administration (MDA) to the cohort from 2007 to 2009. Schools in Pemba, Zanzibar, had a much higher prevalence of soil-transmitted helminth infections than those in Unguja, and the Chaani, Ghana, and Machui schools of Unguja exhibited high S. haematobium infection rates. The MDA program only partially controlled parasite infections, owing to high rates of re-infection. The infection rate of S. haematobium across all 10 schools, for example, was only reduced by 1.8%, and even this change not significant, even though the S. haematobium infection rates of the Chaani and Mzambarauni schools were significantly reduced from 64.4 and 23.4%, respectively, at the first screening, to 7.3 and 2.3% at the last screening. The overall infection rate of Ascaris lumbricoides was reduced from 36.0% at the first screening to 22.6% at the last screening. However, the infection rates for both Trichuris trichiura and hookworm were generally unaffected by MDA. In the future, parasite control programs should involve strategically designed MDA schedules and holistic intervention (e.g., sanitation improvement, hygiene behavior changes, and control of intermediated hosts).

의학전문대학원 지원자 특성에 근거한 선발인재상의 차별화 가능성 탐색

이동현 ( Lee¸ Dong Hyeon ),심서보 ( Sim¸ Seobo ),최재정 ( Choi¸ Jaijeong ) 인하대학교 교육연구소 2020 교육문화연구 Vol.26 No.6

2+4 의과대학과 4+4 의학전문대학원 체제가 병렬적으로 혼재되어 있는 한국 의학교육 제도에서 학사와 석사학위의 학제 상 서로 다른 급위에 해당되는 학교들임에도 두 학교 유형에서의 학생선발 시 적용되는 선발인재상, 선발 전형 등에 있어서 큰 차이를 보여주지 않는 것이 작금의 현실이다. 그러나 의학전문대학원과 의과대학의 지원자는 연령대에 있어서 확연하게 차이가 있으며, 이에 따라 두 집단 간에 유의미한 차이점들이 드러나는 것은 당연한 일이다. 이에 학생 선발전형 시스템 개발 시 의학전문대학원 고유의 선발인재상을 도출함과 동시에 의과대학 지원자들과 뚜렷이 차별화되는 고유한 특성들을 고려할 필요가 있다. 이와 같은 연구 문제 및 필요성에 따른 이 연구의 목적은 3가지이다. 첫째, 의학전문대학원 고유의 선발인재상을 도출하기 위한 기초 작업으로서, 국내·외 의과대학, 의학전문대학원이 지향하는 의사상/졸업역량과 선발인재상/선발역량을 비교, 분석한다. 둘째, 의과대학의 지원자와 차별화되는 의학전문대 학원 지원자의 특성을 분석하기 위하여 두 유형의 학교 지원자들 간의 발달 단계상의 차이점에 대하여 살펴본다. 셋째, 의학전문대학원 재직 교원 및 재학생, 졸업생들이 선발인재상 및 역량 차원에서 의학전문대학원 만의 차별성을 인지하고 있는지 알아본다. 첫 번째, 그리고 두 번째 연구과제의 달성을 위하여 이 연구에서는 문헌 자료 수집 및 비교, 분석 등을 실시하였으며, 세 번째 연구과제 수행을 위하여 설문조사를 실시하였다. 연구 실시 결과, 두 급위 학교 유형이 지향하는 의사상, 졸업역량은 선발인재상 및 선발역량과 비교할 때 건학 이념 등 각 학교의 고유성에 따른 차이 외에는 현재 두 학교 급위 간의 명료한 차이는 보이지 않았다. 반면, 여러 가지 발달단계이론들에 근거하여 면밀히 살펴본 결과 연령대 및 정신적 성숙도 등의 측면에서 바라볼 때 의학전문대학원, 의과대학의 지원자는 뚜렷이 다른 특성들을 보여줄 수 있는 것으로 드러났다. 또한, 의학전문대학원, 의과대학의 각 지원자들의 선발인재상, 선발역량 등에 대한 인식조사를 실시한 결과, 의학전문대학원 재직 교원 및 재학생, 졸업생들이 공히 두 교육 기관 간에 차이가 존재하다는 점에 대하여 압도적인 비율로 긍정하고 있었다. 이상과 같은 연구 결과에 따라 의학전문대학원은 ‘선발인재상’ 및 ‘선발역량’, 그에 터한 ‘선발 전형’의 개발에 있어서 지원자들 간의 차이가 충분히 고려된 적절한 수준의 변별성이 확보되어야 할 당위성 및 필요성이 분명히 존재함을 알 수 있었다. 특히, 선발 전형 중 ‘인성 면접’ 시 의학전문대학원 지원자의 연령에 해당되는 발달단계 차원에서의 성숙도를 가늠할 수 있는 문제들을 개발, 적용할 필요가 있다. 또한 선발 전형 중 ‘인성 면접’ 문제 개발 시 이 연구 과정에서 수행한 중요도 인식 조사에서 나타난 결과들을 충분히 고려할 필요가 있다. In the Korean medical education system, where the 2+4 years type medical school and 4+4 years type medical school systems are mixed in parallel, the same selection type is applied, even though two types of medical school are at different levels in terms of the bachelor's and master's degree system. It is the current reality that there is not a big difference in the talents to be selected and the screening process in two types of medical school. However, there are distinct differences between the applicants in their age groups of both school types, so that it is natural that significant differences between the two groups are revealed. Therefore, when developing a student selection system of 4+4 years type medical school, it is necessary to derive a common selection of talents, and consider the unique characteristics that are distinct from 2+4 years type medical school applicants. The purpose of this study according to such problems and necessity for research is three. First, as a basic work to derive a common principle for selection system of 4+4 years type medical school, we compare between the competencies as outcome of both types of medical school and the selection talent & competencies that domestic and foreign medical schools and medical graduate schools aim for. Second, in order to analyze the characteristics of 4+4 years type medical school applicants that are differentiated from 2+4 years type medical school applicants, the differences in developmental stages between the two types of school applicants are examined. Third, we investigate whether faculty members, students, and graduates of medical graduate schools are aware of the differentiation of medical graduate schools in terms of talent and competency. In order to achieve the first and second research projects, this study conducted literature study, including data collection, comparison, and analysis, and a questionnaire survey was conducted to perform the third research project. As a result of the study, there was no clear difference between the two school levels except for differences according to the uniqueness of each school, such as the vision and mission, in comparison with the selection of talents and selection competencies in terms of competencies as outcome aimed at by the two types of medical school. On the other hand, as a result of a close examination based on theories of various stages of development, it was found that applicants for two types of medical school show distinct characteristics in terms of age group and mental maturity. In addition, as a result of conducting a survey on the perception of the selection talents and selection competencies of each applicant at the two types of medical school, the overwhelming proportion of faculty members, enrolled students, and graduates perceive the differences between two types of medical schools. According to the results of the research, it is necessary, that 4+4 years type medical school has to secure an appropriate level of discrimination that fully considers differences between applicants of two types of medical school in terms of the 'selection talent' and 'selection competency'. In particular, it is necessary to measure maturity at the level of development corresponding to the age of applicants for 4+4 years type of medical school, when developing selection process like “personality interview”. In addition, from the perspective of selection competency, it is necessary to fully consider the results of recognition level which conducted in this research when developing the questionnare for the selection screening process.

Detection of Encephalitozoon spp. from Human Diarrheal Stool and Farm Soil Samples in Korea

김경진,윤세정,천형일,김재환,심서보,유재란 대한의학회 2015 Journal of Korean medical science Vol.30 No.3

Microsporidia are eukaryotic organisms that cause zoonosis and are major opportunisticpathogens in HIV-positive patients. However, there is increasing evidence that theseorganisms can also cause gastrointestinal and ocular infections in immunocompetentindividuals. In Korea, there have been no reports on human infections with microsporidiato date. In the present study, we used real-time PCR and nucleotide sequencing to detectEncephalitozoon intestinalis infection in seven of 139 human diarrheal stool specimens(5%) and Encephalitozoon hellem in three of 34 farm soil samples (8.8%). Genotypeanalysis of the E. hellem isolates based on the internal transcribed spacer 1 and polar tubeprotein genes showed that all isolates were genotype 1B. To our knowledge, this is the firstreport on human E. intestinalis infection in Korea and the first report revealing farm soilsamples as a source of E. hellem infection. Because microsporidia are an important publichealth issue, further large-scale epidemiological studies are warranted.

Detection of Cryptosporidium parvum in Environmental Soil and Vegetables

홍세미,김경진,윤세정,박우윤,심서보,유재란 대한의학회 2014 Journal of Korean medical science Vol.29 No.10

Cryptosporidium parvum is a zoonotic protozoan parasite that causes cryptosporidialenteritis. Numerous outbreaks of cryptosporidiosis have been reported worldwide. Cryptosporidium is transmitted to hosts via consumption of contaminated water and foodbut also by direct contact with contaminated soil or infected hosts. The present studyinvestigated farm soil collected from 34 locations along the western Korean peninsula and24 vegetables purchased from local grocery markets in Seoul. The soil and vegetablesamples were examined by real-time polymerase chain reaction (qPCR) to estimate the riskof infection. Eleven of 34 locations (32.4%) and 3 of 24 vegetable samples (12.5%) werecontaminated with Cryptosporidium parvum, as confirmed by TaqI enzyme digestion ofqPCR products and DNA sequencing. It is suggested that Cryptosporidium infection can bemediated via farm soil and vegetables. Therefore, it is necessary to reduce contaminationof this organism in view of public health.