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        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.

      • 중학생의 역사 드라마 시청이 역사의식에 미치는 영향

        장희흥,차경호,구혜진 大邱大學校 師範大學 附設 敎育硏究所 2010 學校敎育硏究 Vol.5 No.2

        This study is aimed at proposing the specific plans to use history drama lessons through the study on the relations between reality, fascination and involvement that are sub-variables of history drama viewing and middles school students’ historical consciousness, and to raise their historical consciousness by using history drama lessons. In order to accomplish such a goal, the study selected respective 250 middle school students in Daegue and Gumi, Gyeongsangbuk-do as its subjects, and the surveyed and analyzed findings are obtained as follows. First, it is the result obtained by dividing the subjects’ general characteristics. Fascination and involvement among reality, fascination, and involvement that were sub-variables had a difference in the division by sex. Fascination was shown to be higher in female students while involvement was higher in male students. In addition, as to the region, history drama viewing had no difference in middle school students of Daegue and Gyeongsangbuk-do. Historical consciousness was higher in middle school students of Daegue that those of Gyeongsangbuk-do, while regarding the grade there was no difference in history drama viewing and historical consciousness. Second, it was the result regarding how reality, fascination, and involvement that were sub-variables of history dram viewing affected historical consciousness. With regards to types of history dram viewing, fascination, reality, and involvement significantly affected historical consciousness in order. According to the gender, male students’ reality, involvement, and fascination gave a significant effect on historical consciousness while female students’ involvement didn’t affect historical consciousness, and fascination and reality gave an effect on historical consciousness in order. As to the grade, the first graders’ reality, fascination, and involvement were not related to historical consciousness while the second graders’ reality and fascination except for involvement affected in order. Besides, the third graders’ fascination only affected historical consciousness. Regarding the region, fascination and reality of middle school students in Daegu affected historical consciousness in order while fascination, involvement, and reality of middle school students in Gyeongsangbuk-do influenced historical consciousness. Like this, there was a little difference in the gender, grade, and region, but reality, fascination, and involvement that were sub-variables related to history drama viewing affected historical consciousness, and the higher sub-variables related to history drama viewing were, the higher historical consciousness was. Due to the fact that history dramas had a fictional element, there was a discussion on educational efficiency. However, this study verified the fact that history dramas can be educationally used, instead of deciding whether history drams were true or not. Based on the findings of the study, the effective utilization methods of history dramas in history lessons are suggested as follows. First, the study of historical figures using history dramas is possible. Students can understand properties of characters through re-enactment and empathy, and approach various figures that don’t appear in textbooks. Second, they can raise critical view that is able to divide false and fact of history dramas and use it to the fact learning. Third, it is possible to learn historical terms. By learning unfamiliar and difficult historical terms in advance, they can increase interest in history lessons. Fourth, storytelling of historical materials is possible. Students can make their own new interpretation by constructing various historical materials in a way of history dramas. Fifth, they can use a decoration making of history dramas, a visiting of the set, and a clipping of TV screen capture in various manufacturing studies as materials. Sixth, they can have a mock trial and a role-playing lesson regarding behaviors decisions of history drama figures. Seventh, they can study the public life history through history dramas. 이 논문은 중학생의 역사 드라마 시청이 역사의식에 미치는 영향에 대한 것이다. 역사 드라마 시청과 관련된 하위변인인 현실감, 심취도, 관여도는 성별, 학년, 지역에 따른 차이는 있지만, 역사의식에 분명 히 영향을 미치고 있다. 영향력의 크기는 심취도, 현실감, 관여도 순으로 나타났다. 그렇기에 역사 드라 마 시청과 관련한 역사 수업은 중학생의 역사의식 향상에 도움을 줄 수 있을 것으로 보인다. 역사 드라마를 시청하려는 의도와 시청하는 동안의 관여도 정도는 남학생의 경우 역사의식에 유의한 영향을 미쳤지만, 여학생의 경우 유의한 영향을 미치지 않는 것으로 나왔다. 학년별로 결과를 살펴보면 모든 학년에서 관여도는 역사의식에 통계적으로 유의한 영향을 주지 않는 것으로 나타났고, 제일 고학 년인 3학년에서 심취도만이 영향을 주는 것으로 보아 역사 드라마를 시청함에 있어 역사적 사실과 허구를 구별하는 능력이 아래 학년보다 발달하여 현실감의 영향을 덜 받은 것으로 보인다. 역사의식은 대구광역시 중학생이 경상북도 중학생보다 다소 높다. 그리고 실제 사극의 선호도는 퓨전 이나 판타지를 선호하지만 실제 전통사극이 역사의식에 더 높은 영향을 미쳤다. 이것은 현장 교사의 경 험담과 일치한다.

      • SCIESCOPUSKCI등재
      • KCI등재

        쉰소리로 발현한 흉부 대동맥류 1예 : Ortner씨 증후군 orther`s syndrome

        장이선,진승원,박희철,박진아,윤희정,이종민,김재형 대한내과학회 2003 대한내과학회지 Vol.64 No.1

        Ortner씨 증후군은 다양한 심장 질환에 이차적으로 생긴 반회 후두 신경 마비에 의한 쉰소리를 특징으로 하는 임상 질환이다. 저자들은 흉통없이 발생한 쇤소리를 주소로 내원한 환자에서 좌측 반회 후두 신경의 손상에 따른 성대 마비의 1차원적인 원인으로 대동맥궁 부위에서의 대동맥류를 진단하였기에 문헌 고찰과 더불어 보고하는 바이다. Ortner's syndrome is a clinical entity with hoarseness due to a left recurrent laryngeal nerve palsy caused by cardiac disease. It is a recognized complication of a number of conditions including, atrial septal defect, patent ductus arteriosus, primary pulmonary hypertension, Eisenmenger's syndrome and aortic aneurysm. A 71-year-old woman with a history of hypertension and diabetes complained hoarseness and hemoptysis for 3 days. Chest X-ray showed a soft tissue mass shadow in the left upper lung field and chest CT scan revealed a thoracic aortic aneurysm. We report a case of left recurrent laryngeal nerve palsy due to a huge thoracic aortic aneurysm in an old woman. (Korean J Med 64:105-108, 2003)

      • 인공 치아 제작을 위한 기하학적 특성 추출

        장진호,유관희 충북대학교 컴퓨터정보통신 연구소 2001 컴퓨터정보통신연구 Vol.9 No.1

        최근 의학 분야에서는 컴퓨터 그래픽스 기술을 통해 컴퓨터로 인체의 해부학적 조직을 재구성하려는 시도에 많은 관심이 쏟아졌다. 이러한 관심은 치과 치료분야에서도 이루어져 왔는데, 컴퓨터 그래픽스를 이용한 치과 치료에도 많은 응용 분야가 있다. 자료를 측정한다거나, 시각적으로 3차원의 영상을 보여준다거나, CAD-CAM 기술을 이용하여 의치의 틀이나 금형 등을 제작할 수 도 있다. 본 논문은 이러한 다양한 응용에 기반 기술이 될 수 있는 치아의 기하학적 특성을 정의하고, 이것을 찾기 위한 여러 가지 방법을 실험해보고, 더 낳은 방법을 제시하고자 한다. In the latest medical world, the attempt of reconstructing anatomical human body system using computer graphics technology awakes people's interests. Actually, this trial has been made in dentistry too. There are a lot of practicable technology fields using computer graphics in dentistry. For example, the measuring of data, 3D visualization, manufacturing a dentures, die by CAD-CAM technology can be applied. This paper shows the definition of geometric feature of teeth and experiments several different ways and propose better way for serching it.

      • 임부의 연령에 따른 보완대체요법에 관한 인식 태도 경험 비교 연구

        김연진,김지연,노경민,신혜리,유예지,이지민,장희조,정아인,최소정,강숙정,이향연,민혜영 이화여자대학교 간호과학대학 2016 이화간호학회지 Vol.- No.50

        Purpose: This study aims to test if the age of pregnant women affects the perception, experience, and attitude towards complementary alternative therapy (CAT), by investigating the perception, experience, and attitude of pregnant women under the age of 35, and above 35 (Advanced Maternal Age). The study will 1) find the general characteristics of pregnant women under and over the age of 35 2) compare the perception, behavior, and experience of pregnant women under and over the age of 35, and 3) find the comparison of the perception, behavior, and experience according to the general characteristics of pregnant women under and over the age of 35. Method: The subjects of this study are composed of 44 women under the age of 35 and 44 women above the age of 35, totaling 88 pregnant women visiting midwiferies, obstetrics and gynecology, and baby fairs in Seoul and Gyeong-Gi area. Data for this study was collected from November 28, 2015 to January 6, 2016 for 40 days. The collected data analyzed mean, standard deviation, t test, ANOVA, and chi-square by using SPSS 23.0. Result Results show that there is a significant difference in the perception, attitude, and experience of the two-sample groups in the use of CAT. The question of “what is most necessary when applying CAT in a hospital clinical environment” for the perception criteria came out with the results of t=9.980, p<.05. For the attitude, results showed that the answers of pregnant women under the age of 35 displayed a more positive attitude towards CAT. (t=2.421, p<.05) Lastly, in the experience section, pregnant women under the age of 35 showed more CAT use than the other sample group. Conclusion Results have shown that there is a difference in the perception, behavior, and experience between the two sample groups. Therefore further research on the efficacy and the adverse effects of CAT needs to be done.

      • KCI등재

        Langerhans cell histiocytosis

        장창덕,허준,박성환,김철훈,오수진,황희성,최설희,신상훈 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

        Langerhans cell histiocytosis(LCH) appears to arise from Langerhans cell and comprises a spectrum of clinical disease previously described in the literature by a variety of eponyms including histiocytosis X, eosinophilic granuloma, Hand-Christian disease, and Letterer Siwe syndrome. This rare disorder occurs in all groups, predominently affecting children & young adults. LCH has a wide spectrum of clinical features. The differentiation of several forms of this disease is primarily a clinical and not a histologic one. The radiographic characteristics include the appearance of solitary "intraosseous" lesios, the multipicity of "alveolar bone" lesions, the bone lesions, periosteal new bone formation, and slight root resorption. Prognosis of a single bone lesion, is known to be excellent. In contrast, disseminated disease has seen associated with a chronic course, a high rate of morbidity and late consequences, and possible mortality. Treatment of LCH remains problematic. Treatment of multisystem disease, where organ function is being compromised has generally been with high-dose systemic corticosteroids or multiple chemotherapy.

      • SCIESCOPUSKCI등재

        Platinum sensitive 재발성 난소암에서 Carboplatin/Paclitaxel의 효과

        장혜진,유희석,임윤경,문세희,장기홍,이정필 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

        목적 : 재발성 난소암에서 platinum 감수성을 기준으로 2차 항암요법으로 사용한 Carboplatin과 Paclitaxel의 효과를 알아보기 위하여 본 연구를 진행하였다. 연구방법 : 1998년 1월 1일부터 2003년 8월 31일까지 만 5년 8개월 간 아주대학교병원 산부인과에 재발성 난소암으로 입원한 환자 중에서 최초 수술로 난소암을 확진한 후 Cisplatin 또는 Carboplatin 등 platinum 제재가 포함된 항암치료를 받은 후 6개월 이후에 재발한 환자 29명을 대상으로 Carboplatin은 5 AUC를 그리고 Paclitaxel은 175 mg/m^(2)를 투여하였으며, 최소 3회에서 최고 16회까지 투여하였다. 치료효과의 판정은 CT, MRI, Ultrasonography등 영상진단상 암종괴의 크기가 완전히 소실되었을 경우를 완전반응(complete response)으로, 50%이상 감소되었을 경우를 부분반응(partial response)으로, 50% 미만으로 감소되었거나 20% 미만 증가하였을 경우를 불변(stable disease)으로, 그리고 20% 이상 증가되었을 경우를 진행(progressive disease)로 정의하였다. 결과 : 대상 환자에서 완전반응은 6명(21%), 부분반응은 11명(38%), 그리고 불변은 5명(17%)로 전체 반응율 (overall response rate)은 59% 그리고 임상적 유용성(clinical benefit=CR+PR+SD)은 76%이었다. 결론 : 재발성 난소암환자에서 기왕에 사용한 Platinum 제재에 민감한 환자에서는 Carboplatin과 Paclitaxel의 병행 투여가 효과적이었다. Objective : To ascertain the effect of Carboplatin and Paclitaxel combination as a second line regimen for recurrent ovarian carcinoma based on platinum sensitivity. Methods : From January 1st, 1998 through to August 31st, 2003, 29 patients were retrospectively reviewed who had previously underwent primary cytoreductive surgery and adjuvant chemotherapy with Cisplatin or Carboplatin for ovarian carcinoma, and who had later recurred during follow up. All 29 patients had recurred at least 6 months after therapy, and thereafter received second line chemotherapy consisting of Carboplatin (5 AUC) and Paclitaxel (175 mg/㎡) for a minimum of least 3 cycles and a maximum of 16 cycles. Treatment efficacy was assessed by imaging studies including Computerized tomography, Magnetic Resonance Imaging, or Ultrasonography. Complete response was determined as complete disappearance of tumor, partial response at least than 50% reduction in tumor volume, stable disease as less than 50% reduction or less than 20% increase in tumor volume, and progressive disease as more than 20% increase. Results : There was complete response in 6 (21%) patients, partial response in 11 (38%), stable disease in 5 (17%), showing an overall response rate of 59%. The clinical benefit (CR+PR+SD) was 76%. Conclusion : The combination of Carboplatin and Paclitaxel administration seems to be an effective mode of second line therapy in patients with recurrent ovarian carcinoma who had been sensitive to prior platinum based chemotherapy.

      • VBNC Campylobacter jejuni의 회복특성

        장금일,손진영,이희봉,김광엽 忠北大學校 農業科學硏究所 2003 農業科學硏究 Vol.20 No.-

        We studied the characteristics of the recovery process where the coccoid (Viable but non-culturable, VBNC) form Campylobacter jejuni which was inactivated under aerobic condition with lower temperature (4 and 25 C jejuni ATCC 43429 strain did not recovered from VBNC form to active spiral form at 4 and 25, whereas C jejuni ATCC 33291 strain recoveredfro VBNC form at 25 Morphology and the fatty acid pattern of cell membrane of VBNC C. jejuni ATCC 33291 and ATCC 43429 were analyzed. The morphological differences between two C jejuni strains were verified using flow cytometry. C16 0(palmiticacid) and C19 0(cyclic fatty acid) showed decrease in the fatty acid composition of C. jejuni ATCC 33291 On the other hand, C19 0 in the fatty acid composition of C jejuni ATCC 43429 was increased and C14:1(myristoleic acid) was found only in C jejuni ATCC 43429 The differences in the fatty acid composition of C jejuni could be possibly related with the recovery of VBNC form C jejuni

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