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.

노인환자와 중년환자의 병원음식 배식량에 대한 만족도와 섭취율 비교연구

손주현,천종희 한국식생활문화학회 2002 韓國食生活文化學會誌 Vol.17 No.5

The purpose of the study was to compare the satisfaction level on hospital meal size and actual intake rate of hospital foods between elderly and middle aged patients. Sixty one middle aged and one hundered thirty two elderly patients were surveyed on the foods served in the hospital-rice, soup, meat/fish, vegetable, kimchi and daily products. Compared to the middle aged patients, the more elderly thought the serving size of rice was too big(p<0.05), and those of soup, meat/fish and kimchi tended to be too big. There was no difference in the satisfaction level on the serving size of vegetable dish between two age groups. · In actual intake rates of hospital meal there were no significant differences between the elderly and middle aged patients. However, the elderly male ate significantly(p<0.05) less amount of rice than the middle aged male and the elderly female ate significantly(p<0.01) less amount of meat/fish then the middle aged female. Satisfaction levels and actual intake rates were significantly correlated in all food items.

노인환자와 풍년환자의 병원 음식 만족도 비교 분석

손주현,천종희 한국식생활문화학회 2001 韓國食生活文化學會誌 Vol.16 No.5

The purpose of this study was to analyze the satisfaction level on hospital foods in elderly and middle aged patients. The subjects were selected among the patients treated in the Inha University hospital during July of 1999. One hundred thirty five elderly patients aged over sixty(68 men, 67 women) and sixty five patients aged in forties(35 men, 30 women) were surveyed through questionnaires in terms of satisfaction level on hospital foods and the food preferences. Satisfaction on general taste, saltiness, serving temperature, appearance, texture and variety of hospital foods was not significantly different according to age. However, elderly men showed significantly higher satisfaction level than elderly women in terms of general taste of hospital foods(p<0.01). The preferences of cooking method for meat, fish, vegetable and the preferred kinds of kimchi and milk & milk products were not significantly different between the two age groups. However, elderly women significantly preferred sauted meat to broiled meat compared to elderly men(p<0.05).

전자코를 이용한 마늘냄새의 감소 효과 분석

손주아,임채란,손희진,강진희,노봉수 서울여자대학교 자연과학연구소 2007 자연과학연구논문집 Vol.19 No.-

Ths effectiveness of reduction of garlic flavor in model solution was investigated using metal oxide sensor of electronic nose. After removing garlic sample (control) it was washed by milk or casein solution. The obtained data from electronic nose were analyzed by principal component analysis. Control Sample was separated from the treatment that was washed with 1, 3, 5% casein solution by first principal component score. There is no difference between 1% casein treatment and 3% casein one. Five percent casein solution was effectively differentiated from control. It means that casein (5%) might be bound with garlic flavor. One percent green tea was effective but it was done by washing rather than binding.

진행성 위암환자에서 Capecitabine/Cisplatin 치료군과 Fluorouracil/Cisplatin 치료군 간의 삶의 질 비교

유희원,신은정,이광자,한현주,손인자 韓國病院藥師會 2004 병원약사회지 Vol.21 No.1

The improvement of medical treatment and anticancer drug has led a complete recovery and prolonged survival time of cancer patients. And recent study of cancer has included evaluation of quality of life. This study was performed to evaluate quality of life between Capecitabine/Cisplatin arm and Fluorouracil/Cisplatin arm. This study was performed in the Seoul National University Hospital from August to October 2003. A total of 8 AGC patients on adjuvant chemotherapy successfully completed this study. Method of study is questionnairing by EORTC QLQ-C30, cancer specific questionnaire. The questionnaire consists of Functional, Symptom, Global health quality of life scale. Patients eligible for this study had histologically confirmed stage III or IV AGC. Patients were to be between 18 and 60 years old, and have performance status of 1. Patients were ineligible if they had a history of 6 months prior or concomitant chemotherapy, radiotherapy. Statistically significant differences favoring the Fluorouracil/Cisplatin arm was noted in the physical scale. In addition, patients in the Fluorouracil/Cisplatin arm reported an improvement in physical functioning after one cycle chemotherapy.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

통합과학 수업컨설팅을 위한 초·중등학교 과학교사들의 통합과학교육 적용 현황 분석 및 교사의 수업능력 진단

맹희주,손연아 이화여자대학교 교과교육연구소 2012 교과교육학연구 Vol.16 No.2

본 연구는 통합과학 수업컨설팅을 위하여 초․중등학교 과학교사들의 통합과학 수업 적용 현황을 조사하고, 통합과학교육과 관련된 과학교사들의 수업능력을 진단하였다. 연구결과에 따른 결론은 다음과 같았다. 첫째, 통합과학교육은 과학지식과 학생들의 일상 경험을 연결시켜 일상생활을 과학적으로 해결하는 태도를 함양시키는 것에 가장 초점을 두어야 한다고 인식하고 있어, 통합과학교육의 방향이 교육 목표에 따라 다양하게 설정될 수 있도록 컨설팅 되어야 할 것이다. 둘째, 전체 응답자의 43.5% 정도가 통합과학 수업을 적용해 본 경험 있으며, 대부분 생물영역 중심의 통합을 적용하고 있는 것으로 분석되었다. 따라서 학교급에 따라 통합이 취약한 과학영역과 접근방법에 대해 심층적으로 수업컨설팅이 제공되어야 한다. 또한 과학 전영역이 통합 중심영역으로 고르게 적용되고, 수업의 전 과정에서 통합과학 수업이 가능하도록 교수학습 방법과 전략에 대한 컨설팅이 요구되어졌다. 셋째, 수업컨설팅에 대한 인지율(52.1%)에 비해 대부분(83.0%)의 교사들은 수업컨설팅 프로그램에 참여해본 경험이 없는 것으로 나타났다. 초․중등 과학교사들은 통합과학교육에 대한 전문성 개발을 위해 지식습득 보다 교사 연수프로그램에 참여하거나 교사모임을 통한 수업자료의 공유가 필요하며, 수업컨설팅을 통한 수업개선이 필요하다고 인식하고 있었다. 또한 교사들에게 통합과학 수업내용 선정에 대해 수업컨설팅이 가장 필요한 것으로 나타났다. 넷째, 초등학교 교사들과 고등학교 과학교사들은 물리영역에 대한, 중학교 과학교사들은 지구과학 영역에 대한 지식 확보가 컨설팅을 통해 필요한 것으로 분석되었다. 또한 통합과학교육을 위한 수업목표를 구체적으로 설정하고, 수업목표에 따라 수업주제를 선정하고 수업 설계 능력을 계발하기 위한 방안이 수업컨설팅의 내용에 포함되어야 할 것이다. 따라서 본 결과에 따라 학교급의 특성에 맞는 수업컨설팅을 수행함으로 편중된 통합과학교육이 되지 않도록 해야 하며, 과학교사들의 통합과학교육과 관련된 교사의 수업능력의 함양을 위해 차별화된 연수 프로그램과 수업컨설팅 프로그램이 개발되고 보급되어야 할 것이다. To consult Integrated Science Education (ISE), this study examined teachers' teaching abilities related to Integrated Science Instruction and the current status of the Elementary and Middle School Science Teacher Education Application. Conclusions based on the results of the analysis are as follows. First, since ISE is recognised to be more focused on improving students’ attitudes so that they can scientifically solve phenomenon in their daily life through connecting Science knowledge to their daily experiences as students, the direction of ISE will be consulted with respect to its agreement with the objects of education. Second, it was found that the respondents who had experienced the application of ISE comprised about 43.5 percent and that applied to the integration of the main ideas of the biological sciences. Third, most teachers (83.0%) had not experienced participation in the program for class consulting although the rate of awareness (52.1%) about class consulting was significant. The teachers in elementary and middle schools need to share class materials through teacher meetings or participate in teacher training programs rather than simply acquire knowledge to develop professionalism for ISE that has been recognized as being needed for class improvement. Fourth, it was found that the elementary school teachers and the high school science teachers for the physical realm need consulting to improve their knowledge; and the middle school science teachers concerning earth science as well. Therefore, according to the characteristics of the school level, the class consultations should not put too much emphasis on ISE. Moreover, it will be necessary to promote and develop differentiated training and class consultation programs in order to improve teachers’ abilities relating to ISE. (273 words)

간호사의 이직의도 구조모형

김창희,양승순,김연자,손연정,유미애,송주은 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to construct and test a structural equation model of nurses' turnover intention. Method: The participants were 716 nurses at 4 university hospitals. Data were collected by a self-report questionnaire in 2008 and analyzed using SPSS 12.0 and AMOS 4.0 Win program. Results: The fit indices of modified model were x²=285.928(p<.001),x²/df=1.958GFI=0.964, RMSEA=0.037, AGFI=0.944, NFI=0.947, NNFI=0.961, CFI=0.973, PNFI=0.658 and showed high compatibility with the empirical data. In the final model, job stress and satisfaction were found to have significant direct effects on nurses' turnover intention, while organizational culture and emotional labor were very important factors to have indirect effects on turnover intention via job stress and satisfaction. Nurses' turnover intention was accounted for 41.2% of covariance by these factors. Conclusions: Comprehensive nursing interventions for decreasing nurses' turnover intention should be focused on reducing job stress and increasing job satisfaction. Also, Nursing strategy for enhancing positive organizational culture and decreasing emotional labor would be helpful for decreasing nurses' turnover intention, too. Further studies are needed to prospectively conduct to verify these causal relationships with larger sample.

쌍태아에서 제 1태아의 분만 후 제 2태아의 지연분만 : 중례보고

김주환,서민정,유희정,노권일,조대현,박정규,이정헌,조성남,손영수 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.3

With the widespread use of fertility medications and techniques of in vitro fertilization, multiple gestation has become epidemic in modern obstetric practice. Delivery of the initial fetus in a multiple gestation usually is followed by delivery of the subsequent fetus or fetuses shortly thereafter. However in rare circumstances, the delivery is delayed for days due to disappearance of uterine contraction after delivery of the first fetus. When uterine activity ceases after the delivery of the first neonate, a policy of nonintervention may be considered in case of an immature or very premature delivery, in order to achieve a gestational age for the remaining fetus(es) more compatible with neonatal survival. We report a case of twin gestation with prolongation of the delivery interval between the twins for 46 days.

고도정수처리 공정에서의 천연유기물질 특성변화 및 소독부산물 전구물질의 제거특성 평가

노재순,손희종,박은주,황영도,최동훈,배석문,신판세 慶星大學校 環境問題硏究所 2002 環境硏報 Vol.12 No.1

In this research the movement and apparent molecular weight distribution of hydrophilic/hydrophobic organic matters in advanced water treatment process were investigated using the raw water of Maeri area, located in downstream of Nakdong river, and the variation of the disinfection by-product formation potential was also investigated. In the raw water used in experiments, the content of BDOC (biodegradable dissolved organic carbon) in dissolved organic carbon (DOC) was about 39%, and this value is far above a normal, Pre-ozone treatment showed an increase of 40% in the BDOC content, and this means that biodegradability was remarkably increased by ozone treatment BDOC concentration in BAC treated water was 0.09 mg/L, which means 84% of BDOC removal rate compared with that in post-ozone treated water. The variation of chlorine disinfection by-product formation potential in each process unit of water treatment process was analyzed. TOXFP concentration in raw water was 449 ㎍/L, and the contents of THMFP and HAAFP among TOXFP were 24% and 23%, respectively. The removabilities of these materials BAC process had an order of TOXFP > HAAFP > THMFP. BAC process was less effective for THMFP than others. The distribution of hydrophilic organic matters were evaluated in each treatment process. Hydrophilic and hydrophobic matters in the raw water had a ratio of 50 : 50, and the ozone treatment decreased the content of hydrophobic matters. The BAC treatment made the ratio 85:15. These mean that the removal of hydrophilic matters is more difficult than that of hydrophobic materials in water treatment process. In addition the portions of humic and fulvic acid in hydrophobic matters were analyzed. Fulvic acid a large portion among hydrophobic matters in the raw water, and the portion was 78%. Ozone treatment was more effective on the removal of fulvic acid than humic acid. After BAC treatment, the concentration of residual fulvic acid was high than humic acid. Chlorine disinfection by-product formation for hydrophilic and hydrophobic mattrts was compared in each process unit. in the raw water TOXFP and THMFP formation for hydrophobic matter was higher, and HAAFP was highly formated for hydrophobic matter. After post-ozone or BAC treatment, chlorine disinfection by-product formation has high potential for hydrophobic matters. Comparing humic and fulvic acids, chlorine disinfection by-product formation potential was higher for humic acid than for fulvic acid in all processes. In the comparison of the reactivity with chlorine disinfection by-product per unit DOC, THMFP and DOXFP showed higher reactivity with hydrophobic matter than with hydrophilic matter in all processes, and HAAFP was highly reacitive with hydrophilic matter. Apparent molecular weight distributions of organic matters were investigated in each process step.The content of low molecular weight organic matters less than 1000 Da in DOC was high in all processes except raw water, but molecular weight organic matters more than 1000 da was higher than molecular weight organic matters less than 1000 Da in the formation potential of chlorine disinfection by-product.