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.

A Study on Gender Differences in Morality and Ethics: From the Perspective of Feminist Therapy

Ju–yeon LEE 한국융합인문학회 2015 Asian-Pacific Journal of Social Quality Vol.2 No.1

Feminist therapy, based on feminist philosophy, has the aim of supporting and strengthening the powers of social minority groups, including women, and bringing change to society through these efforts. Its basic principle is that of equality, seeking freedom from any prejudice or oppression coming from gender differences. Through the analysis of a commercial entitled “Show,” by Korea Telecom, this study discusses how women, and especially women’s sense of ethics, are viewed in society. The commercial has been analyzed according to ethical theories, and a tentative conclusion has been reached: Women’s ethics is more relationshiporiented and caring than that of men, and it is the product of experiences, and learned through a system. Men and women are not innately different in terms of ethics, but rather the difference is something experienced, learned, and encouraged, and people acquire this difference in the course of interacting with others in order to survive. Taking this into consideration, the current study proposes and discusses a new method of dealing with ethics in feminist therapy: The fact that difference exists should be acknowledged, and an effort should be made to ‘show’ various effects of this difference.

국가예방접종전산등록체계 개발을 위한 민간의료 기관 하부구조 및 환경 조사연구

이무식,김은영,이건세,이석구,홍지영,김건엽,김대경,신의철,이연경,기몽서,나백주,김영택 한국모자보건학회 2003 한국모자보건학회지 Vol.7 No.2

신체화장애 환자의 스트레스 대처방식 및 심리적 특성

이주연,이무석,윤진상,양종철,문지웅,정해원,은성종 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : The purpose of this study was to investigate the stress coping strategies and psychological charactehstics, such as combined psychopathology and tendency of symptom interpretation, in patients with somatization disorder. Methods : Thirty patients meeting the criteria of DSM-IV somatization disorder were compared with thirty controls. We evaluated the subjects using Symptom Checklist-90-Revised (SCL-90-R), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and The Ways of Stress Coping Questionnaire (SCQ). Independent t-test and Pearson correlation analysis were used. Results : From the results of SCL-90-R subscales, the scores of somatization, obsession-compulsion, depression, anxiety, and psychoticism were significantly higher in patients with somatization disorder than nonnal controls. Somatization disorder patients had greater amplification of physical sensation in SSAS and significantly higher score in physical interpretation of SIQ compared with psychological or environmental interpretation, In the SCQ of somatization disorder patients, we observed generallylower levels of total coping scores than the control group and significant positive correlation between passive coping style of SCQ and psychological interpretation of SIQ. Conclusion : These results show that patients with somatization disorder have various psychopathology, greater amplification of physical sensation, physical interpretation tendency of symptoms, and insufficient copying strategy.

유병기간에 따른 한국인 파킨슨병 환자의 영양소 섭취 상태 및 식사의 질에 관한 연구

이주연,안태범,전범석,김윤영,조여원 대한지역사회영양학회 2008 대한지역사회영양학회지 Vol.13 No.4

Both genetic and environmental factors play important roles in the pathogenesis of Parkinson Disease (PD). The contribution of many environmental factors including dietary factor remains unproven. The purpose the study was to investigate the dietary habits, nutrient intake and dietary quality of Korean PD patients according to the duration of disease. PD patients were recruited from K and S university hospitals from May 2005 to January 2006. This study was carried out after approval by the Institute Review Board (IRB). British Brain Bank criteria was used to diagnose PD. The subjects were classified into 2 groups based on the duration of PD: < 25 months and ≥ 25 months groups. General characteristics, anthropometric measurements, food habits and dietary intakes were investigated. The results of this study were as follows: 1) The mean age of < 25 months group (66.9 ± 8.0 yr) was significantly higher than that of ≥ 25 months group (62.2 ± 8.8 yr) (p < 0.05). No significant differences were found for academic background, occupation, living status and social activity, however, numbers of diseases, exercise and family history of PD were significantly different. 2) Anthropometric measurements were not different between the two groups. 3) The frequency of taking snacks was significantly higher in < 25 months group and the amounts of alcohol consumption were significantly higher in ≥ 25 months group. 4) Daily intakes of most nutrients were very low compared with DRI. 5) The MAR score was significantly lower in < 25 months group (p < 0.05;) however, the scores of DVS, DDS and DQI were not significantly different. As a conclusion an overall nutrient intake and dietary quality of the Parkinson's Disease patients need to be improved regardless of duration of the disease and a well-balanced diet should be emphasized.

민사소송법 제217조의 승인대상으로서 ‘외국재판’의 개념 : 외국법원의 면책재판 등에 관한 논의를 중심으로

이연주 梨花女子大學校 法學硏究所 2016 法學論集 Vol.21 No.2

종래 민사소송법 제217조 제1항은 외국법원의 확정‘판결’만을 승인의 대상으로 명시하고 있었으나 판결이 아니라 재판이라도 일정한 경우에는 외국판결의 개념에 포함시키는 것이 타당하다 것이 다수설과 판례의 입장이었다. 개정민사소송법 제217조는 이러한 입장을 반영하여 제217조의 제목을 ‘외국판결의 효력’을 ‘외국재판의 승인’으로 수정하고 승인대상을 외국법원의 ‘확정판결’에서 외국법원의 ‘확정판결 또는 이와 동일한 효력이 인정되는 재판’으로 확대하였다. 우리나라의 외국재판의 승인제도는 외국재판으로서의 대상적격성과 민사소송법 제217조 제1항의 제1 내지 4호의 승인요건을 구비하는 경우 별도의 승인재판 등의 절차를 거침이 없이 바로 효력을 인정하는 자동승인제이다. 이에 반해 채무자회생법상의 외국도산절차의 승인제도는 외국도산절차의 대표자의 신청에 의하여 절차가 개시되고 이에 대한 결정이 필요한 결정승인제이다. 외국법원의 회생계획인가결정에 의한 면책은 외국도산절차의 일환으로 행해진 것이기는 하나 외국도산절차의 승인은 지원처분을 위한 자격을 인정하는 것에 불과하기 때문에 외국법원의 재판의 효력을 국내적으로 인정하기 위해서는 민사소송법 제217조의 외국재판으로서 승인하는 것이 적절하다. 이는 필자가 외국재판이 대상적격성의 요건으로 정리한 ⅰ) 외국의 사법기관이 그 권한에 기하여 재판하였을 것, ⅱ) 재판의 대상이 사법적 법률관계에 관한 것일 것, ⅲ) 당사자에게 의견진술의 기회가 보장된 절차를 거쳤을 것, ⅳ) 당해 재판이 확정되었을 것이라는 요건에 비추어 보더라도 타당하다. Korean Civil Procedure act was amended by Act No. 12587, May 20, 2014. partially, which included Article 217, recognition of foreign judgments. The old regulation had ruled effect of foreign judgment as final and conclusive judgment. The new regulation expand the object of recognition into 'a final and conclusive judgment rendered by a foreign court or a judgment acknowledged to have the same force'. This reflects the existing opinion and precedent of korean courts. The Korean system of 'recognition of foreign judgment' demand ⅰ) the qualification as the foreign judgment, ⅱ) approval requirements by the first to forth clause of Article 4the article 217. If certain foreign judgement meets these prerequisites, it could take effect automatically without any other procedure. Meanwhile, Korean Debtor Rehabilitation and Bankruptcy Act regulate 'recognition of foreign bankruptcy procedures'. The representative of the foreign bankruptcy procedures may file an application for commencement of domestic bankruptcy procedures or participate in domestic bankruptcy procedures that are in progress. This system is non-automatic unlike 'recognition of foreign judgment'. Though the exemption judgement of foreign court is rendered as a process of foreign bankruptcy procedure, recognition of foreign bankruptcy procedures is a process which acknowledge a qualification for relief in korea, to be recognized as a judgement, 'recognition of foreign judgment' is appropriate procedure. This conclusion is adequate, taking into account for 'the qualification as the foreign judgment' which is deducted by the writer of this article, ⅰ) Foreign judicial authority have to judge within it's power, ⅱ) The object of judgement is about civil or commercial matters, ⅲ) The parties foreign of suits have to be given the opportunity to state an opinion in the procedures ⅳ) The judgement have to be final and conclusive.

TMV에 의한 고추의 역병에 대한 전신획득저항성 유도

이성희,차재순,이주연 충북대학교 한국과학재단 지정 첨단원예기술개발 연구센터 1997 연구보고서 Vol.2 No.-

고추에 있어서 전신획득저항성 및 PR 단백질 축적과의 관계를 알아보기 위하여 TMV pepper strain을 고추잎에 접종하고 4일후 고추역병균 P. capsici를 고추줄기에 접종후 역병발생량을 비교하였다. TMV를 전접종한 고추에서는 TMV를 전접종하지 않은 고추에서보다 역병발생량이 크게 감소하였는데, TMV를 전접종한 고추의 역병 발병도와 병반길이는 역병접종 10일째에 TMV를 전접종하지 않은 고추의 약 50% 수준이었다. 담배의 PR1b와 PR5a 항혈청을 이용한 immuno-blot으로 추적한 고추의 PR1 과 PR5 단백질은 TMV 접종엽과 접종상위엽에서 TMV 접종 24시간후부터 세포간극에서 동시에 검출되기 시작하였다. PR1 과 PR5 단백질은 TMV 접종엽에서는 TMV 접종 4-5일후 잎이 탈락할때까지 그 양이 크게 증가하였다. PR5는 TMV 접종상위엽에서 TMV 접종후 그 양이 크게 증가하지는 않았지만 실험종료일인 TMV 접종 20일후까지 검출되었다. 이러한 결과는 고추에서 TMV 검염에 의해 역병에 대한 전신획득저항성이 유도되며, 전신획득저항성이 유도되는 동안 매우 빠르게 고추전신에서 PR 단백질의 생산이 유도되고, 생성된 PR 단백질들이 오래동안 유지됨을 암시하고 있다. Induction of systemic acquired resistance (SAR) against phytophthora blight and PR protein accumulation by TMV in pepper plant (Capsicum annuum cv. Nockwang) were examined to understand the mechanism of systemic acquired resistance in pepper plant. The zoospore suspension of Phytophthora capsici was inoculated on stem of pepper plant on which TMV-pepper strain had been inoculated on fully expanded 3 leaves, and the amount of phytophthora blight incidence was determined with time course. Both disease severity and lesion length of phytophthora blight were much smaller in TMV pre-inoculated pepper plant than in uninoculated control plant. The amount of phytophthora blight in TMV pre-inoculated pepper was about 50% of uninoculated control plant's at 10 days after P. capsici inoculation. PR1 and PR5 protein were monitored in intercellular fluid of TMV inoculated and uninoculated upper leaves by immuno-blot with tobacco PR1b and PR5a antibody to find accumulation of PR proteins locally and systemically during induction of SAR. PR1 and PR5 were detected from 24 hours after TMV inoculation both TMV inoculated and uninoculated upper leaves, and increased rapidly in TMV inoculated leaves until th leaves were defoliated on 4-5 days after TMV inoculation. PR5 was not increased in uninoculated upper leaves as much as in TMV inoculated leaves, but it can be detected until 20 days after TMV inoculation. These results suggest that TMV infection induces SAR against phytophthora blight in pepper plant, and PR proteins is accumulated very rapidly after TMV infection systematically during induction of SAR and maintained for quite long time in pepper plant.

식품제조업 근골격계질환 평가 및 개선방안 연구

이창민;오연주;김진훈;김대응 동의대학교 산업기술연구소 2008 産業技術硏究誌 Vol.22 No.-

국내 산업재해율 중 50% 이상이 근골격계질환으로 최근 몇 년간 급속한 증가수치를 보이고 있다. 특히 산업재해율이 가장 높은 분포를 가지는 제조업분야에서는 작업 특성상 비정형화된 작업을 장시간 정적 작업자세로 수행함으로써 근골격계질환에 노출될 확률이 높다. 최근 몇 년 간 근골격계질환 예방을 위한 꾸준한 노력이 시행되고 있으나 대부분이 대규모 사업장을 비롯한 것으로 중•소규모의 사업장을 대상으로 하는 분석 및 평가가 미비한 실정이다. 식품제조업의 작업 업무는 많은 자동화 설비가 갖추어져 있음에도 불구하고 작업특성상 장시간의 기립자세가 요구되며 불필요한 작업자세가 유발된다. 식품제조업 분야의 작업공정은 작업형태에 따라 들기, 포장, 정돈 제품적재 작업으로 그룹화 할 수 있으며 이를 근간으로 인간공학적 평가도구를 이용한 작업분석을 설시하였다. 근골격계질환 예방을 위한 분석결과 불필요한 작업자세가 유발되거나 장시간 정적 작업을 비롯한 단순 반복 작업이 식품제조업 분야에 있어서 가장 큰 유해요인이라 할 수 있다. 이에 본 연구에서는 식품제조업의 작업평가 시 근골격계질환 유해요인으로 관찰되는 부적절한 작업형태 및 작업환경에 대한 인간공학적 평가 및 개선을 통하여 근로자가 안전하게 작업할 수 있는 적합한 작업공간 및 작업형태를 제시하였다.

진웨어 광고의 내용분석 - 잡지광고를 중심으로 -

李周衍,朴吉順 복식문화학회 1997 服飾文化硏究 Vol.5 No.4

The purpose of this study was to identify the denotating of visual message and linguistic message in the advertisement of Jean-wear, and to identify the image type in the advertisement of Jean-wear. Content analysis was done using the advertisement of Jean-wear from several fashion magazines which were published from January, 1996 to August, 1997. The advertisement of Jean-wear reflects the reality using the photos, and is image appeal type, appeals to the model's lifestyle, the western value. And that mostly single person was appeared in the advertisement means solitude in modern society.

좌측흉수로 발현된 Boerhaave 증후군 1예

이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.