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.

브루셀라균에 노출된 미생물 검사실 직원들에 대한 예방적 항생제 요법과 혈청학적 추적검사

이창섭,이혜수,이재현,박진희,최영실,황규잠,이흥범 대한감염학회 2008 감염과 화학요법 Vol.40 No.2

The aerozolization is one of possible Brucella transmission mechanisms, particularly in air-borne exposed laboratory workers. In this study, seven laboratory workers were potentially exposed to B. abortus via aerosols. Two laboratory workers who sniffed an agar plate several times were considered to be at high risk for acquiring the disease, 5 workers who did not work directly with the strain were be considered at low risk of infection. Prophylactic antibiotics of doxycycline 200 mg/day and rifampin 600 mg/day were offered for 6 weeks in high risk workers and 3 weeks for low risk workers respectively. Enrolled workers were advised to check for serological testing of Brucella species every 3 weeks during a total period of 12 weeks. Compliance with taking medicine was 57.1% (4/7) and compliance for completing the serological tests was 85.7% (6/7). None of the laboratory workers developed clinical disease or tested positive serologically during 3 months of seroloaical testing and 1 year of clinical follow-up.

고량강의 항염증 작용에 대한 연구

박히준,이제현,김수영,심범상,구헌종,강전모,최일환,이재동,김남재,이지숙,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The use of herbal therapy is becoming an increasingly attractive approach for the treatment of various inflammatory disorders. The Alpiniae officinari Rhizoma is popular in Aisa as a traditional herbal medicine. Alpiniae officinari Rhizoma is a species of the ginger family(Zingiberacease). Method : This study was performed to investigate the anti-inflammatory effect of Alpiniae officinari Rhizoma extract by the methods of "carrageenan induced paw edema" and "Lipopolysaccharide-induced inflammatory mediators in mouse macrophage RAW 264.7 cells". Result : We suggest that Alpiniae officinari Rhizoma extract decreased paw volume induced by plantar injection of carrageenan. Also Alpiniae officinari Rhizoma extract inhibited nitric oxide, prostaglandin E₂production and induced nitric oxide synthase, cyclooxygenase-2 protein expression in Mouse macrophage RAW 264.7 cells stimulated with lipopolysaccharide. Conclusion : This study shows that Alpiniae officinari Rhizoma extract seems to have anti-inflammatory effect by inhibition of nitric oxide, prostaglandin E_(2) production and nitric oxide synthase, cyclooxygenase-2 protein expression.

계지의 항염 효과에 관한 연구

박히준,이지숙,이재동,김남재,표지희,강전모,최일환,김수영,심범상,이제헌,임사비나 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : Cinnamomi Ramulus (CR), the young twing of Cinnamomi loureirii nees, has been used for treating symptoms related to pain. rheumatic arthritis and inflammation in Korean herb medicine. This study was carried out to investigate the anti-inflammatory effect of CR in vivo and in vitro. Methods : Extracts of CR were prepared and the chemical components of the extracts were examined by gas chromatography-mass spectrometry (GC-MS). The extracts were administrated to the rat paw edema model induced by carrageenan to evaluate the anti-inflammatory effect of CR. The expressions of nitric oxide (NO). prostaglandin E2(PGE2), inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 were also quantified in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages to survey the effect of CR in vitro. The main components were cinnamaldechyde and coumarin. Results : We examined the anti-inflammatory activity of the 80% ethanol extract of Cinnamomi Ramulus in vivo by using carrageenan-induced rat paw edema model. Maximum inhibition of 54.9% was noted at the dose of 1000㎎/㎏ after 2 hours of drug administration in carrageenan-induced rat paw edema and this showed a potent anti-inflammatory effect. Conclusions : The results showed that Cinnamomi Ramulus suppressed dose-dependently LPS-induced NO production in RAW 264.7 macrophages and also decreased iNOS protein expression. Cinnamomi Ramulus also showed a significant inhibitory effect in LPS-induced PGE2 production and COX-2 expression.

다제내성 그람양성균에 대한 Linezolid(Zyvox^(�))의 시험관내 항균력 비교

박대원,정희진,엄중식,황병연,김성범,이재갑,이연주,정혜원,정성주,박재형,이진수,손장욱,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

배경 : MRSA, VRE, VRSA같은 다제 내성 그람 양성균의 등장에 따라 glycopeptide를 대체할 새로운 항생제의 개발이 필요하게 되었고 결과적으로 새로운 항생제인 linezolid라는 항생제가 개발되었다. Linezolid는 이전의 항생제와는 다른 새로운 계열의 oxazolidinone으로 경구 이용률이 우수하다. 원내 및 원외감염의 중요한 원인균이 되고 있는 MRSA, VRE에 대한 적절한 경구용 항균제가 없는 국내에서 폐렴 및 피부 연조직 감염에서 경구용으로 사용해 볼 수 있는 약제이다. 본 연구에서는 고대 구로 병원에서 분리된 MRSA, VRE 등을 대상으로 다른 여러 항균제와 비교한 linezolid의 시험관내 항균력을 조사하고자 하였다. 재료 및 방법 : 연구대상은 1998년 1월부터 2000년 12월까지 본원에서 입원 및 외래를 통하여 피부 연조직 감염증 및 호흡기 감염증, 요로감염증으로 진단된 환자들의 가검물로부터 분리된 MRSA 60균주, VRE 43균주, PRSP 25균주를 액체배지 또는 한천배지 희석법을 통하여 linezolid 및 기타 항균제에 대한 최소발육억제농도를 구하였다. 결과 : 실험에 사용한 S. aureus는 모두 MRSA였고 이들은 linezolid에 대해 MIC_(90) 2㎍/㎖(MIC 범위 1-2㎍/㎖), Enterococcus spp는 모두 VRE로 linezolid의 MIC_(90)은 2㎍/㎖로 MIC 범위는 1-4㎍/㎖였다. 한 개의 균주에서 MIC 4㎍/㎖로 중등도 감수성을 보였으나 MIC breakpoint가 (8㎍/㎖인 내성균주는 없고 모두 감수성을 보였다. S. pneumoniae의 경우 penicillin 내성이었고, linezolid MIC_(90) 1㎍/㎖ (MIC 범위 0.5-1㎍/㎖)로 전부 감수성을 보였다. 결론 : Linezolid는 MRSA를 위시한 VRE, PRSP 등의 다제 내성 그람 양성균에 대하여 우수한 시험관내 항균력을 보임을 알 수 있었다. Background : The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. Material and Methods : By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. Results : All of S. aureus used in this study were MRSA, and MIG_(90) of linezolid was below 2 ㎍/㎖ (MIC ranged between 1-2 ㎍/㎖). All of Enterococcus spp. were VRE, and had MIG_(90) of 2 ㎍/㎖ (MIC ranged between 1 to 4 ㎍/㎖). One of the VRE showed intermediate susceptibility with MIC of 4 ㎍/㎖. However, none was resistant with MIC breakpoint above 8 ㎍/㎖. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MICao of 1 ㎍/㎖(MIC range 0.5-1㎍/㎖). Conclusion : In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.

기능성 모노머를 포함한 자가부식형 상아질 접착제의 결합강도에 관한 연구

이재범,임호남 大韓齒科器材學會 2003 대한치과재료학회지 Vol.30 No.4

The purpose of this study was to ascertain the influence of functional monomers and bonding methods in self-etching dentin bonding systrms on shear bond strength. Seven commercially available self-etching dentin bonding systems were used. According to functional monomers, they could be divided into two phosphate groups(Clearfil SE, Prompt L-Pop), three dicarboxylate groups(MAC-Bond II, UniFil Bond, One-up Bond F), one anhydride group(AQ Bond) and one pyrophosphate group(Etch&Prime 3.0). According to bonding methods, Clearfil SE, MAC-Bond II and UniFil Bond were two-step self-etching systems and Etch&Prime 3.0, Prompt L-Pop, AQ Bond and One-up Bond F were one-step eslf-etching systems. The buccal surfaces of human molars were grounded flat to expose dentin suface and all bonding systems were appoied according to the manufacturers' instructions. The metal rings were placed on the bonded surface, and composite resin(Z100) were added on that surface and cured by light. The resin-bonded teeth were stored in water(37℃) for 24 hours, and these specimens were tested in a shear mode at a cross-head speed of 1.0mm/min using an Instron testing machine. The data for each groups were subjected to an ANOVA followed by the Duncan's multiple range test at p=0.05. The resin-dentin interfacces were obtained by cutting the specimen vertically and the interfacces were obserbed by SEM. Following results were obtained : The shear bond strength of self-etching dentin bonding systems which contained di-carboxyl and phosphate functional monomers were higher than that of the systems contained another functional monomers(p<0.05). Statistically, there was no signigicance between the one-step self-etching systems and the two-step self-etching systems(p>0.05). There was a trend that the thickness of hybrid layer was increased according to strength of acidity. But the thickness of hybrid layer was not correlation with the group of functional monomer, so that selection of bonding system containing adequate functional monomer was inportant on dentin bonding.

조기 대장암

이재범,박영진,박군주,김선회,박재갑,이건욱,박용현,최국진,김진복 대한대장항문학회 1998 Annals of Coloproctolgy Vol.14 No.3

한국과 미국의 체육계 학과 교육과정 비교

이범제 師範大學 體育硏究所 1995 서울大學校 體育硏究所論集 Vol.16 No.1

The purpose of this study was to provide a comparative analysis of the physical education programs within the department of physical education, leisure, and/or department of sport-for-all in Korea and The United States. The 70 departments that were investigated were within college of education, general colleges, and college of sport science. This analysis was done through the examination of requirements of coursework or elective subjects, credit requirements, and academic classes with laboratory hours according to countries, types of department, and contents of curriculum. Contents of curriculum was divided into theoretical and practical field. Further, nine majoring courses of specialty were classified into detailed areas of specialty. The differences by country, contents of curriculum, and coursework to be taken were noted and following results were obtained. 1. The difference found in the contents of curriculum were: 1) In Korea the percentage of credit units of practical field were higher than those of theoretical field, but the percentage of credit units of theoretical field were higher than those of practical field in the United States. 2) Korea and The United States had more numbers of optional subjects in practical field. 3) In the hour(s) allotted to each subject, the percentage of 2 and 3 hours of theoretical subjects and 2 hours of practical subjects in Korea and The United States were higher than any other hours allotted to each subject in both of theoretical and practical field. 4) The United States attached more importance to courses that included laboratory classes than those in Korea. 2. The differences found in the majoring courses of specialty were: 1) Majoring courses of specialty in Korea showed a tendency to emphasize sport-related area more than those in The United States. 2) The departments in The United States tended to provide more natural science and methodology courses than those in Korea. 3. In a specific contents of specialty, noted differences were observed: 1) Departments in Korea put an emphasis on such theoretical fields as exercise physiology and health area, while in The United States put an emphasis on such theoretical fields as pedagogy, health, exercise physiology area. 2) Departments in Korea put an emphasis on such practical fields as track & fields, gymnastics, ballgame and martial arts area, while departments in The United States highly valued such practical fields as ballgame, swimming and water polo area.

국내 시판 항생제의 허가 용량 및 용법의 적정성에 대한 고찰 : 국내 약제사용설명서(package insert)와 미국 Physicians' Desk Reference의 비교 Comparison of Domestic Package Inserts with Physicians' Desk Reference

이재갑,이연주,황병연,정혜원,정성주,김성범,정희진,김우주,김민자,박승철 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

목적 : 국내 시판중인 항생제의 1일 투여량과 투여간격의 적정성을 확인하고 적응증 및 중증도에 따른 항생제 용량 제시 여부를 확인하기 위하여 항생제 시판시 KFDA의 허가사항을 담은 약제사용설명서을 미국 FDA 공인 약제에 대한 사용지침으로 쓰이고 있는 PDR(Physicians' Desk Peference)과 비교하였다. 방법 : PDR에 등재되어 있는 항생제 중에서 시럽 및 도포용 항생제를 제외한 총 61종에서, 국내에 시판되어 있는 51종 항생제의 약제사용설명서를 대상으로 1일 투여량, 투약횟수, 적응증 및 중증도에 따른 설명 정도를 비교하였다. 결과 : 1) 1일 투여량 비교 : 비교 가능한 전체 항생제에서, 약제사용설명서가 PDR보다 적은 용량을 제시한 경우는 경구용 8종, 주사용 11종으로 총 19종(37%)였으며, 많은 용량을 제시한 경우는 경구용만 2(4%)종이었고, 동일하거나 비슷한 용량을 제시한 경우는 경구용 15종, 주사용 15종으로 총 30(59%)종이었다. 약제사용설명서에서 적은 용량이 제시된 항생제 중 경구용인 cefdnir, cefixime, cefpodoxime, ofloxacin, levofloxacin, norfloxacin(6종), 주사용인 cefazolin, cefotetan, ceftizoxime, meropenem (4종) 등 반수이상의 약제가 일본제약회사로부터 국내에 수입된 약들이었으며 일본의 약제 사용설명서와 동일한 용량을 제시한 것을 알 수 있다. 2) 투여간격 비교 : 비교가능한 항생제 51종 중에서 국내약제사용설명서가 PDR과 동일한 투약횟수, 투여간격을 제시한 항생제는 30종(59%)이었다. 국내 약제사용설명서가 PDR보다 적은 투약횟수, 긴 투여간격을 제시한 항생제는 9종(17%)이었다. 오히려 많은 투약횟수, 짧은 투여간격을 제시한 항생제가 12종(24%)이나 되었다. 경구용만 비교하였을 경우 국내 약제사용설명서가 PDR보다 적은 투약횟수를 제시한 항생제는 없었으며, 동일하세 제시한 경우는 15종, 빈번한 투약횟수를 제시한 경우는 10종이었다. 주사용 항생제에서 국내 약제사용설명서가 PDR보다 긴 투여간격을 제시한 항생제는 9종, 동일한 경우는 15종, 짧은 투여간격을 제시한 경우는 2종이었다. 3) 적응증 및 중증도에 따른 비교 : 약제사용설명서에서 적응증 또는 중증도에 따른 용량에 대한 설명이 부족한 경우는 경구용 13종, 주사용 7종으로 총 20종(39%)이었으며, PDR에서는 경구용 1종, 주사용 2종으로 총 3종(6%)이었다. 결론 : 항생제에 첨부되는 약제사용설명서 및 약제사용설명서를 바탕으로 편집되는 의약품집이 항생제를 처방하는 의사들이 용법과 용량을 결정함에 있어 참고 역할을 하고 있으나, 국내의 시판 허가사항을 담은 약제사용설명서가 많은 수에서 적응증 또는 중증도에 따른 1일 투여량과 투여간격에 대한 정확한 정보를 제공하고 있지 못하고 있다. Background : The appropriate usage of antibiotics needs informations such as its effectiveness for a given infection, administration route, the amount of effective dose, and the dose intervals. In this study, in order to find any significant discrepancy regarding to the details of explanation of the necessary information for appropriate antibiotic usages, we compares informations about 51 antibiotics, one from package inserts in Korea and the other from physician's desk reference (PDR) certified by FDA in the United States of America. Materials and Methods : Package inserts about antibiotics, only oral or parenteral agent, wereperused to collect three categories of data: the recommended dosage, dose interval, and adjustment of dose to indications or the severity of infection. These data available in Korea were compared with 61 antibiotics (32 oral and 29 parenteral agents) cited in PDR. Results : Package inserts for 51 antibiotics were gathered, because the remaining 10 antibiotics in PDR are not domestically commercialized. Among data on antibiotics comparable with those in PDR, 59% (30 cases: 15 oral and 15 parenteral agents) suggested the dose similar to that of PDR, 37% (19 cases: 8 oral and 11 parenteral agents) recommend less dose, and 4% in only 2 oral agents showed more dose. About half of the drugs recommending lower dosage were imported from Japanese pharmaceutical company, and the recommended doses of these antimicrobial agents were similar to those in Japan. About 59% (30 cases: 15 oral and 15 parenteral agents) directed dose interval or duration similar to those of PDR and 17% (9 parenteral agents) suggested less administration or longer duration. Surprisingly, in contrast to only 6% (3 cases) of PDR, 24% (12 cases : 10 oral and 2 parenteral agents) recommended more administration or shorter duration. About 39% (24 cases: 13 oral and 7 parenteral agents) revealed no information for dose adjustment commons to indications or the severity of infection. Conclusion : This study revealed that many guidelines in Korea recommend lower doses and/or unreasonable dose intervals. In future studies, improved antibiotic usage guidelines should be established based on pharmacokinetic and pharmacodynamic researches, on the aspect of optimal dosage, dose interval, and dose adjustment commensurate to the indications and the severity of the infection.

한국에 도해하는 검은머리갈매기(Larus saundersi)의 월동 현황

이기섭,박진영,이재범,김학진,유정칠 경희대학교 한국조류연구소 1999 연구보고 Vol.7 No.1

검은머리갈매기(Larus saundersi)는 그 동안 생존집단이 약 3,000개체로 추정되어온 멸종위기의 종이나, 한국에서의 월동 개체수에 대해선 현재까지 알려진 바가 없다. 본 조사는 1994년에서 1997년까지 동계기간에 실시되었다. 조사기간 동안 1994/95년 겨울에는 548개체, 1995/96년 겨울에는 1,159개체, 1996/97년에는 2,140개체가 관찰되었다. 해마다 증가하는 것으로 되어 있으나 실제는 조사면적이 확대된 데 그 원인이 있는 것 같다. 1994/97년 동계기간 동안에는 8개 조사지역에서 최대 2,425개체가 관찰되었다. 남해안에서는 조사가 광범위하게 이루어지지 않았기 때문에 월동 개체수는 이 보다 더 많을 것으로 추정되며, 종합적인 조사가 이루어진다면 전 세계의 생존집단은 6,000개체 이상이 될 것으로 사료된다. 조사지역 8곳 중에서는 순천만과 금강하구, 만경강하구에 각각 최대 500개체 이상이 도래하여 이 지역이 검은머리갈매기의 중요한 월동지임이 밝혀졌다. 성조에 대한 유조의 비율을 보면 평균 14.8%이었으나, 조사시기에 따라 변동이 있었다. 중국 리아오닝(Liaoning) 지방에서 적색 표식한 2개체가 아산만에서 관찰되었다. 최근 한국에서 새로 3개의 번식지가 발견되었으나 한국에서의 간척사업으로 인해 본 종이 계속 감소할 위기에 처해 있어 보존대책이 시급하다. Saunders's Gulls Larus saundersi are the endangered species and the world populations of the species were estimated about 3,000 individuals. The breeding sites were known at several sites in China, and the wintering areas were known in southern China, Hong Kong, Vietnam, Taiwan, Japan and Korea. Recently, the number of Saunders's Gulls was rapidly increased in Kyushu province of Japan: about 1,000 birds wintering there. One of factors affecting on the increasing population of Saunders's Gulls in Japan may be due to the destruction of the wintering habitats of Saunders's Gulls in Korea. But the wintering population of Saunders's Gulls in Korea has not been reported by now. We surveyed during the winter season of 1994~1997, and counted 548 individuals in 1994~95, 1,159 in 1995~96, and 2,140 in 1996~97. The increasing population each year may be due to the increase of survey areas each year in Korea. The peak count obtained from 8 sites was 2,425 individuals during the winter season of 1994~97. The real wintering population of Saunders's Gulls would be more than 2,425 individuals, because we did not survey many parts of southern coast although most areas of west coast were surveyed. If we estimate the world populations of Saunders's Gulls on the basis of this study and a Japanese report made in 1996(4,387 individuals), the world populations of the species may be more than 6,000 individuals. Sunchon bay, Kum river estuary, and Mankyung river estuary are major habitats supporting over 500 individuls of the wintering Saunders's Gulls every year in Korea. The ratio of juveniles to adults was averaged on 14.8% in the wintering population of Saunders's Gulls in Korea. Two individuals tagged with red colour flags were found in Asan bay, indicating that some birds wintering in Korea bred in Liaoning province of China. Breeding sites were newly found in the three reclaimed salt marshes. The major habitats of Saunders's Gulls should be set aside for nature reserves for effective protection and management, and should be turned into Ramsar sites to protect Saunders's Gulls in Korea.