• 한국산학기술학회논문지
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• 제22권3호
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• pp.65-73
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• 2021

본 연구의 목적은 119구급대원을 대상으로 COVID-19에 대한 지식 및 교육 요구도를 확인하여 신종감염병 대비 시뮬레이션 교육 프로그램 개발에 기초자료를 제공하고자 시도되었다. 186명의 119구급대원을 대상으로 2020년 11월 15일~11월 30일까지 구조화된 설문지를 통해 자료를 수집하였다. 연구 결과 COVID-19 감염관리 교육을 받지 않은 경우가 98명(52.7%)이었고 COVID-19감염관리 지식은 25점 만점에 18.21±1.98점이었으며 환경관리 영역에 대한 정답률이 가장 낮았다. COVID-19 감염관리 교육 요구도는 총 평균은 3.81±.28(4점 척도)점으로 나타났으며 전파경로 및 확산 예방과 직원 안전관리 영역에 대한 교육요구도가 가장 높았다. 일반적 특성에 따른 지식은 성별(t=-1.999, p=.047)에 따라 통계적으로 유의한 차이가 있었으며 교육 요구도는 경력(t=-1.999, p=.047), 교육수준(t=2.336, p=.021)에 따라 유의한 차이가 있었다. 이에 따라 119구급대원을 대상으로 COVID 감염관리 교육 프로그램 개발 시전파경로 및 확산 예방, 직원안전, 환경관리를 포함하는 것이 필요하다.

• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.68-74
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• 2009

목 적 : 2002-2007년 보고된 홍역 사례 및 유행에 대한 역학적 분석을 통해서 현재 홍역퇴치 수준을 평가하고자 하였다. 방 법 : 홍역퇴치 수준을 평가하기 위해서 인구집단의 질병유행 여부를 평가하는데 가장 보편적인 방법인 한명의 환자에서 평균 몇 명의 환자에게 질병이 전파되는지를 나타내는 감염재생산수(R: the effective reproduction number)를 사용하였다. 결 과 : 2002년부터 2007년 까지 각각 11명, 13명, 6명, 6명, 25명, 180명의 사례가 발생하였다. 2006년도에 15명의 환자가 발생한 1건의 유행이 있었고 2007년도에는 각각 2, 2, 2, 3, 3, 3, 5, 9, 9, 12, 50명의 사례가 발생한 11건의 유행이 있었다. 2002- 2007년도 해외유입 사례의 비율에 의한 R 값은 0.95, 유행의 크기에 대한 비율에 의한 R 값은 0.43 이었다. 2007년도에는 원내감염을 중심으로 한 유행이 발생하였고 대부분의 사례가 4세 이하였고 예방접종력이 없었다. 대부분의 사례의 감염원을 찾을 수 없었다. 결 론 : 홍역퇴치 수준의 문제점을 해결하기 위해서는 원내감염과 같은 감수성 집단의 유행 차단 및 신뢰성 있는 감시체계와 역학조사를 시행하여야 할 것이다.

• 한국지리정보학회지
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• 제16권3호
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• pp.12-24
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• 2013

1980년대에 근절된 것으로 여겨졌던 말라리아는 재출현 이후 지난 10년간 증감을 거듭하고 있다. 우리나라의 경우에는, 휴전선에 인접한 지역이 말라리아 발생의 핫스팟으로 분류될 만큼 지역적 특징이 뚜렷하게 나타나고 있다. 특히, 휴전선 부근 시 군지역이 말라리아 발생의 위험지역으로 분류될 뿐만 아니라 지역 간 말라리아 발생률에서 차이가 있으며, 질병 발생의 중심이 변화하는 경향을 보이고 있다. 이는, 말라리아 발생이 지역별로 상이하게 펼쳐져 있는 자연 및 거주지 환경에 영향 받고 있음을 말해준다. 말라리아는 매개모기에 의해 병원체가 전달되는 것으로 이 과정은 특정 기후 및 인문환경 시스템 속에서 발현된다. 기후 요소는 매개모기와 병원체에 매우 다양하게 영향을 미치며 기온은 가장 대표적인 환경요인이다. 또한 매개모기와 인간과의 접촉 빈도와 접촉 거리는 말라리아 발생률에 가장 직접적인 영향을 미치는 요인이다. 본 연구에서는 지역별로 다른 국지적인 기후조건, 매개모기의 산란 및 서식환경의 비중, 매개모기와 거주지 간의 거리에 따라 말라리아 발생이 지역별로 차이가 나타난다는 점을 기상자료, 인공위성 기반의 토지피복 자료를 활용하여 확인하였다.

• Pediatric Infection and Vaccine
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• 제30권2호
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• pp.73-83
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• 2023

목적: 본 연구의 목적은 혈액종양 기저질환으로 치료 중 유증상 코로나바이러스감염증-19(COVID-19)으로 확진 된 소아청소년에서 바이러스 부하(viral load)의 변화를 확인하고자 하였다. 방법: 후향적 종단 코호트연구(retrospective longitudinal cohort study)로, 19세 미만 소아청소년 중 악성 빈혈, 혈액암, 또는 고형암으로 치료 중인 상태에서 2022년 3월 1일부터 8월 30일 사이에 SARS-CoV-2 PCR 양성으로 유증상 코로나바이러스감염증-19가 확진 된 환자를 대상으로 하였다. 환자들의 의무 기록과 전화 문진으로 임상 증상과 전파경로, 그리고 증상의 경과에 대한 자료를 얻었고, 서울성모병원에서 시행했던 SARS-CoV-2 PCR titer 값을 분석하였다. 확진 이후 E gene RT-PCR Ct value ≥25을 전파가능성이 낮은 상태로 정의하였다. 결과: 6개월의 연구 기간 동안 총 43명의 환자에서 44번의 COVID-19 확진 사례가 포함되었다. 환자의 평균 연령은 8세(interquartile range, 4.9-10.5)였으며, 가장 흔한 기저 질환은 급성 림프구성 백혈병(n=30, 68.2%)이었고, 다음으로 조혈모세포이식 후(n=8, 18.2%) 상태인 환자들이었다. 대부분 경증 COVID-19 (n=32, 72.7%)에 해당이 되었고, 3명의 환자(7.0%)는 중증/위중증 COVID-19에 해당되어 산소 치료를 받았다. 2.3% (n=1)는 COVID-19 관련 급성 호흡곤란 증후군으로 사망하였다. 확진 이후 E gene RT-PCR Ct값이 ≥25을 도달한 시점이 15-21일인 환자는 총 39.4%(n=13)이었고, 22-28일에 도달한 환자는 30.3% (n=10)이었다. 15.2% (n=5)의 환자에서는 확진 후 28일이 지난 시점에서도 Ct값 <25를 유지하였다. E gene Ct값이 <25 장기간 지속되는 위험인자로 난치성 악성 종양 상태(β, 67.0; 95% CI, 7.0-17.0; P=0.030)가 유의한 관련이 있었다. 한 환자는 확진 후 Ct 값이 <25으로 유지되던 중, 확진 후 86일 째 보호자로 상주하던 어머니에게 바이러스를 전파하였다. 결론: 난치성 악성 종양 상태에서 유증상 COVID-19에 확진 되는 경우 바이러스를 장기간 배출 할 수 있기 때문에, 이런 환자군에서는 PCR 기반 바이러스 전파 예방 조치가 도움이 될 수 있다.

• 한국환경농학회:학술대회논문집
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• 한국환경농학회 2009년도 정기총회 및 국제심포지엄
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• pp.273-282
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• 2009

The transmissible spongiform encephalopathies (TSEs) disease group are fatal neurodegenerative disorders affecting a wide range of hosts. The group includes kuru and Creutzfeldt-Jakob disease (CJD) in humans, scrapie in sheep and goats and Bovine spongiform encephalopathy (BSE) in cattle. The exact nature of the infectious agent involved in the transmission of these diseases remains controversial. However, a central event in their pathogenesis is the accumulation in infected tissues of an abnormal form of a host-encoded protein, the prion protein (PrP). Whereas the normal cellular protein is fully sensitive to protease ($PrP^{sen}$), the disease-associated prion protein ($PrP^d$) is only partly degraded ($PrP^{res}$), its amino-terminal end being removed. BSE was first reported in the mid-80s in the UK. Ten years later, a new form of human prion disease, variant CJD (vCJD) developed in the wake of the BSE epidemic, and there is now strong scientific evidence that vCJD was initiated by the exposure of humans to BSE-infected tissues, thus indicating a zoonotic disease. However, the ban on the feeding of animal-derived proteins to ruminants, and the apparent lack of vertical transmission of BSE, have led to a decline in the incidence of the disease within cattle herd and therefore, an assumed decreased risk for human contacting vCJD. The origin of the original case(s) of BSE still remains an enigma even though three hypotheses have been raised. Hypotheses are i) sheep- or goat-derived scrapie-infected tissues included in meat and bone meal fed to cattle, ii) a previously undetected sporadic or genetic bovine TSE contaminating cattle feed or iii) originating from a human TSE through animal feed contaminated with human remains. A host cellular membrane protein ($PrP^C$), which is abundant in central nervous system tissue, appear to be conformationally altered in the diseased host into a prion protein ($PrP^{Sc}$). This $PrP^{Sc}$ is detergent insoluble and partially protease-resistant ($PrP^{res}$). The term $PrP^{res}$ is normally used to describe the protein detected after protease treatment, in techniques such as Western immunoblotting, and enzyme-linked immunosorbant assay using fresh/frozen tissue. Immunohistochemistry may performed with formalin-fixed tissues. Also, clinical signs of the BSE are one of the major diagnostic indicators. Recently, atypical forms (known as H- and L-type) of BSE have appeared in several European countries, Japan, Canada and the United States. An unusual case was also reported in a miniature zebu. The atypical BSE fall into two groups based on the relative molecular mass (Mm) of the unglycosylated $PrP^{res}$ band relative to that of classical BSE, one of the higher Mm (H-type) and the other lower (L-type). Both types have been detected worldwide as rare cases in older animals, at a low prevalence consistent with the possibility of sporadic forms of prion diseases in cattle. This raises the unwelcome possibility that vCJD could increase in the human population. Now, active surveillance program against BSE is going on in Korea. In regional veterinary service lab, ELISA is applied to screen the BSE in slaughter and confirmatory tests by Western immunoblotting and immunohistochemisty are carried out if there are positive or suspect in the screening test. Also, the ruminant feed ban is rigorously enforced. Removal of specified risk materials such as brain and spinal cord from cattle is mandatory process at slaughter to prevent the infected material from entering the human food chain.

• Pediatric Infection and Vaccine
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• 제27권1호
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• pp.1-10
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• 2020

2019년 12월에 중국 후베이성 우한시에서 원인 미상 폐렴이 무리 지어 발생하기 시작하였다. 환자의 하기도에서 이전에 알려지지 않은 새로운 코로나바이러스가 분리되었으며 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)로 명명되었다. 세계보건기구는 SARS-CoV-2에 의한 질병을 코로나바이러스감염증-19(coronavirus disease 2019, COVID-19)로 명명하였다. 2020년 3월 11일에 COVID-19는 전세계 최소 114국으로 퍼졌으며 약 4,000명이 사망하여 세계보건기구는 COVID-19가 세계적 대유행임을 선언하였다. 지난 20년 동안 새로운 코로나바이러스에 의한 두 번의 유행이 있었다. 2002-2003년 중증급성호흡기증후군(severe acute respiratory syndrome, SARS) 유행 시에는 8,098명의 확진 환자와 774명의 사망자가 발생하였으며, 2012년에 사우디 아라비아에서 시작되어 현재까지 주로 아라비아 반도에서 발생하고 있는 중동호흡기증후군(Middle East respiratory syndrome, MERS)는 2019년까지 총 2,499명의 환자와 858명의 사망자를 발생시켰다. 본 종설의 목적은 2020년 3월 12일까지 알려진 SARS-CoV-2의 특징과 전파 양상 및 COVID-19의 임상 증상을 알아보고 SARS와 MERS와의 유사점 및 차이점에 대하여 간략하게 소개하는 것이다.

• 한국의료질향상학회지
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• 제8권1호
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• pp.10-21
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• 2001

Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

• 대한본초학회지
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• 제30권5호
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• pp.67-74
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• 2015

Objectives : TheHaedokgumhwa-sanwater extract (HDKHS) is used in Korea, Japan and China as a traditional therapeutic agent to cure an infectious disease. But its study is not enough. Therefore, the present study focused on the elucidation of HDKHS to investigate the anti-inflammatory effects and to established the possible mechanisms involved in its action on LPS-stimulated immune response in murine macrophages.Methods : Inflammatory status was induced by LPS and measured by increasement of inflammatory mediators. LPS induced secretions of NO and PGE₂in RAW 264.7 cells were measured using griess reagent and enzyme-linked immunosorbent assay (ELISA) kit respectively. production of IL-6 was examined using ELISA kit and expression of IL-6 mRNA was measured by RT-PCR method. To investigate the effects of HDKHS on inflammatory mediators, such as iNOS, COX-2 and MAPKs, western blot and RT-PCR were performed.Results : HDKHS significantly reduced production of NO and PGE2 which were induced by LPS. Also, activation of IL-6 was reduced both protein and mRNA levels. The expressions of inflammatory mediator include iNOS and COX-2 were decreased by pretreatment with HDKHS. futhermore The result showed HDKHS down-regulate the LPS induced phosphorylation of ERK 1/2, one of the MAPK family, which is considered as a main regulator of transmission from pathogens to nucleus of immune cells.Conclusions : Our results suggest that the anti-inflammatory properties of HDKHS may stem from the inhibition of pro-inflammatory mediators via suppression of initiation of inflammatory response by inhibiting MAPKs signaling pathways.

• 대한의생명과학회지
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• 제10권2호
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• pp.163-169
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• 2004

Worldwide, tuberculosis remains one of the leading infectious diseases, accounting for nearly 3 million deaths and more than 8 million new cases annually. DNA typing of Mycobacterium tuberculosis is important for the control of tuberculosis, since it can be used to track transmission route of tuberculosis, source of internal laboratory contaminations, and to answer questions on the nature of tuberculosis infections such as reactivation or exogenous reinfection of disease. At present, IS6110-based RFLP is the choice of method for typing large numbers of clinical isolates of M. tuberculosis, since it has the highest resolution power. However, RFLP requires long time, high cost and qualified experts, so only reference level laboratories can use the RFLP technique. In order to have an optional molecular typing method suitable for the clinical settings, this study evaluated the use of one of PCR-based typing methods, IS6110-based outward PCR for typing clinical isolates of M. tuberculosis. In brief, the results from this study showed that IS6110-based RFLP is useful to discriminate diverse clinical isolates of M. tuberculosis as well as to identify clinical isolates that belong to the same family or cluster groups that have been previously classified by RFLP analysis. In addition, the banding profiles resulted from IS6110-based outward PCR seemed to represent genomic characteristics of M. tuberculosis, since strains belong to the K-family generated unique band that is not present in any other strains but present only in the genome of K-family strains. The IS6110-based outward PCR was also shown to be useful with DNAs isolated directly from liquid cultures indicating this method can be suitable for typing M. tuberculosis in clinical settings.

• 상하수도학회지
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• 제30권3호
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• pp.285-291
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• 2016

There has been an accelerating increase in water reuse due to growing world population, rapid urbanization, and increasing scarcity of water resources. However, it is well recognized that water reuse practice is associated with many human health and ecological risks due to numerous chemicals and pathogenic microorganisms. Especially, the potential transmission of infectious disease by hundreds of pathogenic viruses in wastewater is one of the most serious human health risks associated with water reuse. In this study, we determined the response of different bacteriophages representing various bacteriophage groups to chlorination in real wastewater in order to identify a more reliable bacteriophage indicator system for chlorination in wastewater. Different bacteriophages were spiked into secondary effluents from wastewater plants from three different geographic areas, and then subjected to various doses of free chlorine and contact time at $5^{\circ}C$ in a bench-scale batch disinfection system. The inactivation of ${\phi}X174$ was relatively rapid and reached ~4 log10 with a CT value of 5 mg/L*min. On the other hand, the inactivation of bacteriophage PRD1 and MS2 were much slower than the one for ${\phi}X174$ and only ~1 log10 inactivation was achieved by a CT value of 10 mg/L*min. Overall, the results of this study suggest that bacteriophage both MS2 and PRD1 could be a reliable indicator for human pathogenic viruses for chlorination in wastewater treatment processes and water reuse practice.