• 한국임상약학회지
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• 제26권4호
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• pp.330-340
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• 2016

Objective: The outbreak of Middle East Respiratory Syndrome (MERS) started in South Korea in May 2015 and the end of crisis was declared in December 2015 by Korea Centers of Disease Control and Prevention (KCDC). However, Zika virus emerged in less than 2 months following MERS and showed higher mortality than other countries. This study is to assess the current prevention system of overseas infectious diseases, based on MERS and Zika virus outbreak and to suggest effective response system for the future. Methods: We conducted two surveys on medical specialists working at tertiary general hospitals regarding the effectiveness of responding system by KCDC against MERS and Zika virus and education in individual medical institutions using 5-Likert points. Response system was examined in three different periods as initial period, spreading period, and post disease period. Results: Although medical specialists received the notifications in initial period, no practical prevention was proven to be placed in responding stage by medical facilities (averagely 3.5/5 points in total and sub-analyses). During spreading period, there were several academic seminars conducted, which were evaluated as helpful. In post disease period, all answered that there were changes on patient treatment in all medical facilities, with mainly report system and the treatment regulations in case of suspicious patients for infection. Only 49% respondents answered positive on the possibility of initial responses. For questionnaire items regarding Zika virus, all answered that there were notifications prior to the first outbreak of the infected patient. Eighty% of respondents were aware of 'the Guideline system for traveling to dangerous areas', and answered that the system was moderately effective (averagely 3.8/5 points in total). For the effectiveness of prevention measures for foreign novel disease by KCDC, the average point was 3.0 in both of total and sub-analyses. Conclusion: There is not enough response system to prevent infectious disease in medical institutional and governmental levels in Korea. It would warrant the modification of overall medical system to improve preventive measures for initial spread of such diseases.

• Journal of the Korean Data and Information Science Society
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• 제27권3호
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• pp.599-607
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• 2016

한국에서 새로운 유형의 메르스 코로나 바이러스 감염에 의한 중동 호흡기 증후군 환자가 처음으로 발생한 이후 급속하게 번져, 사회적으로 큰 문제가 되었다. 최근 중동의 아라비아 반도를 중심으로 처음으로 감염 환자가 발생한 이 질병은 사우디 아라비아에서의 치사율이 30~40%에 이르는 것으로 알려져 있다. 그러나 전염 과정 초기에 한국질병관리본부에서 발표하는 치사율은 10% 초반으로 기존에 알려져 있는 치사율에 비해 현저히 낮은 수준을 보였다. 이는 전염 진행 과정에서 사망 또는 퇴원하지 않고 입원 중인 메르스 확진 환자의 수를 고려하지 않은 확진자 중 사망자의 비율을 사용하는 단순추정법에 기인한 것이었다. 치사율은 그 값에 따라서 전염병의 대처 정책에 큰 영향을 미치는 값이므로 전염 과정의 초기부터 안정적으로 치사율을 추정하는 것이 중요하다. 따라서 본 연구에서는 기존의 추정치에 비해 감염의 초기 단계에서부터 안정적으로 치사율을 추정하는 방법을 제시한다. 제시된 추정치는 메르스로 인한 사망자 수 이외에 입원 환자의 상태의 정보를 활용하였다. 새로운 추정치의 성능을 보기 위하여 한국에서 발생한 감염 이후 2015년 8월 10일까지 186명의 감염자 자료를 사용하여 치사율을 추정하고 기존의 여러 가지 치사율 추정치와 비교하였다. 제시한 추정치는 감염의 초기 단계에서부터 다른 추정치에 비해 안정적인 모습을 보였다.

• 한국학교보건학회지
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• 제28권3호
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• pp.188-199
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• 2015

Purpose: This study aims to understand schools' response to infectious disease, perceived problems and suggestions, with regard to the 2015 MERS outbreak in South Korea, in order to improve the infectious disease response system. Methods: Data were collected by focus group interviews with three groups composed of school health teachers, other teachers, and parents in Seoul-located schools. Results: The major theme was "Schools' Discretionary Response in the Absence of the Control Tower." Four major categories and 11 sub-categories were drawn from the findings. Four major categories were as follows: (a) Temperature monitoring caused lots of complaints, (b) Closure decisions were left at the discretion of schools, (c) Precautions are now being more emphasized, and (d) The support system were malfunctioning. Conclusion: The main areas to be improved are as follows: (1) School district offices should have an expanded role in infectious disease response and build cooperative partnerships with health authorities. (2) Preparedness for infectious disease should be strengthened. (3) Temperature monitoring systems should be improved, (4) Closure decisions should be made at a local community level. These are expected to help schools establish advanced infectious disease response systems.

• 한국학교보건학회지
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• 제28권3호
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• pp.150-157
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• 2015

Purpose: The purpose of the study was to survey male high school students on their MERS(Middle East Respiratory Syndrome)-related knowledge, risk perception, and health behaviors and to identify the factors affecting health behaviors during the MERS outbreak in Korea. Methods: The subjects in this study were 144 students in a male high school. Data were collected through self-reported questionnaires in July, 2015. The collected data were analyzed by ANOVA, Pearson's correlation and multiple regression using SPSS/WIN 21.0. Results: The proportion of correct answers to questions testing MERS-related knowledge was 71.6% among male high school students; their health behaviors were rated at 48.9%; and their risk perception rate was 1.8 out of 4. There was a positive correlation between knowledge, risk perception, and health behaviors. Knowledge and risk perception explained 15.1% of the variance in health behaviors. Conclusion: To improve students' health behaviors, their risk perception and knowledge over MERS should be strengthened. Therefore, it is necessary to develop and implement efficient and feasible MERS education programs for high school students.

• 의학교육논단
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• 제18권2호
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• pp.99-105
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• 2016

The purpose of this study was to inquire into the knowledge of medical students on the Middle East respiratory syndrome (MERS) and evaluate whether infection prevention education impacts students' level of knowledge and individual hygiene practices. This study also investigated the route by which medical students obtain disease-related information. The study involved a survey conducted in August of 2015 at two medical schools in Busan. In the first year to fourth year, a total of 345 students are enrolled (111 students in A school and 234 students in B school). Before the study was carried out, university A performed infection prevention education related to MERS, but B did not. We used self-developed questionnaires to survey the demographic characteristics, routes of acquisition of MERS information, degree of knowledge of MERS, educational satisfaction, and personal hygiene practices before and after education. Knowledge level differences according to gender and year in school were not statistically significant. Students obtained their information about MERS from various news media sources and the Internet, and through social network sites. Students practiced sanitary control behaviors in an average of 2.2 manners (standard deviation=0.95). The level of knowledge of MERS revealed a positive correlation with the frequency and total numbers of personal hygiene practices. This finding suggests that the infection prevention education program played a role in knowledge acquisition and personal hygiene practices for the medical students. In order to provide accurate and reliable knowledge of disease and preventive health behavior to medical students, continuous and well-planned education programs are necessary.

• Genes and Genomics
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• 제40권12호
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• pp.1363-1371
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• 2018

One of the main concerns in biology is extracting sophisticated features from DNA sequence for gene interaction determination, receiving a great deal of researchers' attention. The epigenetic modifications along with their patterns have been intensely recognized as dominant features affecting on gene expression. However, studying sequenced-based features highly correlated to this key element has remained limited. The main objective in this research was to propose a new feature highly correlated to epigenetic modifications capable of classification of genes. In this paper, classification of 34 genes in PPAR signaling pathway associated with muscle fat tissue in human was performed. Using different statistical outlier detection methods, we proposed that 5-mers highly correlated to epigenetic modifications can correctly categorize the genes involved in the same biological pathway or process. Thirty-four genes in PPAR signaling pathway were classified via applying a proposed feature, 5-mers strongly associated to 17 different epigenetic modifications. For this, diverse statistical outlier detection methods were applied to specify the group of thoroughly correlated genes. The results indicated that these 5-mers can appropriately identify correlated genes. In addition, our results corresponded to GeneMania interaction information, leading to support the suggested method. The appealing findings imply that not only epigenetic modifications but also their highly correlated 5-mers can be applied for reconstructing gene regulatory networks as supplementary data as well as other applications like physical interaction, genes prioritization, indicating some sort of data fusion in this analysis.

• IMMUNE NETWORK
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• 제22권5호
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• pp.41.1-41.16
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• 2022

The human antimicrobial peptide LL-37 has chemotactic and modulatory activities in various immune cells, including dendritic cells. Because of its characteristics, LL-37 can be considered an adjuvant for vaccine development. In this study, we confirmed the possible adjuvant activity of LL-37 in mucosal vaccine development against Middle East respiratory syndrome-coronavirus (MERS-CoV) by means of intranasal immunization in C57BL/6 and human dipeptidyl peptidase 4 (hDPP4)-transgenic (hDPP4-Tg) mice. Intranasal immunization using the receptor-binding domain (RBD) of MERS-CoV spike protein (S-RBD) recombined with LL-37 (S-RBD-LL-37) induced an efficient mucosal IgA and systemic IgG response with virus-neutralizing activity, compared with S-RBD. Ag-specific CTL stimulation was also efficiently induced in the lungs of mice that had been intranasally immunized with S-RBD-LL-37, compared with S-RBD. Importantly, intranasal immunization of hDPP4-Tg mice with S-RBD-LL-37 led to reduced immune cell infiltration into the lungs after infection with MERS-CoV. Finally, intranasal immunization of hDPP4-Tg mice with S-RBD-LL-37 led to enhanced protective efficacy, with increased survival and reduced body weight loss after challenge infection with MERS-CoV. Collectively, these results suggest that S-RBD-LL-37 is an effective intranasal vaccine candidate molecule against MERS-CoV infection.

• 정신신체의학
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• 제25권2호
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• pp.111-119
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• 2017

연구목적 본 연구는 메르스(Middle East Respiratory Syndrome, MERS(Middle East Respiratory Syndrome, 이하 MERS) 사태 발생 당시에 받은 스트레스가 사회심리적 건강에 미치는 영향을 알아보고, 회복탄력성이 매개효과로서 사회심리적 건강에 영향을 주는지를 알아보고자 하였다. 방 법 MERS가 발생한 병원의 병원종사자 156명과 일반인 127명을 대상으로 스트레스 자각척도, 사회심리적 건강측정 도구, 코너-데이비슨 리질리언스 척도를 시행하였다. 스트레스가 사회심리적 건강에 미치는 영향 및 회복탄력성의 매개효과를 확인하기 위해 피어슨 상관관계분석과 위계적 다중회귀분석을 실시하였다. 결 과 병원종사자와 일반인 모두에서 지각된 스트레스가 높을수록 사회 심리적 건강이 좋지 않음을 보였고, 지각된 스트레스가 높을수록 낮은 회복탄력성을 나타냈으며, 스트레스와 사회심리적 건강 사이의 관계에서 회복탄력성이 부분 매개를 하는 것으로 나타났다. 결 론 본 연구는 MERS 사태로 인해 받은 스트레스가 사회심리적 건강에 영향을 미침에 있어서 개인의 회복탄력성의 정도가 간접적으로 사회심리적 건강에 긍정적 효과를 끼칠 수 있고, 회복탄력성 강화를 목표로 한 임상적 개입 및 사회심리적 접근방법이 위기 발생시 정신건강을 유지하는데 중요함을 시사한다.

• 한국산학기술학회논문지
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• 제18권3호
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• pp.175-184
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• 2017

본 연구는 메르스 대유행 시 코호트 격리된 병원 간호사의 이직의도 영향요인을 확인하여 추후 감염병 유행 시 간호사 인적관리를 위한 기초자료를 제공하고자 시행되었다. 연구대상자는 메르스 대유행 시에 코호트 격리된 3개의 병원에서 메르스 확진환자나 의심환자 간호에 직접 참여하였거나, 메르스 확진 혹은 의심환자를 직접 돌보지는 않았으나 이들 환자가 있는 병동 혹은 병원에 근무한 267명의 간호사이다. 원 자료의 수집은 2015년 10월 1일부터 11월 30일까지 이루어졌으며, 수집된 자료는 SPSS/WIN 21.0을 사용하여 빈도와 백분율, t-test, ANOVA 및 다중 회귀분석을 실시하였다. 본 연구에서 대상자의 이직의도에 영향을 미치는 요인은 근무기간과 평소 스트레스로 나타났으며, 메르스 확진환자를 직접 간호한 간호사들의 경우 높은 메르스 스트레스를 경험하였음에도 불구하고(p<.001) 이직의도에는 통계적으로 유의한 영향을 미치지 않았다. 본 연구결과에서 주목해야 할 부분은 치명적인 감염을 야기할 수 있는 메르스 환자 간호에 직 간접적으로 참여한 간호사가 경험한 메르스 스트레스보다 평소 스트레스가 이직의도에 유의한 영향을 미친다는 점이다. 따라서 간호사의 이직의도를 감소시키고, 성공적인 인력관리를 위해서는 감염성 질환과 관련된 특수한 상황에서의 간호사의 스트레스 관리 뿐 아니라 평소 직무특성을 고려한 스트레스 완화에 더 많은 관심을 가질 필요가 있는 것으로 나타났다.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.334-344
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• 2018

본 연구는 메르스 대유행시 요양병원 종사자의 메르스에 대한 지식, 태도 및 감염예방행위 실천도와의 관계를 파악하기 위하여 시도되었다. 연구대상자는 J도 소재 요양병원 종사자 211명으로 구조화된 설문지를 이용하였으며, 자료수집기간은 2015년 6월 15일부터 7월 15일까지였다. 자료 분석은 SPSS/WIN 24.0을 이용하여 independent t-test, ANOVA, Welch test로 분석하였고, 사후 검정은 scheff test, Grames-hawell test 방법으로 시행하였다. 요양병원 종사자의 메르스에 대한 지식점수는 간호사와 간호조무사, 감염관리 교육경험이 있는 경우, 지난 해 인플루엔자 예방접종을 한 경우, 손소독제 사용이 용이한 경우에 높았으며, 메르스에 대한 태도는 간호사가 간호조무사와 간병인보다 긍정적이었다. 메르스 감염예방행위 실천도는 일상생활에서는 지난 해 인플루엔자 예방접종을 한 경우, 환자 간호 시에는 지난 해 인플루엔자 예방접종을 한 경우, 손소독제 사용이 용이한 경우에 높았다. 요양병원 종사자의 메르스에 관한 지식, 태도 및 감염예방행위 실천도와의 관계는 지식이 높고, 태도가 긍정적일수록 감염예방행위 실천도가 높게 나타났다. 이에 메르스와 같은 신종감염병이 유행할 때, 요양병원에서는 메르스 질병 특성 및 전파, 예방법이 포함된 감염관리 교육을 실시해 메르스에 대한 지식수준을 높이고, 태도를 긍정적으로 유도하여, 감염예방행위 실천도를 향상시킬 필요가 있을 것이다.