• Title/Summary/Keyword: 고연령화

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Neonatal hearing screening in a neonatal intensive care unit using distortion product otoacoustic emissions (변조 이음향방사(DPOAE)를 이용한 고위험군 신생아 청각선별검사)

  • Kim, Do Young;Kim, Sung Shin;Kim, Chang Hwi;Kim, Shi Chan
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.507-512
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    • 2006
  • Purpose : Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). Methods : The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups : 'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. Results : The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (${\geq}60dB$) in this study was 2 percent(18 out of 871). Conclusion : This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.

Comparison of Epileptic Seizures between Preterm and Term-born Epileptic Children with Periventricular Leukomalacia (뇌실 주위 백질연화증이 있는 간질 환아에서 조산 및 만삭 출산군 간의 간질 발작 유형의 비교)

  • Jeong, Hee Jeong;Lee, Eun Sil;Moon, Han Ku
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1225-1231
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    • 2005
  • Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.

Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients (소아에서 시행한 치료적 혈장교환술 9례의 임상적 고찰)

  • Lee Jee-Hyun;Jeon Ga-Won;Park Sung-Eun;Jin Dong-Kyu;Paik Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.38-45
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    • 2005
  • Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.

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The Analysis of Radiation Exposure of Hospital Radiation Workers (병원 방사선 작업 종사자의 방사선 피폭 분석 현황)

  • Jeong Tae Sik;Shin Byung Chul;Moon Chang Woo;Cho Yeong Duk;Lee Yong Hwan;Yum Ha Yong
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.157-166
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    • 2000
  • Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

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Fish Community Characteristics and Habitat Aspects of Endangered Species Pseudopungtungia tenuicorpa and Acheilognathus signifer in the Hwayangcheon Stream, Hangang River of Songnisan National Park, Korea (속리산국립공원 화양천의 어류군집 특성 및 멸종위기종 가는돌고기 Pseudopungtungia tenuicorpa와 묵납자루 Acheilognathus signifer의 서식양상)

  • Ko, Myeong-Hun;Han, Mee-Sook;Myung, Ra-Yeon;Yun, Hyeong-Jin
    • Korean Journal of Ichthyology
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    • v.31 no.4
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    • pp.222-234
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    • 2019
  • Fish community characteristics and habitat aspects of endangered species, Pseudopungtungia tenuicorpa and Acheilognathus signifer were investigated in the Hwayangcheon Stream of Songnisan National Park, a tributary of the Hangang River, Korea from April to October 2018. During this period, there were 29 species of 8 families collected from 11 survey stations using kick nets, cast nets long bag set nets. The dominant and subdominant species were Zacco koreanus (38.81%) and Rhynchocypris oxycephalus (16.64%), respectively. The next most abundant species were Z. platypus (14.28%), Pungtungia herzi (6.92%), Hemibarbus longirostris (4.52%), Pseudogobio esocinus (3.51%), A. signifer (2.31%) and P. tenuicorpa (1.90%). Among the fish collected, 18 species (62.1%) were Korean endemic species. Endangered species were A. signifer, P. tenuicorpa and Gobiobotia brevibarba. From upstream to downstream, the dominance index has gradually decreased, but number of species and individuals, diversity and evenness has gradually increased. Also, river health (index of biological integrity) is assessed as good (St. 1~8) and very good (St. 9~11). Fish communities were divided into four sections by the similarity index based on species and their numbers, i.e., upper section (St. 1~2, 4~5), upper-middle section (St. 3, 6), middle section (St. 7~9) and lower section (St. 10~11). Endangered species, Pseudopungtungia tenuicorpa inhabited in mostly lower section (St. 10~11) with rock and boulder bottoms, and age groups in April estimated from total length indicated that the 44~61 mm group is 1 year old, the 66~81 mm group is 2 years old, the 88~99 mm group is 3 years old, and the 104~107 mm group is more than 4 years old. Also, endangered species, A. signifer inhabited in middle-lower section (St. 7~11) with boulder and cobble bottoms and slow velocity, which the place inhabited by water plants. Meanwhile, their age structure in April estimated from total length indicated that the 30~43 mm group is 1 year old, the 48~58 mm group is 2 years old, the 62~77 mm group is 3 years old, and the 84~100 mm group is more than 4 years old. The sex ratio of female (47) to male (42) was 1 : 0.89.

Sodium and Potassium Content of School Meals for Elementary and Junior High School Students in Daegu, Masan, Gwangju, and Jeju (대구, 마산, 광주, 제주지역 학교급식의 나트륨 및 칼륨 함량 분석)

  • Lim, Hyeon-Sook;Ko, Yang Sook;Shin, Dongsoon;Heo, Young-Ran;Chung, Hae-Jung;Chae, In-Sook;Kim, Hwa Young;Kim, Mi-Hye;Leem, Dong-Gil;Lee, Yeon-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.8
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    • pp.1303-1317
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    • 2013
  • The purpose of this study was to determine the sodium (Na) and potassium (K) content of school meals served in elementary and junior high school in Korea. In this study, 872 kinds of school meal dishes were collected from twelve elementary and twelve junior high schools located in four different cities in Korea (Daegu, Masan, Gwangju, and Jeju). The dishes were classified into three main categories; staple dish, subsidiary dish, and dessert. Each main category was further sub-classified into 4 kinds of staple dishes, 15 kinds of subsidiary dishes, and 5 kinds of dessert dishes. The Na and K content of dishes were then analyzed by atomic absorption spectroscopy. The Na content of individual dishes showed considerable differences, ranging from 9 to 2,717 mg/100 g. Among the staple dishes, cooked rice contained relatively less Na, but other staple dishes such as a la carte, noodle, and rice-gruel contained considerably high amounts of Na. Regarding the subsidiary dishes, the Na content of salad was low, but those of Jangachi, stir-fried dishes, and kimchi were considerably high. Among the dessert dishes, beverages, fruit, and milk/dairy products contained relatively low amount of Na, while rice cakes and baked goods, and snacks contained noticeably high amounts of Na. Unlike the Na content, the K content between the dishes did not show much variability. Cooked rice and rice cakes contained relatively low amounts of K, similar to other dishes, and ranged from 104 to 220 mg/100 g. The Na/K ratio was especially high in rice cakes and Jangachi, while of the ratio in beverages, milk/dairy products, salad, and fruit were pretty low. The total content of Na and K and the Na/K ratio of elementary school meals were 974 mg, 378 mg and 2.7, respectively, and those in junior high school meals was 1,466 mg, 528 mg and 3.0. The results show that most school meals provide a significant amount of Na but significantly small amounts of K, as suggested by the Dietary Reference Intakes for Koreans.

Clinical Study of Pulmonary Thromboembolism (폐혈전색전증의 임상적 연구)

  • Bak, Sang-Myeon;Lee, Sang-Hwa;Lee, Sin-Hyung;Sin, Cheol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.106-116
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    • 2001
  • Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.

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Clinical Observations on 12 Children with Alport Syndrome (Alport 증후군 환아 12명의 임상적 고찰)

  • Bae Young-Min;Kim Seoung-Do;Kang Hyeon-Ho;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.48-56
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    • 2000
  • Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

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SHRIMP V-Pb Zircon Ages of the Granite Gneisses from the Pyeonghae Area of the northeastern Yeongnam Massif (Sobaeksan Massif) (영남(소백산)육괴 북동부 평해지역 화강편마암류의 SHRIMP U-Pb 저콘 연대)

  • Kim, Nam-Hoon;Song, Yong-Sun;Park, Kye-Hun;Lee, Ho-Sun
    • The Journal of the Petrological Society of Korea
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    • v.18 no.1
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    • pp.31-47
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    • 2009
  • We performed petrological, geochemical, and geochronological study for the Pyeonghae granite gneiss and the Hada leuco-granite gneiss intruding the Paleoproterozoic meta-sedimentary rocks (pyeonghae formation and Wonnam formation) of the Pyeonghae area located in northeastem part of the Yeongnam (Sobaeksan) massif. The Pyeonghae granite gneiss generally has higher abundance of mafic minerals (biotite etc.), and posesses higher ${Fe_2}{O_3}^t$, MgO, CaO, $TiO_2$, $P_{2}O_{5}$ contents but lower $SiO_2$ and $K_{2}O$ contents than the Hada leuco-granite gneiss which tends to have slightly high $Al_{2}O_{3}$ and $Na_{2}O$ contents and slightly high larger negative Eu anomalies. However both gneisses reveal very similar REE concentrations and chondrite-normalized patterns and apparently show differentiation trend affected by crystallization of biotite, plagioclase, apatite and sphene. Their peraluminous and calc-alkaline chemistry suggests tectonic environment of volcanic arc. SHRIMP Zircon U-Pb age determinations yield upper intercept ages of $1990{\pm}23\;Ma$ ($2{\sigma}$) and $1939{\pm}41\;Ma$ ($2{\sigma}$), and weighted mean $^{207}Pb/^{206}Pb$ ages of $1982{\pm}6.3\;Ma$ ($2{\sigma}$) and $1959{\pm}28\;Ma$ ($2{\sigma}$) for the Pyeonghae granite gneiss and the Hada leuco-granite gneiss respectively, showing overlapping ages within the error. Our study suggests that the Precambrian granitoids in this area intruded contemporaneously with the Buncheon granite gneissin volcanic arc environment.