• Title/Summary/Keyword: 고위험군

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Asthma predictive index in children with recurrent wheezing (반복성 천명을 가진 소아에서 천식 발생 예측 지표의 적용)

  • Jang, Joo Young;Kim, Hyo Bin;Lee, So Yeon;Kim, Ja Hyung;Kim, Bong Seong;Seo, Hee Jung;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.298-304
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    • 2006
  • Purpose : We compared the asthma predictive index(API) and the modified asthma predictive index (mAPI) of the Tuscon Children's Respiratory Study Group in Korean children with recurrent wheezing. We investigated the atopic profiles and presence of allergen sensitization of each risk group, and ascertained the significant clinical risk factors. Methods : Two hundred and sixty two children, who visited for recurrent wheezing from 1998 to 2005, were enrolled and divided into groups by API and mAPI. We investigated the history of the patients and their families, atopic profiles, and sensitization to aeroallergen and food allergens. Twenty nine children were followed up to 6 years of age and we evaluated the sensitivity, specificity and positive and negative predictive value of both indices. Results : The high risk group of API were of older age, were more likely to be sensitized to aeroallergen(P=0.001) and food allergen(P=0.034) and had higher levels of total eosinophil count, eosinophil percent, serum ECP, total IgE, and D.p-, D.f-specific IgE. High risk group of mAPI showed higher levels of atopic markers such as egg-, milk-, D.p- and D.f-specific IgE. Even though API did not include allergen sensitization, the high risk group was more significantly sensitized to common allergens than the low risk group. Twenty nine children were followed up until 6 years of age; therefore 15 children were diagnosed as asthma, clinically. The sensitivity, specificity, positive and negative predictive values of mAPI were higher than API. Conclusion : Both high risk groups of API and mAPI had higher levels of atopic markers and were more sensitized to common allergens. These findings suggest that sensitization to aeroallergens and food allergens are more objective markers as asthma predictive indices. In addition, mAPI is a more reliable index in predicting asthma in Korean children with recurrent wheezing than is API. But only 29 patients were followed until the age of 6, so we need to include more children with long term follow up for future study.

Study of Serious Bacterial Infections in Febrile Infants Younger than Three Months of Age (열이 있는 3개월 이하의 영아에서 세균성 감염의 예측에 대한 연구)

  • Jeon, Myeoung Won;Lee, Ji Young;Jang, Young Taek
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.215-222
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    • 2003
  • Purpose : This study was to analyze serious bacterial infections in infants younger than three months of age and to review the direction of treatments for these patients. Methods : 378 febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ visited from Jan. 2001 through Dec. 2002 were retrospectively studied. Infants with the following criteria belonged to the low risk group. WBC $5,000{\sim}15,000/mm^3$, WBC negative in urine stick test and negative for nitirite test, CSF WBC < $10/mm^3$ and negative in CSF gram stain, negative chest X-ray, stool WBC <5/HFP(high power field), and focal infection. If any of the above criteria were not met, they belonged to the high risk group. SBI was defined as a positive culture of urine, blood or CSF. SI was defined as aseptic meningitis or pneumonia including above laboratory tests of SBI. SBI patients were separately compared with two groups, high risk and low risk. Results : Of the 378 infants that were tested 216(57.1%) were in the high risk group and 162(42.9%) in the low risk group. Among 105 SBI(27.8%) and 172 SI(45.5%), there were 98 urinary tract infection(25.2%), 10 bacteremia(2.6%), 2 bacterial meningitis(0.6%), and 77 aseptic meningitis(22.8%). There were 76 SBI(35.2%) from the high risk group and 29 SBI(17.9%) from the low risk group identified. The results of the sensitivity(72.4%), the specificity(48.7%), the negative predictive value(82.1%) and the positive predictive value (35.2%) were calculated. Conclusion : Even though the probability of SBI in the low risk group is insignificant, it should still be considered in febrile infants younger than 3 months of age. I believe the CSF study is necessary because of the moderate high incidence of abnormal finding in our study.

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The Effects of Job Stress and Psychosocial Stress among Dental Hygienists (치과위생사의 직무스트레스가 사회심리적 스트레스에 미치는 영향)

  • Won, Young-Soon;Oh, Han-Na
    • Journal of dental hygiene science
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    • v.15 no.5
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    • pp.679-687
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    • 2015
  • The purpose of this study was to examine the job stress and psychosocial stress of dental hygienists and risk factors related to psychosocial stress. The subjects in this study were 349 dental hygienists in dental hospitals and clinics located in Jeonbuk Province. A self-administered survey was conducted, and the collected data were analyzed. The findings of the study were as follows: The median of their total scores in job stress was 46.0, and the average of psychosocial stress scores was 23.67. As a result of analyzing their demographic characteristics and psychosocial stress, many of the respondents who were younger, who had less working experience and who drank once or twice a week belonged to the high-risk group of psychosocial stress (p<0.05). Concerning the relationship between job stress and psychosocial stress, many of the respondents who suffered from heavier job stress belonged to the high-risk group of psychosocial stress (p<0.05). The group whose occupational climate was less stressful was 3.6-fold more likely to belong to the high-risk group of psychosocial stress than the other whose workpalce culture was more stressful before the correction of the data, and the former was 3.4-fold more likely to do that than the latter after that. The group whose total score in workplace stress was higher was 2.3-fold more likely to belong to the high-risk group of psychosocial stress than the other whose workplace stress was lower before the correction of the data, and the former was 2.7-fold more likely to do that than the latter after that. Given the findings of the study, the development of job stress management programs is required, and everybody should make sustained self-management efforts to relieve their own stress and try to get rid of it in their own way.

Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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Dental Caries Status of 14-16 Year Old Adolescents in Yangsan Area (양산시 거주 14-16세 청소년의 치아우식증 상태에 대한 조사연구)

  • Kwon, Bomin;Bae, Ikhyun;Kim, Shin;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.8-17
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    • 2014
  • Although adolescents usually show peculiar aspects in oral health status, there have been not so many studies about it, while there have been innumerable studies for children. This study aimed at evaluating the prevalence of dental caries of adolescents in Yangsan in Republic of Korea, detecting its contributing factors, and distinguishing the high-risk group by epidemiological mass survey. Besides, the significance including early caries lesion in diagnosis criteria was assessed with minimal invasive concept. This survey was performed on 1,371 adolescents aged 14 to 16 in Yangsan as subject examinees by a single trained examiner. The dental caries status was checked by oral examination at schools and questionnaire survey was accompanied for some relevant risk factors. The data were analyzed to yield the results as follows: Regarding the caries experience, the DMFT score by WHO criteria with ECL including or not was 4.79 and 3.97 respectively. In both the criteria, female showed higher values and that of high-risk group was almost twice compared with whole examinees by Sic Index. About pit & fissure sealed rate, it revealed the tendency that the more sealed teeth, the lower DMFT values. Among the studied risk factors, only the habit of brushing before going to bed showed positive relationship (p < 0.05).

Predictors of Serious Bacterial and Viral Infections among Neonates with Fever (신생아 발열 환자에서 중증 감염의 예측 인자)

  • Choi, Ui-Yoon;Lee, Jung-Soo;Lee, Jung-Hyun
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.61-66
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    • 2008
  • Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

Caries Management of High-Risk Children by Caries Risk Assessment (우식위험평가에 의한 우식 고위험 유아의 치아우식 관리)

  • Koo, Seo-Yeon;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.18 no.2
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    • pp.97-104
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    • 2018
  • The purpose of this study was to classify risk groups according to Caries Risk Assessment (CRA) and to investigate the effect of caries prevention program after 1 year of caries prevention intervention program in 6-year-old infants with high caries risk. The subjects were selected based on responses to CRA questionnaires. At the first visit, oral examination, Cariview, bacteria and saliva flow test were performed. The caries risk group was classified accordingly. The subjects were given fluoride application and oral health education every four months and evaluated the same as the first visit after 1 year. As a result of classifying the risk level according to CRA, more than 80% of the subjects were in the high or extreme high risk. The dft index was increased in all risk groups after the intervention. There was a significant difference between the before and after intervention (p<0.05). The Cariview score showed a slight decrease after the intervention in the moderate and high risk groups. As a result of the evaluation of bacteria test, Streptococcus mutans were decreased to ${\geq}10^5CFU/ml$ saliva after intervention in all groups. Lactobacilli were decreased after intervention in high risk and extreme high risk groups. As a result of saliva flow, there was significant difference between caries risk groups before and after intervention (p<0.05). In conclusion, regular caries management has been shown to influence caries risk factors in high-caries risk children. Also, it is necessary to find out periodical dental risk management system which is suitable for domestic situation through the related studies.

Prevalence of Human Papillomavirus by DNA Chip Test in Women (여성에 있어 DNA 칩검사에 의한 인유두종바이러스 감염률의 조사)

  • Kim, Jae-Woo;Kim, Yun-Tae;Kim, Dae-Sik;Choi, Seok-Cheol
    • Journal of Life Science
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    • v.18 no.12
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    • pp.1657-1664
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    • 2008
  • We determined the prevalence of human papillomavirus (HPV) by DNA chip test in 549 women and cytologic diagnosis. 237 of 549 women (43.17%) subjected with HPV DNA Chip examination were found positive for HPV. 210 (88.60%, High group) were infected with high-risk HPV types. 17 (7.17%, Low group) were infected with low-risk HPV types (6, 11, 40, 44, 70) and 17 (7.17%, Mixed group) were infected with mixed types. According to age, in their twenties, thirties, forties, fifties and over sixties, the prevalence of infection with high-risk HPV types were 1.26% (3/237), 15.61% (37/237), 31.65% (75/237), 23.21% (55/237), and 13.92% (33/237), respectively. In the Low and Mixed group, percentages of infection with HPV were significantly lower than that of the High group. On the comparison of cytologic diagnosis (224 women) by Pap smear and DNA chip positive (237 women) for HPV, 132 out of 194 cases in the High group (68.04%) suffered cervical lesions with ASCUS (atypical squamous cells of undetermined significance, 7.22%), LSIL (low grade squamous intraepithelial lesion, 15.98%), HSIL (high grade SIL, 23.20%) and ICC (invasive cervical cancer, 21.65%). The Low group (14/224 women) showed 1 case of ASCUS and 6 cases of LSIL, whereas the Mixed group (4/224 women) had only 2 cases of ASCUS. According to the HPV subtypes, the high-risk types 16 and 18 induced 26 and 7 cases of ICC, respectively, whereas other HPV subtypes induced lower or no ICC incidence. In conclusion, the present data imply that the prevalence of HPV was 43.17%, high-risk HPV type 16 is a major factor, which causes precancerous and/or cervical cancer in woman and that HPV DNA chip is an accurate and useful tool for detecting HPV.