• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1175-1180
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• 2009

We report a case of a full-term neonate with persistent pulmonary hypertension who developed asphyxia after birth and was treated with iloprost. The neonate had persistent hypoxia and did not respond to supportive treatment. Because inhaled nitric oxide (iNO) was not available in our hospital, inhaled iloprost was administered via an endotracheal tube. This resulted in an immediate elevation of oxygen saturation. Echocardiography revealed the conversion of the right-to-left ductal shunt to the left-to-right one and a decrease of the right ventricular pressure. The use of inhaled iloprost did not cause any significant side effects. Here, we describe our experience where iloprost was used in a neonate with persistent pulmonary hypertension because the standard therapy with inhaled nitric oxide was not available.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.76-84
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• 2002

Objectives：This study was conducted to investigate the effect of oxygen on attention and memory functions in healthy adolescents. Methods：The participant subjects were recruited from local advertisement. All subjects are students attending ordinary middle and high school. Their degree of achievement was average or below average. Before the study, its nature and purpose were fully explained to the patients and their parents, and a written informed consent was obtained from each child's parent and a written assent from each child for entire the procedure. The Ethics Committee and Clinical Research Committee of Gyeongsang National University Hospital approved the protocol. For baseline assessment, all subjects received tests for attention and memory. All tests were conducted by a certified psychologist. Stroop test, continuous performance test and trail making test A and B were used for evaluation of attention. As memory tests, we used memory assessment scale(MAS), standardized memory assessment tools. Ten to fourteen days after initial assessments, same tests was applied to the same subjects after prior 5 minute oxygen inhalation. Results：1) Attention test：Improved performances in trail making part B, and stroop test were found in normobaric oxygen inhalation group compared to air inhalation group. Improved reaction time in those tests seemed to reflect the enhanced executive prefrontal activity. 2) Memory test：More words and digits memorization were found in short-term memory subscale score in MAS in oxygen inhalation group compared to air inhalation group. This finding suggested the improved working memory function after oxygen inhalation. Conclusion：Though interpreted cautiously, these results suggested that normobaric oxygen inhalation could enhance executive function and working memory of prefrontal lobe. Further study, however, should be performed to investigate the mechanism of effects of oxygen on cognitive enhancement.

• Proceedings of the Korean Society of Disaster Information Conference
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• 2022.10a
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• pp.381-382
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• 2022

국내에서 1980년대까지 연탄을 에너지로 많이 사용하면서 일산화탄소 중독이 빈번하여 고압산소치료가 활용되다가 이후 연탄 사용의 감소로 고압산소치료기가 대부분 활용되지 못하고 폐기되는 경우도 많았다. 이후 세월호 사고에서의 잠수사들에 대한 고압산소치료 적용, 가스누출이나 번개탄을 활용한 자살시도가 빈번해지며 고압산소치료기를 보유하고 있는 기관이 부족해 적절한 치료를 제 때 받지 못하여 고압산소치료기의 필요성이 되두되었다. 국내에서는 2021년 기준으로 한해 36,266 건의 화재가 발생하고 2020년에 365명이 화재로 사망하며, 화재로 인한 손상은 1,917건이었는데. 화재 시 여러 유독가스를 흡입하게 되고, 이에 따라 고압산소치료가 필수적으로 진행되어야 한다. 유해화학물질 사고, 대규모 오염, 다양한 교통수단에서의 대형 사고, 건축물 붕괴 사고 및 대규모 지진, 화산폭발 같은 자연재해 시에도 가스 중독이 발생하며, 이는 고압산소치료가 필요하게 된다. 따라서 다양한 종류의 재난에서 발생하는 유독가스 피해자에게 고압산소치료는 필수적이나 본 연구에 의하면 국내에는 고압산소치료챔버의 숫자와 동시에 고압산소치료로 수용할 수 있는 환자수에도 한계가 있고 그 분포의 불균형도 존재하고 있어 재난 시 인명 피해 감소의 기반 장비, 시설로서 고압산소챔버의 균형있는 확산, 적용이 시급한 실정이다. 다행히 최근 전국적으로 고압산소챔버가 증가하는 추세에 있어 그 현황과 배치 상황을 조사하여 이를 통하여 고압산소챔버가 필요한 유독가스 발행 재난에 대비할 수 있는 역량이 증가하고 있다.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.42-49
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• 1999

Background: In patients with chronic obstructive pulmonary disease(COPD). it is well known that hypoxemia increases the frequency of VPB, which is associated with the poor prognosis such as sudden death. The aim of this study is to evaluate the effect of short and long-term low flow oxygen therapy on the development of VPBs in patients with COPD by correcting the hypoxemia. Method: In 19 patients with COPD, oxygen saturation and VPB's were monitored by pulse oxymeter and 24-hour Holter EKG, with room air and oxygen saturation and VPB's were monitored on the 1st and on the 8th day during oxygen therapy with nasal prong (2L/min). Results : The arterial oxygen saturation was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and was also higher on the 8th day of oxygen therapy than on the 1st day. We found that there was significant correlation between the lowest value of the arterial oxygen saturation and the mean value of the arterial oxygen saturation. The number of VPB's per hour was significantly lower on the 1st day of oxygen therapy compared with breathing room air, and also lower on the 8th day of oxygen therapy than on the 1st day. Our results showed positive correlation between the decrease in the frequency of VPB's and the increase in the lowest arterial oxygen saturation, even though correlation was not significant(p=0.056). Conclusion: With oxygen therapy, the arterial oxygen saturation was increased and the number of VPB's was decreased. Long-term oxygen therapy more than 7days, would be helpful to decrease the number of VPB' s in patients with COPD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.117-128
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• 2002

Objectives：For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods：Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results：(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions：Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.564-570
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• 2006

Toxic gases and soot deposition as a consequence of smoke inhalation can cause direct injury to the upper and lower airways and even to the lung parenchyma. A delay in proper and prompt therapy can be detrimental to critically ill burn patients with an inhalation injury. Therefore, serial chest radiography is an important diagnostic tool for pulmonary complications during treatment. The radiographic findings of the chest include normal, consolidation, interstitial and alveolar infiltrates, peribronchial thickening, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, and a pneumothorax as acute complications of smoke inhalation. In addition, bronchiectasis, bronchiolitis obliterans and pulmonary fibrosis can occur as late complications. We encountered a case of 44-year-old male who presented with acute lung injury after an inhalation injury. He required endotracheal intubation and mechanical ventilation due to respiratory failure. He was managed successfully with conservative treatment. Later, a cavitary lesion of the left upper lobe was observed on the chest radiography and computed tomography, which was complicated by massive hemoptysis during the follow-up. However, the cavitary lesion disappeared spontaneously without any clinical consequences.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.75-79
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• 2015

Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.313-323
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• 2021

The purpose of this study was to investigate trends in dental sedation of Korean children and adolescents. A retrospective study was conducted on patients under 20 years of age who received dental treatment under sedation using National Health Insurance Service-National Sample Cohort Database from 2002 to 2015. Based on the 1 million standard data, there were 436 cases of dental treatment under sedation in 2002, but 4002 cases in 2015, showing a trend increasing every year. The 3 - 5 year old group accounted for the largest portion (54.2%), while the 6 - 8 year old group increased recently. Nitrous oxide inhalation sedation is the most commonly used, accounting for 45.9% in 2002, but increased to 89.5% in 2015. Combination of nitrous oxide inhalation sedation, chloralhydrate and hydroxyzine was the most common, accounting for 5.7% in 2002, but decreased to 2.9% in 2015. There is a trend to use the sedation method more safely and in a way that reduces side effects.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.12-25
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• 2003

Objectives：As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods：Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results：1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion：Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.