• Title/Summary/Keyword: 이중상

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The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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The Brewing of Kochuzang (Red Pepper Paste) from Different Starch Sources - Part I. Proximate Component and Enzyme Activity during Koji Prepartion - (전분질(澱粉質) 원료(原料)를 달리한 고추장의 양조(釀造) - 제1보(第1報). 제국과정(製麴過程)중의 일반성분(一般成分)과 효소력(酵素力) -)

  • Lee, Taik-Soo;Cho, Han-Ok;Kim, Chul-Soo;Kim, Jong-Goon
    • Applied Biological Chemistry
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    • v.23 no.3
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    • pp.157-165
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    • 1980
  • Kojis were prepared from the different starch raw materials such as glutinous rice, barley rice, wheat flour and sweet potato, and were tested in an effort to reduce production cost and to improve quality of Kochuzang(red pepper paste). During the starting period of Koji preparation, there were less significant changes in pH; however, pH decreased somehow in the case of sweet potato, whereas it increased for the other Kojis. In general, the highest acidity was obtained after 72 hours of Koji preparation. Total nitrogen, soluble nitrogen and amino-nitrogen content increased in order of wheat flour, barley rice, and glutinous rice; Kojis they were markedly produced between 72 and 96 hours of Koji preparation. The maximum amount of reducing sugar was observed between 48 and 72 hours of Koji preparation during this period the reducing sugar content varied widely depending on starch source. Sweet potato Koji produced the highest level of ethyl alcohol content after 72 hours of Koji preparation; for the other Koji the same trends were observed after 24 hours. The starch liquefying activities have reached the highest level after 96 hours and for glutinous rice and barley rice; however, they kept on increasing until 120 hours for wheat flour and sweet potato. Koji Starch liquefying and saccharogenic amylase activities tended to increase in order of sweet potato, glutinous rice, barley rice and wheat flour. Kojis Various protease activities were measu-red during the Koji preparation, and they increased in order of alkali, neutral and acidic protease.

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Development and Content Characteristics of Cartoons in the 1910s: focusing on cartoons published in Maeilsinbo (1910년대 만화의 전개와 내용적 특질: 『매일신보』 게재 만화를 중심으로)

  • Seo, Eun-Young
    • Cartoon and Animation Studies
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    • s.30
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    • pp.139-168
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    • 2013
  • This article aims to explain the significance and value of cartoons in the 1910s which were largely passed unnoticed in the preceding cartoon studies by scrutinizing cartoons published in Maeilsinbo in the 1910s. Until now, Korean cartoons in the 1910s has been neglected just because it were published in Maeilsinbo. However, this writing analyzed cartoons in this period on the base of the fact that the cartoons in the 1910s printed in Maeilsinbo diversified the horizon of the Korean cartoon. Cartoons in Maeilsinbo functioned as a bridge connecting cartoons published in Daehanminbo in 1909 reputed as a root of Korean cartoon and 1920s, the time when satirical cartoons and comics started being printed in newspapers. The characteristics of Maeilsinbo as a bulletin of government general and periodical characteristics that the agent of popular culture begun to move reside as multi layers in the cartoons in the 1910s. In this article, the process and the development of how cartoons published in Maeilsinbo. As pleasure became important in everyday life in Korea, cartoons were able to earn a portion in the newspaper. In the beginning, modern cartoon style seemed vague, but as time goes by, its own style gradually settled. Cartoons in this period were not fixed in specific section but various kinds of cartoons were developed during the time since works of Korean as well as Japanese cartoonists and illustrators were published. Among them, representative cartoons in Maeilsinbo were analyzed in this article under three categories: first, cartoons represented 'Choseon-ness' through scenes of daily life and customs concurrently contained a view of anti-civilization/enlightenment; second, cartoons represented the accumulation of wealth as valid from the view point of public interest; last, cartoons divided Koreans who suffered from hardships of life in Kyungsung and Japanese in Jingogae in order to divide space. In conclusion, Maeilsinbo disciplined the colonized, Koreans, and exposed the discourse of the colonial power via cartoon.

A Study on the Spectacles Wearing State of High School Students (고등학생들의 안경착용에 관한 연구)

  • Doo, Ha-Young;Sim, Sang-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.1
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    • pp.107-116
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    • 2000
  • This study is of investigation of refraction error, spectacles and contact lenses wearing state, visual acuity test, ophthalmologic common sense and vision care, using questionnaire study for 850 male and female high school students in Kunsan and Chongup City, Cheolla North Province. The results are as follows: 1. Among the 823 answerers, emmetropia is 18%, myopia is 55.1%, and hyperopia is 7%, respectively. 2. Among the 837 answerers, 381 students(45.5%) wear spectacles or contact lenses. Among the 381 students who wear spectacles or contact lenses, 78% wear only spectacles, 4% wear only contact lenses and 18% wears spectacles sometimes or contact lenses sometimes. 3. The places where the answerers had visual acuity test to wear spectacles or contact lenses are optical shop(64.7%), hospital(28.3%), unchecked(4.2%) and the others(2.7%). The places where the answerers had visual acuity test to change their spectacles or contact lenses are optical shop(82%), hospital(28.3%), unchecked(6.6%) and the others(1.9%). 4. As for the period of visual acuity test, from 6 months to one year is 54.1%, within 6 months is 9.2%, from one year to two years is 29.5%, and more than two years is 7.2%. 5. The contact lens wearers purchased their contact lenses at optical shops(94%) and at hospital(6%). 6. The reasons why they like wearing contact lenses are their appearance(51.2%), convenience in physical excercise(23.l%), lighter weight than spectacles(9.8%) and the others(15.7%). 7. As for the spectacles frame they like, plastic frame is 24.4%, gold or silver plated frame is 43.4%, coloured frame is 32.1%. 8. As for the considerations in choosing spectacles frame, their design is 37%, their quality is 36%, their price is 14.7% and their brand is 12.5%. 9. As for the period for changing spectacles, 10.5% is within 6 months, 57.3% is 6months to 1 year, 22.4% is 1 year to 2 months and 9.6% is more than 2 years. 10. There is a false fact, in Korea, that even though one has his poor eyesight, not wearing custom is helpful for the eyesight recovery. As for their conviction of the false fact, 10.5% of the answerers have 100% conviction, 22.5% of them have 22.5% conviction, 49.5% of them have 50% conviction and 17.5% of them don't have any conviction. 11. 48.5% of the answerers are interested in their vision care while 51.5% of them are not interested at all. As for the way of vision care, the vision-care way to keep enough distant when they are watching TV, when they are using computers and when they are reading, is 49% while the vision-care way such as hypogastric breathing or eye massage is 11%. And alimentotherapy is 4% and the rest who are not interested in vision care is 36%. 12. When they come to an age, the students who want vision correction operation are 45.9% while the students who do not want it are 27%. The students who do not have any idea about the operation are 27.1%

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Follow-up of children with isolated microscopic hematuria detected in a mass school urine screening test (학교집단소변검사에서 발견된 단독 현미경적 혈뇨의 추적 관찰)

  • Yum, Mi-sun;Yoon, Hoe Soo;Lee, Joo Hoon;Hahn, Hyewon;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.82-86
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    • 2006
  • Purpose : The isolated microscopic hematuria is the most common abnormality detected by school urinary screening, but there is no consensus about the range of investigations and long-term outcomes of isolated hematuria in children yet. This study aims to elucidate the prognosis of hematuria and the range of diagnostic studies by follow-up results. Methods : Students with isolated hematuria who were referred to the Department of Pediatrics, Asan Medical Center from Aug. 1990 to Feb. 2004 were analysed retrospectively. Cases that presented Through significant proteinuria(>250 mg/day), other symptoms of nephritis or renal dysfunction (creatinine clearance <85 mL/min/$1.73m^2$) were excluded. Follow-up was done every six months with checking urinalysis, serum creatinine, protein and albumin. When albuminuria was detected, 24 hour urine protein was checked. Renal biopsy was done when urine protein was over 500 mg/day. Results : A total of 331 students were enrolled in this study. There were 157 males and 174 females. The mean age at presentation was $9.9{\pm}2.3$ years(7-15 years) and mean follow-up period was $2.2{\pm}1.6$ years(1-10 years). Seventy five(22.7 percent) patients showed the resolution of microscopic hematuria. The mean resolution period was $2.6{\pm}1.7$ years(1-8 years). Eight(2.4 percent) patients developed significant proteinuria and renal biopsy was done in four of them. Two cases of mild IgA nephropathy and two of minimal change were detected. None of them developed hypertension. At the end of the follow-up, renal function had remained stable in all subsets of patients. Conclusion : The prognosis of isolated microscopic hematuria was good. This study suggests that invasive studies including renal biopsy are not necessary and a regular follow-up of urinalysis is enough for children with isolated microscopic hematuria.

A Clinical Manifestation of Meckel's Diverticulum (Meckel 게실의 임상양상)

  • Lee, Jin Beom;Lee, Yong Soon;Yoo, Eun Sun;Kim, Hae Soon;Son, Se Jeong;Park, Eun Ae;Lee, Seung Joo;Sung, Sun Hee;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.466-472
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    • 2002
  • Purpose : The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children. Methods : Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken. Results : The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal( GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan($^{99m}Tc-pertechnetate$ scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan. Conclusion : In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.

Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.576-584
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    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

Clinical aspects of chronic urticaria in children (소아 만성 두드러기의 임상 양상 및 경과)

  • Kang, Hye Seon;Shin, Mee Yong
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.205-212
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    • 2009
  • Purpose : Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. Methods : 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. Results : The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. Conclusion : Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.

Epidemic acute interstitial pneumonia in children occurred during the early 2006s (2006년 초에 유행한 소아 급성 간질성폐렴)

  • Cheon, Chong Kun;Jin, Hyun-Seung;Kang, Eun Kyeong;Kim, Hyo Bin;Kim, Byoung-Joo;Yu, Jinho;Park, Seong Jong;Hong, Soo-Jong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.383-390
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    • 2008
  • Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

Clinical characteristics of severe respiratory syncytial virus infection requiring mechanical ventilation in neonatal period and early infancy (신생아기와 조기 영아기에 발생한 기계환기요법이 필요했던 중증 respiratory syncytial virus 감염의 임상적 특성)

  • Shin, Seung Han;Kim, Jae Ri;Lee, Jin-A;Choi, Chang Won;Kim, Ee-Kyung;Choi, Eun Hwa;Kim, Han-Suk;Kim, Beyong Il;Lee, Hoan Jong;Choi, Jung Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.372-376
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    • 2008
  • Purpose : To identify clinical characteristics of severe respiratory syncytial virus (RSV) in neonatal period and early infancy and provide information in clinical practice. Methods : Twelve neonates and young infants (<6 months) who were infected by respiratory syncytial virus and required mechanical ventilation between March 2005 and July 2007 were enrolled. Diagnosis of RSV infection was made based on the positive results by rapid antigen immunoassay or polymerase chain reaction. Results : There were four premature infants, of whom three were near-term. Birth weight of subject patients was $2.8{\pm}0.6kg$, gestational age was $37{\pm}2weeks$ and the age at the time of admission was $35{\pm}15days$. Nine of them showed apnea and in five patients, apnea itself was an indication for mechanical ventilation. In seven of the apneic patients, apnea was the first manifestation of RSV infection. In three of these seven apneic patients, apnea preceded definite respiratory distress signs or typical stethoscopic findings by 1-3 days. Mean duration of mechanical ventilation was $3{\pm}2days$, and mean duration of stay in intensive care unit was $6{\pm}2days$. Conclusion : RSV is a major cause of severe respiratory tract infection in term or near-term infant younger than 2 months. For apnea could be the first manifestation of the RSV infection, high level of suspicion is required in practice of neonates or young infants who show any upper respiratory infection symptoms during RSV season.