• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1187-1192
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• 2005

Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.130-141
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• 1995

Background: Endobronchial tuberculosis is one of the serious complications of pulmonary tuberculosis. Without early diagnosis and proper treatment of endobronchial tuberculosis, bronchostenosis can leave and lead to the collapse of distal lung parenchyme, bronchiectasis, and secondary pneumonia accompanied with moderate to severe dyspnea, cough, hemoptysis, and localized wheezing. Therefore steroid therapy has been tried to prevent bronchostenosis. But the effect of steroid therapy on the endobronchial tuberculosis is not definite at present. We tried to elucidate the effect of steroid on the treatment of endobronchial tuberculosis for prevention of bronchostenosis. Methods: We observed the initial and sequential bronchoscopic findings, pulmonary function tests and simple chest roentgenograms in 58 patients diagnosed as endobronchial tuberculosis and admitted to Chung-Ang university hospital from 1988 to 1992. The patients in nonsteroid group (n=39) were treated with anti-tuberculosis chemotherapy only and steroid group(n=17) with combined steroid therapy. Sequential bronchoscopic findings, pulmonary function tests, and chest roentgenograms were comparatively analyzed between the two groups. Results: 1) The endobronchial tuberculosis was highly prevalent in young females especially in third decade. 2) Both actively caseating type and the stenotic type without fibrosis was the most common in the bronchoscopic classification. 3) The sequential bronchoscopic findings in steroid group 2 months after treatment showed no significant improvements compared with nonsteroid group. 4) There was no significant difference between the two groups in the sequential bronchoscopic improvements according to bronchoscopic types. 5) We did not find any significant difference in improvements on follow-up pulmonary function tests and simple chest roentgenograms between the two groups 2 month after treatment. 6) There was no significant adverse effect of steroid during the treatment. Conclusion: Combined steroid therapy provably would not influence outcome of the treatment of endobronchial tuberculosis.

• Radiation Oncology Journal
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• v.23 no.2
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• pp.78-84
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• 2005

Purpose: The studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). Materials and Methods: From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy The follow-up periods were from 1 to 180 months with a median of 5.6 months. Results: The main clinical manifestations were dyspnea ($84.7\%$), facial edema ($81.9\%$), arm edema ($22.2\%$), neck vein distension ($25\%$), hoarseness ($12.5\%$) and facial plethora ($5.6\%$). Eighty percent of patients achieved excellent to good symptom improvement and $19.4\%$ experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were $17.7\%$ at 2 years (2YOS) and $14.8\%$ at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, $16.7\%$ and $13.4\%$ for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, $25.6\%$, $\leq$ 30 Gy $6.7\%$, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p > 0.05), Conclusion: Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.241-250
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• 1997

Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.49-63
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• 2018

Purpose : The purpose of this study is investigating the changes of treatment plan and comparing skin dose with or without the skin flash. To investigate optimal applications of the skin flash, the changes of skin dose of each plans by various thicknesses of skin flash were measured and analyzed also. Methods and Material : Anthropomorphic phantom was scanned by CT for this study. The 2 fields hybrid IMRT and the 6 fields static IMRT were generated from the Eclipse (ver. 13.7.16, Varian, USA) RTP system. Additional plans were generated from each IMRT plans by changing skin flash thickness to 0.5 cm, 1.0 cm, 1.5 cm, 2.0 cm and 2.5 cm. MU and maximum doses were measured also. The treatment equipment was 6MV of VitalBeam (Varian Medical System, USA). Measuring device was a metal oxide semiconductor field-effect transistor(MOSFET). Measuring points of skin doses are upper (1), middle (2) and lower (3) positions from center of the left breast of the phantom. Other points of skin doses, artificially moved to medial and lateral sides by 0.5 cm, were also measured. Results : The reference value of 2F-hIMRT was 206.7 cGy at 1, 186.7 cGy at 2, and 222 cGy at 3, and reference values of 6F-sIMRT were measured at 192 cGy at 1, 213 cGy at 2, and 215 cGy at 3. In comparison with these reference values, the first measurement point in 2F-hIMRT was 261.3 cGy with a skin flash 2.0 cm and 2.5 cm, and the highest dose difference was 26.1 %diff. and 5.6 %diff, respectively. The third measurement point was 245.3 cGy and 10.5 %diff at the skin flash 2.5 cm. In the 6F-sIMRT, the highest dose difference was observed at 216.3 cGy and 12.7 %diff. when applying the skin flash 2.0 cm for the first measurement point and the dose difference was the largest at the application point of 2.0 cm, not the skin flash 2.5 cm for each measurement point. In cases of medial 0.5 cm shift points of 2F-hIMRT and 6F-sIMRT without skin flash, the measured value was -75.2 %diff. and -70.1 %diff. at 2F, At -14.8, -12.5, and -21.0 %diff. at the 1st, 2nd and 3rd measurement points, respectively. Generally, both treatment plans showed an increase in total MU, maximum dose and %diff as skin flash thickness increased, except for some results. The difference of skin dose using 0.5 cm thickness of skin flash was lowest lesser than 20 % in every conditions. Conclusion : Minimizing the thickness of skin flash by 0.5 cm is considered most ideal because it makes it possible to keep down MUs and lowering maximum doses. In addition, It was found that MUs, maximum doses and differences of skin doses did not increase infinitely as skin flash thickness increase by. If the error margin caused by PTV or other factors is lesser than 1.0 cm, It is considered that there will be many advantages in with the skin flash technique comparing without it.

• Korean Journal of Environment and Ecology
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• v.30 no.1
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• pp.118-129
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• 2016

The purpose of this study was to offer the preliminary data for the development of forest therapy program. This exploratory study is about the development of forest healing program by identifying what is the forest healing program preferences of potential consumers and would be an important basis for the operation. The survey of interests and needs of 620 people on the forest therapy was analyzed. Using SPSS 21.0 program, statistical analysis, frequency analysis, T-test, One-way ANOVA, we looked at the differences in forest healing program preferences according to gender, age, occupation. Forest therapy program preference was found to vary depending on sex, age and job. First, according to gender, men preferred athletic in the forest and camping compared to women, and women showed a higher preference than men in the overall program. Second, depending on age, as compared to other age, for 20s; stress assessment & diagnosis, cooking in the forest, photo therapy in the forest, for 30s; walking in the forest, counseling, listening to lectures(stress-related or interpersonal relationships-related), communication-related lectures and vision quest, for 40s; meditation, viewing the forest, forest bathing wind bathing sun bathing, walking on barefoot in the forest, for 50s; breathing breathing exercises, yoga, mountaineering, climbing in silence, eating wild food, respectively, each of those programs were especially favored. Third, the forest healing program preference in accordance with the job is as follows. For students; stress assessment & diagnosis, cooking in the forest, etc., for teachers; walking in the forest, mountaineering, reading in the forest, viewing the forest, forest bathing wind bathing sun bathing, camping etc., for housewives; yoga, listening to the sound of water flowing, drinking herbal tea, eating wild food, for specialist researcher; breathing breathing exercises, climbing in silence, meditation, sleeping in the forest, respectively, each of those programs were especially favored. We expect the results of this study to be utilized as basic data for the development of forest therapy program targeting on adults.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.57-65
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• 1999

Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.23-30
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• 2011

Purpose : Acinetobacter baumannii is an aerobic, gram negative coccobacillus. Due to its pathogenicity and ability to accumulate diverse mechanisms of resistance, the importance of this organism is increasing. Many reports have targeted adults, and studies of pediatric patients are limited. This study aims to investigate the current status of A. baumannii infection in children. Methods : From January 2001 to December 2008, 505 patients hospitalized with A. baumannii infection were enrolled. Admission records for underlying disease, duration of hospitalization, previous antibiotic use, location of admission, presence of ventilator care, and resistance to antibiotics were retrospectively reviewed and analyzed. Results : Hemato-oncological disease and neurological disease were 30.6% and 24.3% of all cases; therefore, these were the most common underlying diseases of patients with A. baumannii infection. Prevalence of A. baumannii infection was 78.1% in patients with previous antibiotic use, which was higher than that of the group not using previous antibiotic. And prevalence of multi-drug resistant and pan-drug resistant A. baumannii infection was 76.4% and 38.3% in patients with ICU care, 76.8% and 38.9% with ventilator care, and these were higher than the others. Rate of resistance to all groups of antibiotics showed a gradual increase to over 50% in 2008. Multi-drug resistant A. baumannii was 63.5% and pan-drug resistant A. baumannii was 48.2% of all cases. Conclusion : Prevalence of A. baumannii infection and resistance to antibacterial agents of A. baumannii is increasing. Adequate use of antibiotics and infection control should be emphasized in pediatric patients.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1194-1201
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• 2006

Purpose : The comatose mentality can be catastrophic, especially if the condition is severe or the duration is prolonged. Therefore, delayed diagnosis can result in a poor outcome or death. The best radiologic modality to differentiate from cerebral lesions in patients suffering from cerebral diseases is magnetic resonance imaging (MRI) rather than computed tomography (CT). Special apparatuses with metal materials such as ventilators, and cardiac pacemakers belonging to patients cannot be located in the magnetic field. We aimed to exhibit the possibility of examining MRI, maintaining ventilation at a relative long distance by means of modified $Ambu^{(R)}$. Methods : Self-inflating bags as a sort of a manual ventilator, connected with relatively long extension tubes instead of mechanical ventilators, were adopted to obtain MRI. PVC (polyvinyl chloride) extension tubes had different lengths and diameters. Lengths were 1, 2, and 3 cm and diameters were 15, and 25 mm. The work of breathing and expiratory changes of expiratory tidal volume (TVe), minute volume of expiration (MVe), peak inspiratory pressure (PIP) were measured by use of the mechanical ventilator, $Servoi^{(R)}$, as the alteration of TVi (inspiratory tidal volume), extension tube lengths and diameters with other values fixed. Results : Measured TVe and MVe by ventilator were the same values with control at every TVi, regardless of extension tube lengths and diameters, but PIP were increased with the rise of TVi, tube lengths, with decline of tube diameters, these were statistically significant. Conclusion : MRI examination can be carried out with a self-inflating bag connected with an extension tube at a long distance in patients who need artificial ventilation.