• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.56-63
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• 2006

Purpose : This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods : During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results : M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The $2^{nd}$ most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The $3^{rd}$ common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion : Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.9-14
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• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

• Child Health Nursing Research
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• v.4 no.2
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• pp.159-176
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• 1998

In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.239-244
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• 1998

Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.532-539
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• 1993

Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

• The korean journal of orthodontics
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• v.39 no.5
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• pp.300-309
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• 2009

Objective: The purpose of this study was to evaluate the correlation between menton deviation and dental compensation in facial asymmetry. Methods: Tooth axis and distance of first molar and canine to the reference plane were investigated by cone-beam computerized tomography. The subjects consisted of 50 patients with asymmetric mandibles (male 21, female 29, mean age 24.3 years). Control groups were also assessed (male 11, female 9, mean age 25.6 years). Nine measurements (5 linear measurements and 4 angular measurements) were measured in order to evaluate the correlation between menton deviation and the linear and angular difference of first molar and canine in the deviated and none-deviated sides using the defined MPR images. The differences between deviated and non-deviated side, according to menton deviation, were statistically analyzed using stepwise multiple regression analysis. Results: From the result, Menton deviation was negatively correlated with mandibular first molar's angular measurement (${\Delta\angle}LM6$-Mn plane (dev.-ndev.)) and positively with maxillary fist molar's angular measurement (${\Delta\angle}UM6$-FH plane (dev.-ndev.)) (p < 0.01). Two angular measurements (${\Delta\angle}LM6$-Mn plane (dev.-ndev.), ${\Delta\angle}UM6$-FH plane (dev.-ndev.)) explained the variability in menton deviation with a significant $r^2$ value of 0.589. Conclusions: This study suggests that the tooth axis of upper and lower first molars leans towards the deviated side of Menton when there is mandibular asymmetry with Menton deviation.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.191-196
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• 2005

Purpose : Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. Methods : The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. Results : Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was $0.8{\pm}0.2IU/kg/wk$ in GH treated group. Mean growth velocity was $5.6{\pm}2.0cm/yr$, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were $12.2{\pm}2.7yr$ $10.3{\pm}2.5yr$ $127.5{\pm}10.1cm$ and $-3.1{\pm}1.1$, respectively. In the GH treated group, the mean FAH and SD score of FAH were $146.9{\pm}5.8cm$ and $-2.7{\pm}1.2$, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. Conclusion : GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.

• Journal of Korean Physical Therapy Science
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• v.1 no.1
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• pp.135-144
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• 1994

The authors studied therapeutic effects and related clinical data retrospectively on a series of 48 consecutive patients with head injury who were referred to physical therapy and occupational therapy, Kosin University Medical Center during 1 year, from March, 1993. through March, 1994. The conclusions were as follows : 1. Average age of the subject patients was 50.6 years, their age remped from 14 to 72 years, and the incidence between male and femele was 1:1.1. 2. In respect to the educational level high school graduates showed the highest incidence 18 (39.1 %) of 46 cases, and in respect to economy level, middle class revealed the highest incidence, 31(64.6 %) in 48 cases. 3. The HBP was the most common cause of spontaneity injury, disclosing 19 cases in 35 patients(54.3%), whereas the main cause of traumatic injury was a traffic accident, 7 cases ( 53.8 %) in 13 patients. 4. As for the region of injury in the cases of spontaneity ICH was 14 persons (40%). In the cases of trauma, hematoma was seen in 6 cases(42.2 %) in 48 total cases ICH was seen in 17 cases (35.4 %) to be the most common region. 5. Among 35 persons, spontaneity CBR was the highest region of injury, 13 cases(37.1 %) ; the side of paralysis in extremities the right side showed higher incidence, 18 cas (1.4 %) as compared to the left, 16 cases(45.7%). In the case of traumatic injury, CBR was the highest region of injury, 4(30.8% )in 13 cases and as for the paralysis side, right side showed higher incidence 7 cases(53.8%) as compared to the left side 5 cases(38.5%). 6. In respect to recurrence, HBP was seen in 5 cases to be the most common cause, and as for the region of injury, CBR was the highest. 7. A period of rehabilitation therapy in the cases of physical therapy the highest term was 1-2 month, 14 persons(29.2%). As for occupational therapy within 2 week-term was the highest, 24 persons(50%). 8. Physical strenth grade M.T in the cases of the upper extrimities before therapy, the low mark(grade 0) was 30 cases(62.5%), compared to the high mark(above grade 3)seen in 1 case(2.1%), And after therapy, the lowest mark(grade 0)was seen in 5 cases(10.4%) where as the high mark(above grade 3)was seen in 29 cases(60.4%). In the case of the lower extremities before therapy, the mark(below grade 1)was 37 cases(77.1 %), while the high mark(above grade 3)was seen n 4 cases(8.4%). And after therapy the low mark(below grade 1)was seen in 5 cases (10.4 %) and the high mark (above grade 3)was seen in 29 cases(60.4 %). 9. Before therapy conigtive function-level evaluation utilized R.L.A.L, the low mark(below level 3)was seen in 9 cases(18.8%), while the high mark(above level 7)was seen in 18 cases(37.5%). And after therapy the low mark (below level 3)was 4 cases(8.3%) and high mark(above level 7)was seen in 38 cases(79%). 10. After rehabilitation therapy, patients who were able to walk independently were 29 persons(60.4%), among which 16 cases(55.2%) depended on cane. The ratio between the cases who were able to walk and unable to walk was 1.5:1.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.175-181
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• 2002

Purpose : Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus. Methods : Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients. Results : There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications. Conclusion : Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.27-42
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• 2000

The purpose of this study was to identify the degree of sexual adjustment and quality of life in married men with spinal cord injuries and to furnish primary data to sexuality rehabilitation nursing practice which can lead to ideal sexual life and quality of life those men with SCI. Seventy married men with SCI were conveniently sampled in Kwangju, Suncheon, Mokpo and Seoul for responding the questionnaire, which was based on this research. With the research scale, SIS (Sexual interest and satisfaction) by Siosteen et al.(1990) and SB(Sexual behaviour) by Kreuter et al.(1996) were used for the measurement of sexual adjustment. And, for measuring quality of life was used SCI QL-23(Spinal cord injury of life-23) scale by Lundqvist et al.(1997). Data were collected from January 20 to March 20, 1999, using a structured questionnaire. A hundred volumes of questionnaire were used. and 85 volumes were collected, 70 volumes were used as research data after excluding 15 volumes unsuitable to data analysis. The obtain data were analysed using percentage, t-test, ANOVA, Duncan test, and Pearson's correlation by SAS PC+ program. The results were as follows: 1. The mean score of sexual interest and satisfaction of the subjects was 8.42. out of 18. The ways of their sexual behavior after spinal cord injuries were embracing and caressing (62.9%), kissing(58.6%), caressing breast with hands (55.7%), caressing breast with hands (52.9%), caressing genitals with hands (37.2%), caressing genitals with mouth(30.0%) and sexual intercourse (18.6%). The mean score of quality of life was 52.53 out of 100. 2. Age(F=3.24, p=.045) and caregiver (F=4.02, p=.022)were major variables which reveals significant differences in terms for sexual interest and satisfaction. The later results on Duncan's test showed that subjects who were in their 30s or 40s were significant higher than subjects whose age were in their 50s in their sexual interest and satisfaction. Also subjects with their spouse's care or mother's care were higher than those with other's care. 3. Subjects with incomplete paraplegia were higher than those with the complete paraplegia in sexual interest and satisfaction (F=3.01, p=.036). 4. Variables that showed the significant differences in the quality of life were education(t=2.860, p=.007) and period of marriage(t=2.125, p=.037). and occupational status(t=-2.161, p=.034). High school graduates, those who married before spinal cord injuries and those who didn't have occupation were higher than the other subjects. 5. Variables that revealed significant differences in the quality of life were time passage after spinal cord injuries(F=8.72, p=.001) and injured level of spinal cord(F=3.32, p=.042). Duncan's test showed that subjects who had lived for less than 4 years were higher those with time passage of 5-9 years and 10 years. Also subjects with lumbar injuries were higher than those with thoracic injuries in terms of quality of life. 6. There was negatively correlated between sexual interest and satisfaction and quality of life(r=-.256, p<.05). As a result of these findings sexuality rehabilitation for individuals with SCI was very important issue for their quality of life. Thus, registered nurses who care clients with SCI should activily participate in the client's sexual needs. Also, various sexual behaviors as well as sexual intercourse should be encouraged for the sexual adjustment of client's with SCI.