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비만(肥滿) CLINIC 내원환자(來院患者) 453 CASES에 대(對)한 임상적(臨床的) 고찰(考察)

  • An, Gyeong-Sun;Seong, Nak-Gi
    • Journal of Haehwa Medicine
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    • v.2 no.2
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    • pp.219-246
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    • 1993
  • In 1991, Obesity rate of South Korea has reached to 18.7%. Because of economical development, the pattern of diet is exchanged from carbohydrate to rich protein and fat. The more problem is not only obesity of adult but also one of little child. Obesity is induced to diabetes mellitus, hypertension, artherosclerosis, hyperlipoidemia. heart and C.V.A disease, etc. In Woman, special important ploblem is the complex of beauty about Woman's figure. In Oriental Medicine, the factor of obesity is mainly regarded as dampness. And there are many treatments and methods to body weight loss, but obesity patients dislike to use them because of their side effects and inconvenience, intolerance. Now ear acupuncture is applied on so many disease because of its easy handly, non-side effect and high efficiency in clinics. Here obesity acupuncture is used to ear and whole body acupuncture. Because they react eachother for lack point. Therefore, in order to investigate the effect of obesity acupuncture and develop non-drug, non-starvation etc, we analyzed 453 the cases of body weight loss patients treated with ear and whole body acupuncture in Oriental Medicine Hospital of Jeon-Ju Woo-Sug University from April.1.1992. to March.17. 1993. The results were summarized as follows. 1. Distribution of sex ; male (4.4%), Female(95.6%) 2. Distribution of age in descending order ; 30s, 20s, 40s, 10s, 50s, below 10s, abowe 60s. The 20s-30s are group made up 60.7% of the group. 3. Distribution of occupation in descending order; housewife, student, service, salaried, merchant, teacher, farmer, inoccupation. 4. Distribution of human coporal constitution in descending order : Tae-Eum-In, So-Eum-In, So-Yang-In. 5. Distribution of body height and weight, 155-164cm ; 71.1%, 60-70kg, 74.6% are majority. 6. Distribution of weight variation, 2-6kg(71.0%) is majority, also 13-14kg(0.4%). 7. Distribution of duration in descending order ; 1-3 years, 3-6 years, 1-12months, above 10 years but in success, 1-12 months, 1-3 years, 3-6 years, above 10 years. Therefore, we know that the shorter duration of obesity is, the more loss of body weight. 8. Past experiences to body weight loss; Yes(69.5%), No(30.5%). The success rate accordant with the past temporary experiences shows that the cases without experience is higher than the ones with experience. 9. In distribution of times(treatments), 10 times is top. The rate of body weight loss is the highest in 14 times. Therefore, I think that one would need at least 10 times. in order lose body weight 10. Distribution of body weight variation in treatments times is at 2 times(3-4kg loss), and surprisingly is 14kg loss at above 15 times. 11. Distribution of symptoms improvement, in descending order ; heavy sense in body, dec. of appetite, inc.of exercise, lumbago, edema, knee pain, inc.of urine, inc. of fullness sense, thirsty, disease of gynecology, white tung, chest burning, heart burning, dec.of tobacco, drink taste. motion sickness, allergy, water eczema, arthma, belching. 12. Distribution of snack; Yes(87.4%), No(78.6%) 13. Distribution of exercise; Yes(21.4%), No(78.6%) 14. Distribution of sleeping times, above 7 hours(79.0%) 15. Distribution of the reason to body loss, the complex of beauty(68.7%) is top. 16. Distribution of side effect in obesity acupuncture, constipation (17.4%) is top. 17. Distribution of method in body weight loss ; dietary treatment (31.1%), sauna(26.7%), exercise(19.7%), the center of body weight loss (15.0%) herb-med and starvation treatments (5.1%), hand-finger acupuncture (hand-foot acupuncture) is 1.6%, diet pill(0.3%), etc(0.6%).

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A Comparative Study on Closed vs. Open Endotracheal Suctioning on the Newborn Infants Treated with Ventilator (인공호흡기 사용 신생아의 폐쇄형과 개방형 기관흡인에 관한 연구)

  • Park, Jeong-Won;Park, Yeong-Ae
    • 아동간호학회:학술대회논문집
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    • 1997.11a
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    • pp.61-74
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    • 1997
  • Endotracheal suctioning is a routine procedure used for clearing secretions from the airway of the intubated infant. This procedure is not without complications. Endotracheal suctioning has been associated with decreases in $PaO_2$, decreases in systemic venous oxygenation, alterations in mean arterial Pressure, disturbances in cardiac rhythm and development of nosocomial pneumonia. So several endotracheal suctioning techniques have been developed to prevent these blown complications. Another method of Endotracheal suctioning eliminates the risk associated with disconnecting the infant from the ventilatior to perform the suctioning procedure. Studies examining closed endotracheal suctioning methods reported that the closed method results in less arterial oxygen saturation, and less systemic venous oxygen desaturation. However those studies have focused on adult patients, and there have been no published studies for newborn infants. The specific purpose of this study is to investigate the two methods and to make a comparison in terms of (1)variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning; (2)difference in occurrence of nosocomial infection; (3)difference in recovery time to arrive at pre-suction baseline after suctioning and in nursing time taken for the suctioning. The present study is based on the data obtained from two groups of newborn infants : one group comprises 8 infants with closed suctioning (a total of 304 suctions) among 17 infants treated with ventilator and the other group 9 infants with open method (a total of 629 suctions). The data were analyzed using the SPSS statistical program package. As the distribution test on dependent variables with the Skewnesser Shapiro Wilk test showed an asymmetric distribution, the Wilcoxon Matched-pairs Singled- Ranks test was used for the test of variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning. The difference in $SaO_2$ recovery time and nursing time was analyzed with the Mann-Whitney U-Test. The difference in physiologic consequences and occurrence of nosocomial infection between the two groups was analyzed with the Fisher's Exact Test. The results of the study are summarized as follows. For the hypothesis 1 (There would be a difference in $SaO_2$, heart rate, and respiration rate before and after suctioning between the two suctioning methods), the difference in $SaO_2$ turns out to be statistically significant (P=0.015), but heart rate and respiration rate do not procedure a notable difference (P=0.630). The hypothesis 2 (There would be a difference in rates at which a complication arises after suctioning between the two groups) does not prove to be statistically valid (P=0.246). For the hypothesis 3(There would be a difference in $SaO_2$ recovery time and nursing time between the two groups), the average $SaO_2$ recovery time after suctioning turned out to have somewhat significant difference (P=0.064), however the difference in nursing time taken for the suctioning was not statistically significant (P=0.610). The analyses indicate that the closed endotracheal suctioning is more efficient as compared with the open method, in maintaining pre-suction baseline $SaO_2$ and a rapid recovery of newborn infants. Based on these results we suggust to apply the closed method to newborn infants in the ventilation treatment. We also suggest to extend the investigation to include the comparison of suction cost taking into account the case in which a complication arises after endotracheal suctioning between the two groups.

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Evaluating and managing hypertension in children: a survey of Korean cardiologists and nephrologists (소아 고혈압의 평가와 관리 방법; 한국 소아심장 전문의와 소아신장 전문의 설문)

  • Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.992-997
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    • 2008
  • Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

The Study on Effects of "the Unsafe Food Program" designed For Improving Children's Eating Habits (유아들의 식습관 개선을 위한 "위험한 먹거리 프로그램"의 효과에 대한 연구)

  • Seo, Sun Suk;Lee, Ju Rhee
    • Korean Journal of Childcare and Education
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    • v.6 no.1
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    • pp.157-176
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    • 2010
  • The purpose of this study was to estimate the effect of "The unsafe food program" designed for improving children's biased eating habits coming from defenceless exposure to the instant food, fast food and adulterated food with MSG and artificial additives with analyzing the current condition of children's biased eating habits and preference for the unsafe foods. This program was performed for 5 year old children who was attending the kindergarten run by the author every day for two months. "The unsafe food program" consisted of the surveys on the parents' attitude towards food and health and children's eating habits, and of programs that was designed to attract children's attention to their daily food intake and to provide physical fitness, information about differences between wholesome food and junk food, and junk food's bad impacts on human body for children. In order to see the changes of children's body through this program, two physical examinations was preformed: SH pharmaceutical company's hair test to measure the accumulation level of toxic metal in children's hair and children's nutrition level before starting the program, and Ilsan Health Center's 'INBODY' test to analyze children's body composition such as body weight, skeletal muscle mass, body fat mass, BMI, body fat percentage and so on before and after the program. The results from this program follow as below. First, the unsafe foods were excluded from children's diet after parents came to recognize the negative effects of the unsafe foods. Second, children became highly interested in their daily diet through the course of gathering information by themselves and discussions together while testing and analyzing foods, and children demonstrated more self-restraint on fast food and instant food. Third, children's body constitution turned out to be improved by physical fitness in addition to this program. Fourth, children formed a good habit of eating well-balanced diet consisting of vegetables, staple food and fruits through this program designed to improve children's biased eating habits. From the results of this study it was confirmed that "the unsafe food project" had effects on improving children's eating habits.

Infantile risk factors for obesity in preschool children (학령전기 소아비만에 영향을 주는 영유아기 인자)

  • Park, Sun Ju;Moon, Jae Won;Kim, Hyun Ji;Cho, Min Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.804-811
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    • 2008
  • Purpose : Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods : A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results : There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion : Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

Acquisition of High Resolution Images and its Application using Synchrotron Radiation Imaging System (방사광 X-선을 이용한 고해상도 영상획득과 응용)

  • 홍순일;김희중;정해조;홍진오;정하규;김동욱;제정호;김보라;유형식
    • Progress in Medical Physics
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    • v.12 no.1
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    • pp.51-58
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    • 2001
  • Synchrotron radiation (SR) has several advantages over convetional x-rays, including its phase, collimation, and high flux. A synchrotron radiation beamline 5C1 at Pohang Light Source (PLS) was recently built for imaging applications. We have shown that a SR imaging system is useful in imaging microscopic structures. SR with broad-band energy spectrum were adjusted to an object by Si wafers and their energy were approximately ranging from 6 keV to 30 keV. SR were passed through an object and finally transformed into visible lights by CdWO$_4$ scintillator screen. The visible lights which were reflected at an angle of 90 degrees by gold plated mirror were detected by a CCD camera and the image data were acquired using image acquisition system. A high-resolution phantom, capacitor, adult tooth, child tooth, cancerous breast tissue, and mouse lumbar vertebra were imaged with SR imaging system. The Objects were rotated within the field of view of the CCD detector, and their projection image data were obtained at 250 steps over 180 degrees rotation. Image reconstructions were carried out in a PC by using IDLTM(Research systems, Inc., US) program. The spatial resolution of the images acquired by the SR imaging system was measured with a high-resolution chart manufactured for several micrometer resolution. The specimens were also imaged with conventional x-ray radiography system to compare the image quality of radiography obtained with the SR imaging system. The results showed more structural details and high contrast images with SR imaging system than conventional x-ray radiography system. The SR imaging system may have a potential for imaging in biological researches, material applications, and clinical radiography.

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The Validity and Reliability of 'Computerized Neurocognitive Function Test' in the Elementary School Child (학령기 정상아동에서 '전산화 신경인지기능검사'의 타당도 및 신뢰도 분석)

  • Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Shin, Hyoun-Jin;Bai, Dai-Seg;Lee, Hye-Lin
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.97-117
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    • 2003
  • Objective: This study is to examine the validity and reliability of Computerized Neurocognitive Function Test among normal children in elementary school. Methods: K-ABC, K-PIC, and Computerized Neurocognitive Function Test were performed to the 120 body of normal children(10 of each male and female) from June, 2002 to January, 2003. Those children had over the average of intelligence and passed the rule out criteria. To verify test-retest reliability for those 30 children who were randomly selected, Computerized Neurocognitive Function Test was carried out again 4 weeks later. Results: As a results of correlation analysis for validity test, four of continues performance tests matched with those on adults. In the memory tests, results presented the same as previous research with a difference between forward test and backward test in short-term memory. In higher cognitive function tests, tests were consist of those with different purpose respectively. After performing factor analysis on 43 variables out of 12 tests, 10 factors were raised and the total percent of variance was 75.5%. The reasons were such as: 'sustained attention, information processing speed, vigilance, verbal learning, allocation of attention and concept formation, flexibility, concept formation, visual learning, short-term memory, and selective attention' in order. In correlation with K-ABC to prepare explanatory criteria, selectively significant correlation(p<.0.5-001) was found in subscale of K-ABC. In the test-retest reliability test, the results reflecting practice effect were found and prominent especially in higher cognitive function tests. However, split-half reliability(r=0.548-0.7726, p<.05) and internal consistency(0.628-0.878, p<.05) of each examined group were significantly high. Conclusion: The performance of Computerized Neurocognitive Function Test in normal children represented differ developmental character than that in adult. And basal information for preparing the explanatory criteria could be acquired by searching for the relation with standardized intelligence test which contains neuropsycological background.

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A Study on Epidemiologic Characteristics of Recurrent Abdominal Pain in Elementary School Children (반복성 복통증 환아의 역학적 특징에 관한 조사)

  • Oh, Sang-Hyun;Yang, Eun-Seok;Park, Sang-Kee;Park, Young-Bong;Park, Jong;Park, Sang-Hak;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.21-29
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    • 1999
  • Purpose: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find posssible factors influencing the onset and the course of the disorder. Method: We performed questionnaires in Kwangju on children from two primary schools from June,1 1998 to June 30 and carried out statistical analysis. Result: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02:1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor. The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as internal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. Conclusion: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.

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A Study on the Change of household-Economy incidental to the Family Life Cycle. (가정생활 주기에 따른 가계변동에 관한 연구)

  • 서병숙;임혜경
    • Journal of Families and Better Life
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    • v.2 no.1
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    • pp.35-55
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    • 1984
  • This study aims to present basic data for a reasonable home management through investigating the change of home economy conditions incidental to the family life cycle, also through analyzing the effect of socio-anthropological variables on the family-life cycle. The data investigation using the questionnaires method was conducted on housewives in Seoul as the central census tract. Housewives as the subject of investigation were chosen by the method of the purpose-sampling in consideration of the regional differences and the socio-economical strata. Nine hundred and forty questionnaires were distributed to housewives but seven hundred questionnaires were collected. Only five hundred and ten questionnaires of them were analyzed in this study. The frequency and the percentage of collected data, first of all, were founded in order to grasp the general characteristics of the subject of investigation. To classify the stage of family life cycle, the correlations of the classifying factors among each group were examined x2 Test and One-Way ANOVA were applied to explore the differences among each stage of the change of household-economy. And the effect of socio-anthropological variables on the change of household- economy was analyzed by Two-way ANOVA. the conclusions derived from the results of this study are as follows; 1) The marriage-period and the educational conditions of the first child were selected as the classifying factors through analyzing correlation among the age, the marriage-period and the educational conditions of their children. As a result of this analysis, the family life cycle were classified into seven stages: Stage 1; Establishment Stage 2; Preschool family Stage 3; Elementary school family stage 6; Adult period family Stage7; Marriage period family . 2) The change of household economy incidental to the progress of family life cycle has a significant differences in all of variables (except the other member of family's income) Stage 1; Though the husband's income and the income from property are on a low level, the total income is on a high level due to the housewife's income. Stage 2; The total income is on a low level owing to the decrease of house wife's income, though the husband's income keep growing. Stage 3; Owing to the increase of husband's income, the cost of living as well as the total income keeps growing but the savings are on the decrease. Stage 4; Compared with Stage 3, the total income tends to be on a low level but the living expenses are on the increase. Stage 5; The husband's income is on the highest level in the stages of family life cycle. The total income and the living expenses are on a high level. Stage 6; The income of husband and housewife are on the remarkable decrease but the children's income is on the increase. Stage 7; Owing to the increase of the children's income and the income from property, the total income is on the highest level in the stages of family life cycle. 3) Considering the effect of socio-anthropological variables on the conditions of household-economy, family system has an significant effect on children's income. the husband's occupation exerts a significant effect upon the housewife's and children's income. The husband's schooling exercises an effect upon the children's income. S.E.S has a important effect on the income of husband, housewife and children. From the above results, it is found that the change of household-economy conditions is incidental to the progress of family life cycle. Therefore, a suitable measure to cope with the desire of family and the conditions of household-economy should be prepared, in order to carry on a reasonable home management.

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Fixed Dose Regimen of Heparin Administration with Activated Coagulation Time During Cardiopulmonary Bypass (심폐바이패스시 활성응고시간을 이용한 헤파린 고정용량법)

  • 김원곤;박성식
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.867-872
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    • 1998
  • Background: The fixed dose regimen with activated coagulation time(ACT) is the most commonly employed method for determining the required dosage of heparin and protamine during cardiopulmonary bypass(CPB). Material and Method: We performed a prospective study on a fixed dose regimen for analyzing adequate dosages of heparin and protamine, the incidence of heparin resistance and heparin-induced thrombocyt openia, factors affecting ACT during CPB, and changes of ACT during aprotinin usage. 300 units/kg of heparin were administered to patients, and ACTs were measured after 5 mins. ACTs were checked at 10 mins and 30 mins after the onset of CPB, and then at 30 min intervals thereafter. If the measured ACT was under 400 secs, we added 100 units/kg of heparin. The heparin was reversed with 1 mg of protamine for each 100 units administered. If the measured ACT was longer than 130 secs 30 mins after protamine administration or if there was definitive evidence of a coagulation defect, we administered a further 0.5 mg/kg of protamine. Result: We studied 80 patients(50 adults and 30 children) who underwent open heart surgery(OHS) at Seoul National University Hospital. Preoperative ACT was 114.3${\pm}$19.3 secs in adults, and 119.5${\pm}$18.2 secs in children. There were no differences in preoperative ACT due to age, body weight, body surface area, or sex. The preoperative ACT was not influenced by a positive past history of OHS. Ten adults(20%) and 3 pediatric patients(10%) needed additional doses of heparin to maintain the ACT above 400 secs. Additional protamine administration was needed in 9 adults(18%) and 10 children(33%). Heparin resistance was found in only two adults. Heparin-induced thrombocytopenia was detected in 2 adults and 1 child. During CPB, ACT was prolonged. 12 adult patients received a low dose of aprotinin and showed longer celite activated ACT compared to the control group.The kaolin activated ACT showed a lower tendency than the celite activated ACT in aprotinin users. Conclusion: In conclusion, fixed dose regimen of heparin and protamine can be used without significant problems, but the incidence of need of additional dosage remains unsatisfactory.

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