• Childhood Kidney Diseases
• /
• v.9 no.1
• /
• pp.46-55
• /
• 2005

Purpose : Recurrent urinary tract Infection(UTI) in primary vesicoureteral reflux(VUR) may lead to serious renal scarring, a major cause of childhood hypertension and end-stage renal disease. To prevent recurrent UTI, low-dose long--term antibiotic prophylaxis has been recommended. However, recurrent UTI still develops during antibiotic prophylaxis, the efficacy of which is now being disputed. The emergence of resistant bacteria has also raised concerns. To evaluate the effect of antibiotic prophylaxis, we investigated recurrent UTI during prophylactic antibiotic use in children with primary VUR Materials : The incidence and risk factors of recurrent UTI were retrospectively evaluated in ninety-one children with primary VUR on trimethoprim- sulfamethoxazole(TMP/SMX) prophylafis during the year following their index febri]e UTI. Results : Recurrent UTI occurred in 31.9%(29/91) children and comprised 0.32 episodes/patient year. Febrile UTI was 0.26 episode/patient year and afebrile UTI was 0.07 episodes/patient year. The recurrent rate of UTI in male patients with phimosis was 37.2%(19/51), which was significantly higher than in males without phimosis 0%(0/5)(P=0.025). In the logistic regression analysis for recurrent UTI, renal scar was the significant risk factor for recurrent UTI [RR 3.8(95% CI 1.0-14.1) P=0.04]. For other well-known risk factors such as sex, age, degree of VUR, APN, and voiding dysfunction, the differences were not significant. Conclusion : TMP/SMX prophylaxis did not prevent recurrent UTI in children with primary VUR. Phimosis and renal scars were the risk factors for recurrent UTI but the grade of primary VUR was not. In VUR without phlmosis and renal scar, a randomized controlled study without antibiotic prophylaxis is required. (J Korean Soc Pediatr Nephrol 2005;9:46-55)

• Childhood Kidney Diseases
• /
• v.14 no.1
• /
• pp.42-50
• /
• 2010

Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.

• Journal of Hospice and Palliative Care
• /
• v.17 no.1
• /
• pp.27-33
• /
• 2014

Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.

• Korean Journal of Hospice Care
• /
• v.8 no.1
• /
• pp.1-12
• /
• 2008

Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

• Journal of Yeungnam Medical Science
• /
• v.22 no.2
• /
• pp.150-165
• /
• 2005

Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

• Korean Journal of Social Welfare Studies
• /
• v.48 no.3
• /
• pp.171-208
• /
• 2017

The purpose of this study is to classify the underlying and parsimonious types of child maltreatment and examine whether the effects of risk factors on child maltreatment recurrence differ by type of maltreatment. We utilized the multiyear national administrative data from the National Child Maltreatment Information System collected by Child Protection Agency in Korea. Of 26,921 child maltreatment victims reported and substantiated on or after January 1, 2012, 1,447 children who had recurrence of child maltreatment until December 31, 2015 were selected as maltreatment recurrence group and 4,580 children who had not experienced maltreatment since first substantiation were assigned as maltreatment non-recurrence group. Latent class analysis(LCA) and latent transition analysis(LTA) were used to group children with similar maltreatment subtypes into discrete classes of child maltreatment recurrence. Logistic regression is employed to examine the association between the child maltreatment predominant types and risk factors for recurrence. Results of LCA and LTA showed four latent classes representing predominant type of child maltreatment: 'physical abuse predominant type', 'emotional abuse predominant type', 'sexual abuse predominant type', and 'neglect type'. Significant differences in the effect of risk factors among latent classes were found in child's age and gender, perpetrator's gender, family poverty, biological parent as the perpetrator, domestic violence toward partner, perpetrator's alcoholic problem, insufficient parenting skills, and out-of-home care service, Based on these findings, results suggested how the typology can be used to guide decision about who to target in prevention and intervention programs, and which features of risk factors to target. Practice and policy implications as well as further research tasks were discussed in the lights of searching for useful and important strategies to prevent recurrence of child maltreatment.

• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.2
• /
• pp.191-199
• /
• 2016

Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

• 한국사회정책
• /
• v.25 no.2
• /
• pp.125-163
• /
• 2018

Social and health problems related to drinking are serious. Drinking behavior is affected not only by personal factors but also by environment factors. The purpose of this study is to find out how the alcoholic beverage stores in community influence the drinking behaviors of individuals after adjusting the individual level variables and provide it as basic data for alcohol related regulatory policies. In order to identify the factors affecting drinking behavior, we conducted a multilevel logistic regression analysis with high-risk drinking and current drinking as dependent variables. Individual-level data provided by 2015 community health survey from respondents of urban residents, and regional level data provided by the National Statistical office. The variables such as age, education level, and income level were used as individual level variables and the number of basic living allowances, divorce rate, and the number of pubs were used as community level variables. According to the research results, after controlling all variables, the number of bar, retail per $1km^2$ in residential area effect on current drinking. But, they are not effect on high risk drinking. In the high risk drinking, only the divorce rate effect on drinking behavior. As a result of the stratified analysis, there was no difference in the current drinking. But, it shows that the higher the number of retail stores and the total alcohol availability, the higher risk drinking behavior in the 60s. The results of this study suggest that policies aimed not only on individuals but also on the local environment are necessary.

• 한국노년학
• /
• v.38 no.3
• /
• pp.551-567
• /
• 2018

Demographic and socio-structural information is useful to identify potential welfare recipients who are in need of disease-prevention and intervention services. Thus, the present study aims to explore the differences in grip strength among middle and old-aged adults by living conditions and by living area. The 5th wave data of Korean Longitudinal Study of Aging was utilized. The dependent variable was grip strength, and the independent variables were living alone (living alone or not) and living area (city or non-city). Covariates were age, education, log-transformed household income, spouse existence, body mass index, self-rated health conditions, depressive symptoms, cognitive function, smoking, regular exercise, frequency of meeting with friends, and the number of social participation. Regression analysis was performed for middle-aged men, middle-aged women, old-aged men, and old-aged women, respectively. ANOVA and Chi-test were additionally used to specifically discuss significant results. Cross-sectional weight was applied to all analyses. According to the results, living alone and living area did not have significant effects on grip strength among middle-aged men, old-aged men, and old-aged women. In middle-aged women, however, living alone and living area were significantly associated with grip strength. To be specific, middle-aged women who lived alone in rural areas had the lowest grip strength compared to other middle-aged women. Additional analysis showed that middle-aged women who lived alone in rural areas had risk factors, such as low education level, low income, or high depressive symptoms. It implies that middle-aged women living alone in rural areas may have physical health risks, so they might be in need of disease prevention. This study is meaningful in that it can provide reliable information on the latent welfare recipients by using representative panel data and applying weight values.

• Korean Journal of Community Nutrition
• /
• v.23 no.6
• /
• pp.475-487
• /
• 2018

Objectives: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). Methods: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. Results: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18-4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. Conclusions: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.