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Lower respiratory tract infection of positive antigen test for respiratory syncytial virus on children under 2 years of age (2세 이하의 소아에서 respiratory syncytial virus의 항원검사에 양성인 하기도 감염)

  • Jeong, Jea Heon;Moon, Kyoung Hee;Lee, Chang Woo;Choi, Du Young;Oh, Yeun Geun;Yoon, Hyang Suk;Cho, Ji Hyun;Kim, Jong Duck
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.394-400
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    • 2006
  • Purpose : This study was design and performed for evaluations of resent clinical pattern of bronchiolitis caused by RSV infection with children under 2 year of age for 5 years, who were admitted to pediatric ward. Methods : The inclusion criteria of the patients were children under 24 month-of-age, clinical manifestations of lower respiratory tract infection, and RSV antigen that was detected by a direct immunofluorescence test from the nasal secretions. The additional laboratory and simple chest X-ray findings were reviewed from the medical records of children who were admitted Wonkwang university hospital from Jan. 1999 to Dec. 2003. Results : In the 5 year study duration, 127 patients were enrolled and outbreak of RSV bronchiolitis took place in 2001. The 80 cases(63 percent) of RSV infection were concentrated in later autumn and winter. Number of the cases show coughing were 120(94.5 percent), but rale was audible in 78 cases(61.4 percent). Dyspnea, wheezing, and intercostal retraction were noticed in 27(21.3 percent), 21(16.5 percent), and 4(3 percent) cases respectively. The most common chest X-ray finding was hyperinflation of the lung that was noticed in 110 cases(86.6 percent). Care with mechanical ventilator for more than 2 days required in 5 cases. Conclusion : Lower respiratory tract infection by RSV was common in late autumn and winter season but year-round infection was noticed. The severity of RSV respiratory tract infectiontakes in some degree a grave course. So we suggest that population-based surveillance of acute respiratory infection due to RSV is necessary for assessment of prevalence and epidemiology of this disease.

Outcome of pregnant mothers with systemic lupus erythematosus (focusing on congenital heart block) (전신성 홍반성 루푸스 산모의 출산아의 임상적 고찰 (완전 방실 블록을 중심으로))

  • Baek, Hey Sung;Choi, Jae Hyung;Kim, Nam Su;Kim, Chang Ryul;Moon, Su Ji
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.381-387
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    • 2006
  • Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1224-1229
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    • 2003
  • Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

Analysis of Set-up Errors during CT-scan, Simulation, and Treatment Process in Breast Cancer Patients (유방암 환자의 모의치료, CT 스캔 및 치료 과정에서 발생되는 준비 오차 분석)

  • Lee, Re-Na
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.169-175
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    • 2005
  • Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

TEACHERS' PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN STUDENTS AND PSYCHIATRIC CONSULTATIONS (학생들의 정신건강문제와 정신과 의뢰에 대한 교사의 인식도 조사)

  • Kwak, Young-Sook;Chun, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.82-90
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    • 1998
  • This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools;distractibility and inattention, conduct problems, and lack of academic skills in middle schools;and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

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A Study on the Relationships between the Oral Health Activities and Oral Health Conditions of the Elderly (노인의 구강보건행위와 구강건강상태와의 관련성 조사 연구)

  • Gwon, Mi-Young;Young, Jin-Young
    • Journal of dental hygiene science
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    • v.6 no.4
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    • pp.271-276
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    • 2006
  • This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).

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Surgical Treatment of the Congenital Esophageal Atresia (선천성 식도 폐쇄증의 외과적 치료)

  • 최필조;전희재;이용훈;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.567-572
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    • 1999
  • Background: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. Material and Method: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. Result: There were 21 male and 6 female patients. Mean birth weight was 2.62$\pm$.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). Conclusion: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.

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Usefulness of Cardiac Troponin I as a Prognostic Marker in Noncardiac Critically Ill Patients (비순환기계 중환자의 예후인자로서 Cardiac Troponin I의 유용성)

  • Kim, Hwi Jong;Ham, Hyoun Seok;Cho, Yu Ji;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.53-61
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    • 2005
  • Background : Cardiac troponin I (cTnI) is a specific marker of myocardial injury. It is known that a higher level of cTnI is associated with a poor clinical outcome in patients with acute coronary syndrome. An elevation in cTnI is also observed in various noncardiac critical illnesses. This study evaluated whether cTnI is useful for predicting the prognosis in noncardiac critically ill patients. Methods : From June 2003 to July 2004 at Gyeongsang National University Hospital, we enrolled 215 patients (male:142, female:73, mean age:$63{\pm}15$ years ) who were admitted for critical illness other than acute coronary syndrome at the medical intensive care unit(ICU). The severity score of critical illness (SAPS II and SOFA) was determined and serum cTnI level was measured within 24 hours after admission to the ICU. The mortality rate was compared between the cTnI-positive (${\geq}0.1{\mu}g/L$) and cTnI-negative ($cTnI<0.1{\mu}g/L$) patients at the $10^{th}$ and $30^{th}$ day after admission to the ICU. The mean cTnI value was compared between the survivors and non-survivors at the $10^{th}$ and $30^{th}$ day after admission to the ICU in the cTnI-positive patients. The correlation between cTnI and the severity of the critical illness score (SAPS II and SOFA) was also analyzed in cTnI-positive patients. Results : 1) The number of cTnI-negative and positive patients were 95(44%) and 120(56%), respectively. 2) The mortality rate at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the cTnI-positive patients (29%, 41%) than in the cTnI-negative patients (12%, 21%)(p<0.01). 3) In the cTnI-positive patients, the mean value of the cTnI at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the non-survivors ($4.5{\pm}9.2{\mu}g/L$, $3.5{\pm}7.9{\mu}g/L$) than in the survivors($1.8{\pm}3.6{\mu}g/L$, $2.0{\pm}3.9{\mu}g/L$) (p < 0.05). 4) In the cTnI-positive patients, the cTnI level was significantly correlated with the SAPS II score (r=0.24, p<0.001) and SOFA score (r=0.30, p<0.001). Conclusion : The cTnI may be a useful prognostic marker in noncardiac critically ill patients.

The Perception of Aseptic Foods in Cancer Patients (멸균식 개발에 대한 암환자의 인식조사)

  • Lee, Kyung-A;Son, Eun-Joo;Song, Beom-Seok;Kim, Jae-Hun;Lee, Ju-Woon;Lyu, Eun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.2
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    • pp.203-211
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    • 2013
  • The purpose of this study was to investigate the perception of aseptic foods (sterilized foods with radiation technology) in cancer patients in Busan. The subjects were 192 cancer patients at a hospital. This study was performed through interviews using questionnaires. Patients had perception scores on the need to develop aseptic foods (4.30 points out of 5.00), use aspetic foods (4.06/5.00), and intake aseptic foods (4.04/5.00). Patients less than 59 years old had significantly higher perception scores than those over 60 years old (p<0.05). The scores on aseptic food indicated the importance of various factors, including sanitation (4.86/5.00), good materials (4.82/5.00), nutritional value (4.79/5.00), unused of monosodium glutamate (MSG) (4.66/5.00), taste (4.61/5.00), and reasonable prices (4.60/5.00). The patients who were college graduates showed significantly higher scores and importance in good materials, proper packaging unit, simple cooking methods, food diversity, and familiar foods (p<0.05). In the aseptic menu items, patients wanted to include seasoned raw vegetables (4.11/5.00), a set menu (including cooked grain, soup, and a side dish) (4.08/5.00), seasoned cooked vegetables (4.04/5.00), low sodium kimchi (3.98/5.00), and fermented sauces (3.92/5.00). The patients with gastrointestinal cancer and other cancers (e.g. breast, thyroid, and renal cancer) had significantly higher necessity scores than lung patients for stew, seasoned raw vegetables, salad, low sodium kimchi, and a set menu (p<0.05).

Reduction Effect of Aromatherapy on Stress and Insomnia (아로마요법의 스트레스 및 수면장애 감소효과)

  • Park, Sang-Ock;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.17-26
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    • 2002
  • Reducing the level of stress and insomnia by aromatherapy is proposed as a method of self-care and health promotion in the future. Of the people who received aromatherapy from July, 1999 to February, 2000 at the Complementary and Alternative Medicine Center at the Gyeongu City Health Center, 48 people agreed to participate in a questionnaire survey, presented before and after their aromatherapy, and the data were analyzed. When the people received aromatherapy at the Complementary and Alternative Medicine Center, they inhaled the aroma from a vaporizer and when at home, they inhaled from a tissue, gauze or washbowl. Two sessions per week (2 hrs./session) were provided at the Center in the total 1-month duration of the therapy. The oil made from a blend of clarysage, geranium, rose at a ratio of 3:2:1 was used for relieving stress, and the oil made from a blend of clarysage, lavender, and lemon at 2:2:1 ratio was used for relieving insomnia. The scores of stress of 92.5 17.5 points before aromatherapy significantly reduced to $87.4{\pm}4.2$ points after therapy(p<0.01), and the scores of insomnia of $2.5{\pm}1.2$ points before aromatherapy significantly reduced to $1.0{\pm}1.1$ points after therapy(p<0.01). The reduction in stress and insomnia from aromatherapy was more significant in those who were experiencing high levels of stress and insomnia. Therefore, stress and its related insomnia can be effectively relieved with proper application of aromatherapy. With benefits such as little side-effects, convenient and simple education, low cost, and the do-it-yourself feature. aromatherapy can be expanded into a self-management program for promoting health of the community people.

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