Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.
Kim, Hea Sook;Choi, Yun Soon;Chang, Soon Bok;Jung, Jae Won
The Korean Nurse
/
v.34
no.3
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pp.85-98
/
1995
The purpose of this study is to provide basic data regarding effective learning opportunities in childbirth education classes. Also analysis of the data indicates the optimum conditions for the welfare and improvements in the promotion of health in childbearing mothers. The results of this study are as follows; 1) The average age of the subjects in this study was 30.6 years and the total number of subjects was 58 pregnant women. The average number of children was one and 84.5% of the subjects were unemployed even though 63.8% of them held over bachelor's degrees. It was found that 22.4% of the subjects were living in an extended family. Also 61.5% of them were living with parents-in-law. The number of pregnancies were calssified as one, two, or three to nine times with the percentages of 58.7%, 22.4% and 18.9%, respectively. Further, 72.4% of the subjects had no abortion experience and 15.5% had one aborion experience. While 89.7% of the subjects planned to feed their babies with breastmilk, mixed feeding were used by only 22.4% of the sample. These data were collected at about 6 months after delivery. Thus one can see that a low rate of breastfeeding was common. 2) The length of one period of childbirth education is four weeks. It was found that 36.2% of the subjects participated in childbirth education only once, where as 13.8% participated four times and 19% of the subjects participated in this class more than four times. pregnant at least once. Further, 75.9% of the participants were participated in this education through their own will. Their motivation for participation developed through information, advertisement and posters which contained information on childbirth education. Those with unplanned pregnancies 92.9% participated after a suggestion by the nurses. The number of participants in terms of percentage according to the childbirth education contents can be classified as following. The most active participation was shown in preparation of delivery(77.6%), postpartrm management(56.9%) fetal development(37.6%) and physiology of pregnancy(17.2%). It was found that 75.9% of the subjects were willing to participate again if they were given a chance. The reason can be summarized as following: The content of the education is very helpful(47.7%). Scientific knowledge can be obtained through this program(20.5%). Participation helps in achieving psychological stability(9.1%). Participation enables one to establish a friendly relationship with other participants(6.8%) of the sample. 24.1% of the participants did not want to participate again. The reasons can be as following: They do not want another baby(42.9%). The first paricipation in childbirth education gave enough knowledge about childbirth(21.4%). Another reason for not want to participate again was because they had a cesarean birth(14.3%). Only 7.1% of them responded with a negative view. A response that they do not need childbirth education after their operation can be traced back to the general belief that childbirth education is the place where one prepares for natural birth through the Lamaze breathing technique. Of the subjects, 91.4% suggested that this program could be recommended to other childbearing mothers, because this program gave educational content along with psychological stability for childbearing women. Of the subjects 41.4% did not see any efforts towards the welfare of the baby, where as 88.2% did. Among the subjects 58.6% made some effort to eliminate the discomfort of labor by breathing and imagination and breathing and walking. Further 41.7% of the 24 subjects did not do anything toward the welfare of the baby, because they did have a cesarean section so that they didn't have a chance even though they had been educated about childbirth. Also 33.3% of the subjects did not do anything toward the welfare of the baby, because they lacked a willingness. After leaving the hospital, only 75.9% of the subjects did some exercises. The subjects who tried participate this program with their husband accounted for 20.7% of the sample. Interviewing with the subjects solved some of the uneasiness and. fear of delivery, increased self-confidence in parenting and active coping in the delivery process.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.9
no.1
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pp.98-104
/
1998
A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.
Journal of the korean academy of Pediatric Dentistry
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v.35
no.4
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pp.642-651
/
2008
This study was carried out to give basic information of traumatic injuries of primary and permanent teeth which can be used for diagnosis and management of injured teeth. From January 2003 to July 2007, 570 children with 1394 teeth who came to pediatric dentistry and emergency center of Chonnam National University Hospital due to the traumatized teeth participated in this study. The following data were investigated. : age, sex, causes and places of trauma, position of injured teeth, types of injury, and treatment at the first visit. 1. Trauma prevailed at the age of 1, $6{\sim}8$, $17{\sim}18$ and the rate of males was more likely to be higher than the rate of females(1.9 : 1). 2. The main cause of injury is a fall-down injury for primary and mixed dentition, but is a traffic accident and fighting for permanent dentition, respectably. The place of injury for primary dentition is mainly home(45.3%), while street for mixed and permanent dentition. 3. The position of injured teeth according to the area in the mouth is mainly maxillary anterior teeth in both case of primary and permanent teeth and especially, the ratio of central incisors is high. 4. The periodontal tissue injury occurred the most frequently in the primary and the permanent teeth, but the ratio of hard tissue injury in the permanent teeth increased, compared with the primary teeth. 5. Among treatments at the first visit, observation without actual treatment comprised 75.6% in the primary teeth and 55.4% in the permanent teeth, respectably. The pulp necrosis occurred in 20.3% of the primary teeth and 26.6% of the permanent teeth in the case of the periodontal tissue injuries, respectably.
The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.
Journal of the korean academy of Pediatric Dentistry
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v.34
no.2
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pp.215-221
/
2007
The aim of this study was to test whether metric measurements of crown length, root length and apex width during tooth development could be a better basis for correlation with age than the classical methods based on subjective estimations of various stages of tooth development. Panoramic radiographs of 120 children, aged 7 to 9 years, were collected from the department of the pediatric dentistry of Chonnam National University Hospital, Korea. The methods of Mornstad was used to estimate age. The structures measured were crown length root length and apex width in panoramic radiographic. The results were as follows : 1. In the boys, it showed higher correlation between lower 2nd molar crown length, lower 1st molar root length or lower 1st permolar apical width and age. In the girls, it showed higher correlation between lower 2nd premolar crown length, lower 2nd molar root length or lower 1st molar apical width and age. 2. With the aid of a multiple regression model, a linear relationship between some of these distances and age was shown. Boy(months) = 43.958 + lower 2nd molar crown length ${\times}$ 4.392 + lower 1st molar root length ${\times}$ 2.255 - lower 1st permolar apical width ${\times}$ 2.046, Girl(months) = 75.213 + lower 2nd premolar crown length ${\times}$ 3.910 lower 2nd molar root length ${\times}$ 2.280 - lower 1st molar apical width ${\times}$ 6.217 Age was estimated in boys and girls using the mathematic model ; the mean difference between chronological and estimated ages was $-2.1{\pm}6.8$ months for boys and $6.1{\pm}6.2$ months for girls. Therefore, it seems to be more accurate and easier than the earlier methods.
Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
Clinical and Experimental Pediatrics
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v.50
no.5
/
pp.436-442
/
2007
Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.
Purpose : To test whether the expression of ${\beta}$-catenin, a component of podocyte as a filtration molecule, would be altered by puromycin aminonucleoside (PAN) in the cultured podocyte in vitro. Methods : We cultured rat glomerular epithelial cells (GEpC) with various concentrations of PAN and examined the distribution of ${\beta}$-catenin by confocal microscope and measured the change of ${\beta}$-catenin expression by Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR). Results :We found that ${\beta}$-catenin relocalized from peripheral cytoplasm to inner cytoplasm, therefore, intercellular separations were seen in confluently cultured cells by high concentrations of PAN in immunofluorescence views. In Western blotting of GEpC, PAN ($50{\mu}g/mL$) decreased ${\beta}$-catenin expression by 34.9% at 24 hrs and 34.3% at 48 hrs, compared to those in without PAN condition (P<0.05). In RT-PCR, high concentrations ($50{\mu}g/mL$) of PAN also decreased ${\beta}$-catenin mRNA expression similar to protein suppression by 25.4% at 24 hrs and 51.8% at 48 hrs (P<0.05). Conclusion : Exposure of podocytes to PAN in vitro relocates ${\beta}$-catenin internally and reduces ${\beta}$-catenin mRNA and protein expression, which could explain the development of proteinuria in experimental PAN-induced nephropathy.
Purpose: To evaluate the validity of the Korean Ages and Stages Questionnaire (K-ASQ) in premature infants. Methods: Infants with a gestational age of less than 37 weeks were assessed with K-ASQ and Bayley Scales of Infant Development-III (BSID-III) at the outpatient clinic of Seoul National University Children's Hospital between October 30, 2006 and August 1, 2010. Less than 1 standard deviation of the ASQ was defined as positive, and the results were compared with those of BSID-III. Results: The mean gestational age of subjects in the study group was 28$\pm$2.87 weeks (median, 28.43 weeks; range, 23.57-35.86weeks), and the mean birth weight was 1,027$\pm$363 g (median, 950 g; range, 480-2,870 g). The sensitivity of K-ASQ at 8 month was 0.2, and the specificity was 0.93. The sensitivity of K-ASQ at 18 months was 0.72, and the specificity was 0.94. The validity of each of the 4 matched subunits was separately compared, and it also had a high specificity and a low sensitivity. In addition, KASQ showed a higher sensitivity at 18 months than at 8 months. Conclusion: ASQ was developed to screen the general population, and its specificity has been powered. The specificity was also proven in our study. The results of this study suggest that although screening use of K-ASQ in preterm infants may have some limitations, the specificities at 8 and 18 months can be clinically implicated. Further studies are needed to confirm our results.
The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.
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