• Clinical and Experimental Pediatrics
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• 제61권11호
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• pp.366-370
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• 2018

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

• Pediatric Infection and Vaccine
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• 제23권2호
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• pp.94-101
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• 2016

목적: 대학병원에 근무하던 중 활동성 폐결핵으로 진단된 전공의에게 노출된 의료종사자들에 대하여 실시한 접촉자 조사의 결과를 보고한다. 방법: 활동성 폐결핵 환자와 밀접한 접촉을 한 사람(접촉자) 101명 중 89명이 접촉자 조사에 응하여 조사를 받았다. 1차 접촉자 조사는 지표환자의 증상 개시 후 30일경에, 2차 조사는 1차 조사 10주 후에 기침, 발열, 인후통, 체중 감소와 같은 임상증상 확인 및 단순흉부촬영과 함께 결핵반응검사(Tuberculin skin test, TST)/QuantiFERON-TB Gold (QFT-G) 2단계 검사법을 시행하였다. 결과: 1차 TST 양성자는 34명(38.2%)이었고, TST 양성자 중 35세 이하 접촉자에서 시행한 QFT-G 양성률은 37.5% (6/16)이었다. 1차 TST 음성 대상자 41명에게서 시행한 2차 TST에서 17명(41.5%)이 양전을 보였고 그들 중 시행한 QFT-G 검사에서 3명(17.6%)이 양성이었다. 활동성 결핵으로 진단된 접촉자는 없었으며 지표환자에 노출되어 발생한 결핵 전파율은 2단계 검사법으로는 7.3% (3/41)였고, TST 진단법으로는 41.5% (17/41)였다. 결론: 국내에서 처음 보고되는 병원 내 결핵 접촉자 조사 연구로서 LTBI 발생률이 그 진단 기법에 따라 달랐으며 따라서 앞으로 발생할 수 있는 의료종사자들에 대한 병원 내 결핵 접촉자 조사를 위해 조직적이고 실용적인 가이드라인이 필요할 것이다.

• 대한미생물학회지
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• 제20권1호
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• pp.115-125
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• 1985

Hemorrhagic fever with renal syndrome (HFRS) is a debilitating disease of humans caused by Hantaan virus (HV), the prototype member of a newly proposed genus of Bunyaviridae. Studies of HV pathogenesis have been limited by the absence of a well defined model for a virus-induced disease state. In an attempt to devise a model for HV pathogenesis in laboratory rodents, newborn outbred suckling ICR mice were shown to be uniformly susceptible to lethal infection with non- mouse adapted HV by intracerebral (IC), intraperitoneal (IP), intramuscular (IM), and subcutaneous (SC) inoculation routes. Clinical coures, mean time to death, and fatal outcome were age-dependent. With an inoculum of 10 $LD_{50}$, mortality was 100% in mice infected within 72h of birth, but declined to 50% by 7 days. By 2-2.5 weeks, animals developed complete resistance to clinical disease. Virus was consistently detected in serum by day 6 post-infection in IC- and IP- inoculated animals, and reached peak levels of $10^5\;PFU/ml$ by day 8 Mice infected IM and SC showed delays in onset of viremia, but achieved similar titers. Immunofluorescent antibody appeared by 17-18 days, and neutralizing antibody by 15 days, in all experimental groups. Two of 8 inbred mouse strains were identified as resistant to clinical disease : SJL/J and A/J. Manipulation of this model will allow investigation of natural rodent pathogenesis with HV, as well as offer insight into disease mechanisms and therapy of HFRS.

• 혜화의학회지
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• 제15권1호
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• pp.41-45
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• 2006

Aims: This overview summarizes the existing evidence on acupuncture for cancer-related pain. Methods: Literature searches were conducted in 7 databases. All clinical studies of acupuncture, electroacupuncture, ear acupuncture and transcutaneous electrical nerve stimulation (TENS) in cancer patients with the main outcome measure of pain were included. Results: Of the 8 studies included, one high quality randomized clinical trial (RCT) of ear acupuncture showed statistically significant pain relief in comparison with placebo ear acupuncture. All the other studies were either non-blinded (n = 2) or uncontrolled clinical trials (n = 5). Most investigations suffered from methodological flaws such as inadequate study design, poor reporting of results, small sample size and overestimation of the results. Conclusions: The current evidence does not support the use of acupuncture as an adjunctive analgesic method for cancer patients. Only one high quality RCT showed promising results thus warranting further investigation into this under-researched area.

• 대한임상검사과학회지
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• 제49권2호
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• pp.171-179
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• 2017

본 연구는 서울경기지역의 의료기관에 근무하는 임상병리사 158명을 대상으로 은퇴기대에 영향을 미치는 요인을 찾고자 자기기입식 설문조사를 실시하였다. 학력수준과 경제적 준비는 음의 상관성을 보였으나 성별, 월 소득 수준은 은퇴기대수준에 미치지 않는 요인이었다. 좌절감 수준에서는 연령과 근로시간 면에서 유의한 증가를 보였으며, 교육수준과 결혼 상태는 은퇴 준비에 미치는 요인이나 은퇴 기대에는 연관성이 없음을 알 수 있었다. 따라서, 연령, 교육수준, 가족, 은퇴기대 조건이 상호 연관성을 미치는 요인임을 알 수 있었다. 결론적으로 본 연구는 의료현장의 임상병리사들이 향후 은퇴기대 및 은퇴준비를 위해 영향인자를 발굴하는 기초정보를 제공하였고 향후 은퇴를 위한 교육, 심리적 수준, 직업특성을 고려하는 연구가 추가되어야 할 것으로 사료된다.

• 한국임상약학회지
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• 제22권2호
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• pp.131-136
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• 2012

Objective: This study evaluated and compared the adherence to the CONSORT for quality of reports on the randomized controlled trials (RCT) abstracts by four major Korean Science Citation Index (SCI) journals and The New England Journal of Medicine (NEJM). Methods: A descriptive analysis of published RCT abstracts in Korean SCI journals and NEJM from 2007/01 to 2011/06 was conducted by two reviewers, independently extracting data from a PubMed search. A modification of CONSORT for abstract was used including 16 checklist items. Reporting of checklist items for individual group was conducted to compare adherence patterns between two groups. Results: We identified the potential 57 RCT abstracts from Korean SCI and 50 from NEJM meeting our inclusion criteria; among them, three abstracts from Korean SCI and one from NEJM were excluded. Among total 16 checklist items based on CONSORT statement, Korean SCI journals and NEJM were statistically equivalent in 4 items; Korean journals were better in three items and NEJM were in nine. The methodological quality domains were inadequately reported in both journals: allocation concealment about 1.9% and 4.0%, and blinding 44.4% and 40.8%. In general, The CONSORT adherence of NEJM was better than that of Korean SCI in the method and result domain (p < 0.0001). Conclusions: The quality of NEJM reporting of RCT abstracts was better than that of Korean SCI, in general. This study on adherence of RCT reports from Korean SCI journals and NEJM abstracts to the CONSORT statement reveals that there is a need for improvement, especially Korean SCI. Further investigation on the quality of RCT reports and ways to improve reporting quality is required.

• 한국보건간호학회지
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• 제13권2호
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• pp.202-214
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• 1999

This study was conducted to provide the data for the improvement of home health nursing services through the investigation of burden and satisfaction felt by family caregivers under home health nursing care. The study subjects consisted of 200 family caregivers who were enrolled m six university hospital home care services. Data were collected by using constructed questionnaires through mail from March to April of 1999. and analyzed by using t-test. ANOVA, Duncan-test. and Pearson Correlation Coefficients. The results were as follows: 1. The mean score of burden was 2.24. Among the SIX burden dimensions. the highest score was marked in time-dependence dimension. Caregivers were found to have greater burden in the low income families living in flats. In relation to the characteristics of patients. higher scores were shown in the male patients with cerebrospinal diseases. who also revealed higher score of dependency in the Activities of Daily Living. As a whole. there was no significant difference between home nursing care and clinical nursing care in terms of family caregivers' burden. The burden of time-dependence dimension in home nursing care was significantly higher than that of clinical nursing care while the burdens of physical. social. and financial dimensions were significantly lower than those of the clinical nursing care. 2. The mean score of satisfaction was 3.14. Among the six items. the highest score was marked in the nursing care and treatment skill. while the lowest score was marked in the cost containment. Family caregivers with higher academic background and higher income showed higher satisfaction score. The mean score of home care nursmg was significantly higher than that of clinical nursing care.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.7-12
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• 2010

Purpose: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. Methods: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. Results: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. Conclusion: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.

• 대한족부족관절학회지
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• 제19권3호
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• pp.86-90
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• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.259-268
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• 2016

Purpose: Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods: Hair mineral analyses were performed in 56 children (age, 1-15 years) presenting with malnutrition, poor growth, poor appetite, anorexia, with/without other GI symptoms (diarrhea, abdominal pain, constipation) from August 2012 to March 2015. Biochemical studies for macronutrients and major micronutrients were also conducted. Results: Hair zinc deficiency was diagnosed in 88%, and serum zinc deficiency was diagnosed in 55% of the children. There was no statistical correlation between serum and tissue zinc level. Hair zinc levels were highly correlated with serum vitamin D (r=-0.479, p=0.001), which also showed correlation with hair levels of magnesium and calcium. (r=0.564, 0.339, p=0.001, 0.011). Hair calcium level was correlated with serum pre-albumin (r=0.423, p=0.001). These correlations may explain the phenomenon that the major clinical manifestation of zinc deficiency is poor body growth. Clinical symptoms were resolved in most children after zinc supplementation. Conclusion: Hair zinc and mineral analyses are useful as a therapeutic guide in the clinical investigation of children with malnutrition and poor growth.