• Title/Summary/Keyword: Clinical practice

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Analysis of online breast-feeding consultation on the website of the Korean Pediatric Society (대한소아과학회 홈페이지의 모유수유 상담내용 분석)

  • Kim, Jung Yun;Hwang, Seung Jae;Park, Hyun Kyung;Lee, Ha-beck;Kim, Nam Su
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1152-1157
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    • 2008
  • Purpose : Since the infant formula milk has been produced in Korea, it has faced a low rate of breast milk feeding, though breast milk feeding is a little increasing. Therefore, the Korean Pediatric Society launched its website for breast-feeding consultation to provide information to the general public and enhance the health of growing infants. The consultation results were analyzed to identify the problems that mothers encounter during breast-feeding. Methods : From August 1, 2004 to July 31, 2007, 1001 mothers who visited the online consultation webpage (www. pediatrics.or.kr) of the Korean Pediatric Society asked 1,021 questions. The questions were divided into 3 major categories and 14 specific categories. Interesting questions asked more than 100 times were retrospectively analyzed. Results : The results for the major categories were as follows: 413 questions (40.3%) were on how to breast-feed, 315 (30.8%) on problems of feeding mothers, and 293 (28.8%) on problems of the fed babies. In the specific categories, 22.2% of the questions were on how to breast-feed. With the increasing number of working couples and working mothers, many questions were asked on the problems of breast-feeding after returning from work. Conclusion : The author expects that analyses of these consultations will contribute to the enhancement of information on the consultation website, thus enabling to provide clearer answers to people's increased interest in and concerns on breast-feeding. Furthermore, this research will help to establish correct breast-feeding practice.

An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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Clinical Analysis of the Belsey Mark IV Operation in Hiatal Hernia with Gastroesophageal Reflux and Achalasia (위 식도 역류를 가진 열공 헤르니아 환자와 식도 무이완증 환자에서 시행한 Belsey Mark IV 수술의 임상적 고찰)

  • 최영호;조원민;류세민;황재준;손영상;김학제;김광택
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.217-222
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    • 2002
  • Background: The incidence of gastroesophageal reflux disease(GERD) is increasing recently, but medical management for GERD has many limitations. Therefore, variable surgical treatments have been introduced. Material and Method: A retrospective study was done in 10 patients who underwent the Belsey Mark IV operation at Korea university Guro hospital between 1996 and 2001. Preoperative diagnoses were hiatal hernia with gasroesophageal reflux in 8 patients and achalasia in 2 patients. Result: Mean age of the patients was 54.3$\pm$19.0 years. Belsey Mark IV operation was performed on patients where preoperative medical failed and mean hospital days were 13.1$\pm$2.6 days. We routinely practiced follow-up endoscopy on postoperative 3rd, 6th, 9th, and 12th months. After remission for reflux and esophagitis, they were transferred to internal medicine department. Six patients of hiatal hernia with reflux (one patient who lost follow-up and the other patient who didn't practice the follow-up endoscopy due to short postoperative follow-up period were excluded) had lowered endoscopic gradings and two patients of achalasia did not complained of reflux symptoms, postoperatively. We experienced 10% operation failure rate. Conclusion: We experienced satisfactory operation results with Belsey Mark IV in hiatal hernia with GERD and achalasia patients.

Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.371-377
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    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

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Effect of Supportive Nursing Intervention on Hopelessness, Self-Esteem, Self-Concept of Operative Patient with Head and Neck Cancer (전인적 지지간호중재가 두경부암 수술환자의 절망감, 자아존중감 및 자아개념에 미치는 효과)

  • Seok, Jung-Hee;Kang, Eun-Sil;Choi, Hwa-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.189-199
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    • 2004
  • Purpose: Despite the small incidence, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking. It may provoke hopelessness, change self-esteem and self-concept after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. Methods: This study was a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research designed to determine how supportive nursing intervention effects on hopelessness, self-esteem and self-concept of head and neck cancer patients. Subjects of the study included 40 adult inpatients of K University hospital in Pusan who were diagnosed as having head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher by means of reference, literal review and expert's advice. The measurement tool of hopelessness was translated by Won was the device of hopelessness self-evaluation from Beck, the tool for self-esteem measurement was developed by Rosenberg and translated by Kim, and the device of self-concept used by Lee et al, modified by Lee were used respectively. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using $x^2-test$ and t-test. 3 hypotheses were tested using t-test. Results: The results of the study can be summarized as follows. 1. The third hypothesis that the experimental group receiving supportive nursing intervention showed a little hopelessness than the control group not receiving supportive nursing intervention was supported (t=4.550, P=.000). 2. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-esteem than the control group not receiving supportive nursing intervention was supported (t=-6.40, p=.000). 3. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-concept than the control group not receiving supportive nursing intervention was supported (t=-6.065, P=.000). Conclusion: Supportive nursing intervention was effective nursing intervention strategy for reducing hopelessness and increasing self-esteem and self-concept of head and neck cancer patients. Then the quality of life of head and neck cancer patients can be enhanced by providing supportive nursing intervention in nursing practice.

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The Effect of Temperature and Concentration of Setting Solution on the Rheological Properties of Injectable Calcium Phosphate (경화액의 농도와 온도가 인산칼슘시멘트의 유변학적 성질에 미치는 영향에 관한 연구)

  • Yoo, Hyun-Mi;Chang, Seok-Woo;Park, Dong-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.1
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    • pp.73-82
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    • 2009
  • Injectable calcium phosphate cement (CPC) has been used as bone substitute successfully due to good biocompatibility and osteoconductivity. One of the important mechanical characteristics of CPC is flowablility, which can be evaluated by measuring rheological parameters. However, there have been few studies that measured rheological properties of CPC. The purpose of this study was to evaluate the effects of temperature and concentrations of 2 kinds of setting solutions, hydroxyprophyl methylcellulose (HPMC) and polyacrylic acid (PAA), on rheological properties of CPC. The CPC used was dicalcium phosphate dihydrate (DCPD). Rheological properties of CPC paste were measured using rheometer. The effect of concentrations of each solution (2% and 1% HPMC and 35% and 17.5% PAA) was evaluated. The effect of temperature ($25^{\circ}C$ and $37^{\circ}C$) on the rheological properties of CPC was also investigated. The statistical analysis was carried out with Mann-whitney test with Bonferronis collection. CPC with both setting solutions showed shear thinning behavior. Higher concentrations of setting solution (2% HPMC and 35% PAA) produced significantly higher viscosity than lower concentrations of setting solution (1% HPMC and 17.5% PAA). CPC with HPMC showed significantly higher viscosity at $37^{\circ}C$ that at $25^{\circ}C$. CPC with PAA showed lower viscosity at $37^{\circ}C$ than at $25^{\circ}C$, although the difference was not statistically significant. The results showed that CPC with HPMC or PAA solutions are pseudoplastic and the concentrations of setting solutions and temperature may have an effect on the rheological properties of CPC paste. These results showed that the flowability of injectable CPC could be improved by use of increasing frequency of oscillation. In clinical practice, the use of ultrasonic vibration would be helpful in application of injectable CPC. CPC with HPMC could be more easily applicated at $25^{\circ}C$ than $37^{\circ}C$. The use of lower concentrations of HPMC and PAA solution would be beneficial in terms of flowability.

A Study on the Relationship between Sleep Quality and Cognitive Function in Community Elderly (지역사회 노인에서의 수면의 질과 인지기능의 관련성에 대한 연구)

  • Oh, Youn-Kyoun;Kim, Bong-Jo;Park, Chul-Soo;Lee, Cheol-Soon;Cha, Bo-Seok;Lee, So-Jin;Lee, Dong-Yun;Seo, Ji-Yeong;Choi, Jae-Won;Lee, Young-Ji;Lee, Jae-Hon;Lee, Youn-Jung
    • Sleep Medicine and Psychophysiology
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    • v.27 no.1
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    • pp.16-23
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    • 2020
  • Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.

Comparison Research of Clinical Effect of Eastern and Western Medical Treatment on Frozen Shoulder Patients (동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 - 견관절 가동운동범위(ROM) 변화를 중심으로 -)

  • Nam, Dong-Woo;Kim, Haeng-Beom;Yang, Dong-Hoon;Lim, Sa-Bi-Na;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Jae-Dong;Choi, Do-Young;Lee, Yun-Ho
    • Journal of Acupuncture Research
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    • v.23 no.5
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    • pp.105-113
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    • 2006
  • Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

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THE CALCIFICATION TIMING OF THE PERMANENT TEETH BY NOLLA STAGE (Nolla stage에 의한 영구치의 석회화 시기에 대한 연구)

  • Ahn, Sang-Hyun;Yang, Kyu-Ho;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.540-548
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    • 2000
  • The aim of this study was to evaluate the timing of sequence of tooth calcification in current Korean growing children. The Calcification stage of permanent teeth of Korean children was investigated by classifying them into 10 stages by the criteria of Nolla, using the panoramic radiographs of 258 healthy Korean children, 149 males and 109 females, between the ages of 4 years and 13 years, with normal growing tendency and no orthodontic treatment experience. The obtained results were as follows: 1. Timing of calcification of permanent teeth by Nolla stage was established with mean values. Among the mean value, results of Nolla stage 7 were as follows: Calcification timing of male in the maxilla was 6 year 9 month on central incisor, 7 year 4 month on lateral incisor,7 year 9 month on canine, 8 year 8 month on the first premolar, 9 year 4 month on the second premolar, 6 years 3 month on the first molar and 10 year 8 month on the second molar, calcification timing of male in the mandible was 5 year 11 month on central incisor, 6 year 4 month on lateral incisor, 7 year 5 month on canine, 8 year 1 month on the first premolar, 8 year 6 month on the second premolar 5 years 6 month on the first molar and 10 year 3 month on the second molar. Calcification timing of female in the maxilla was 6 year 2 month on central incisor, 6 year 7 month on lateral incisor, 6 year 11 month on canine, 8 year 1 month on the first premolar, 8 year 5 month on the second premolar, 5 years 10 month on the first molar and 9 year 10 month on the second molar, calcification timing of male in the mandible was 5 year 6 month on central incisor, 5 year 9 month on lateral incisor, 6 year 8 month on canine, 7 year 6 month on the first premolar, 8 year 4 month on the second premolar, 5 years 3 month on the first molar and 9 year 7 month on the second molar. 2. The sequence of calcification at Nolla stage 7 was in consequence to the first molar, central incisor, lateral incisor, canine, the first premolar, the second premolar and second molar. 3. While the sequence of root completion of maxilla was in consequence to the first molar, central incisor, lateral incisor, that of mandible was in order of central incisor, first molar and lateral incisor. 4 the calcification timing of permanent teeth was earlier in female than in male (p<0.05). According to above data, the result of this study is applicable for diagnosis and routine clinical practice for children.

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