• Journal of Chest Surgery
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• v.17 no.1
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• pp.118-124
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• 1984

Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.40-48
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• 2005

The purpose of present study was to compare the sedative effect of chloral hydrate and oral midazolam treatment. The study was conducted on twenty two child patients who required at least two visits. All the patients showed a good physical status (ASA-I). The patient was randomly assigned to receive drug either chloral hydrate 60mg/kg and hydroxyzine 25mg(Group I) or midazolam 0.5mg/kg and hydroxyzine 25mg(Group II) at each visit. Treatment procedures were divided into six stages. In each stage, sleep, crying, movement and overall behavior score were evaluated. The overall results can be summarized as follows: 1. Success rate was 59.9% in group I and was 77.8% in Group II. 2. Mean sleep score was $1.81{\pm}0.93$ in group I and was $1.44{\pm}0.69$ in group II (P<0.05). 3. Through all treatment procedures, no significant difference was observed between group I and group II in terms of crying, movement and overall behavior score(P>0.05). 4. There was no significant difference between the sex and the age(P>0.05). In regard to above results, oral midazolam considered to be a valuable drug as sedative agent in pediatric dentistry.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.431-438
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• 2004

The purpose of present study was to compare the sedative effect of intranasal and oral midazolam treatment. The study was conducted on twenty eight child patients who required at least two visits. All the patients showed a good physical status (ASA-I). The patient was randomly assigned to receive midazolam either intranasal (Group I, 0.25 mg/kg) or oral (Group II, 0.5mg/kg) route at each visit. Treatment procedure was divided into six stages. In each stage, sleep score, crying score, movement score and overall behavior score were evaluated. The overall results can be summarized as follows: 1. Through all treatment procedures, no significant difference was observed between Group I and Group II in terms of sleep, crying, movement and overall behavior index. 2. In a questionnaire to the parents, 67.8% of parents answered that the child suffered at intranasal administration, while only 17.7% of parents responded the same way at oral administration. 3. In a questionnaire regarding patients' behavior at home after midazolam treatment, 'Similar to normal behavior' was 78.6% in Group I and 57.1% in Group II, indicating that intranasal treatment of midazolam may be more effective for the recovery.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.489-497
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• 2002

The purpose of this study was to compare the clinical sedation effect of chloral hydrate and hydroxyzine combination with and without nitrous oxide/oxygen inhalation when young children were sedated for dental treatment. The uncooperative 20 children aged, 21 to 47 months of age(ASA Class I), participated in the study. The author examined 20 children(male 12, female 8). Each patient was assigned to receive chloral hydrate(50mg/kg) and hydroxyzine(25mg). Next appointment, each patient was assigned to receive $N_2O-O_2$, choral hydrate and hydroxyzine. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale. Pulse rate and peripheral oxygen saturation were also measured for monitoring the sedated patients during treatment period by pulse oximeter. The result were as follows : 1. In the evaluation of sleep scores, crying scores, and movement scores, chloral $hydrate/hydroxyzine/N_2O-O_2$ combination group was significantly rated high(p<0.05). 2. In the evaluation of overall behavior scores, chloral hydrate/hydroxyzine/$N_2O-O_2$ combination group was significantly rated high(p<0.05). 3. In the evaluation of overall behavior evaluation scores(by Houpt), 93.3% in chloral $hydrate/hydroxyzine/N_2O-O_2$ combination group and 63.3% in chloral hydrate/hydroxyzine combination group were rated "good" or "very good". 4. There was no adverse side effect(i.e. respiratory depression) in both group.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.283-291
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• 2000

The purpose of this study was to compare the sedative effect of three routes of administration - intramuscular, intranasal drop-in, intranasal spray - with midazolam. The twenty two uncooperative children from 23 months to 76 months who required at least three dental appointment. Each patient was assigned randomly to receive intramuscular(Group I, 0.15mg/kg), intranasal drop-in(Group II, 0.20mg/kg), intranasal spray(Group III, 0.20mg/kg) administration at each visit. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale In order to monitor the sedated patients, pulse rate and peripheral oxygen saturation were measured by pulse oximeter during treatment procedures. The results were as follows 1. Pulse rate and peripheral oxygen saturation were stable through all the treatment procedures, and there were no statistically significant differences among three routes of administration(P>0.05). 2. The effect on sleep was, III, II, I, in order, III group was the most effective through all the treatment procedures, except rubber-dam placement and filling phase (P<0.0001). 3. The effects on crying, movement, overall behavior were II, III, I, in order, II group was the most effective through all treatment procedures(P<0.0001).

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.189-195
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• 2002

In the area of pediatric dentistry, several behavior modification techniques have been attempted to relieve young patients' dental fear. The use of audio-visual(AV) aids is one of them and is increasing. In this study, several patients' reactions to dental treatment have been investigated after using AV aids, including patients' sleep, movement, crying and overall behavior. The effectiveness of AV aids have also been investigated through patients' age, previous dental experience and daily exposure to TV or video. Thirty healthy children with Frankl behavior rating (+) or (-) were included in this study. The average age of the children was $52.9{\pm}12.7$ months and no statistical difference was found between the two groups. Thirty patients were equally divided into two groups. Group I(control) received dental treatment with the conventional tell-show-do while group II(AV) with tell-show-do and AV aids. All patients received only restorative dental treatment and received no extraction. Houpt behavior rating scale was used to evaluate patients' behavior during the dental treatment. As a result, there was no significant difference between the two groups in movement and crying. However, more patients in the AV group fell asleep during the dental treatment compared to the control group. Within the AV group, patients with previous dental experience, older age and frequent exposure to AV materials showed better overall behavior during the dental treatment as audio-visual aids were used for behavior management.

• Journal of the Korean Data and Information Science Society
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• v.27 no.1
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• pp.203-215
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• 2016

This study was performed in order to investigate the effect of breast milk on pain relief in newborn during heel lancing. Nonequivalent control group pretest-posttest design by double blinded experiment was used. 50 neonates were randomized to receive breast milk (experimental group, n=25) or no treatment (control group, n=25) before undergoing heel lancing. Informed consent was obtained from parents of 50 neonates. Neonatal infant pain scale (NIPS), respiration rate, heart rate, oxygen saturation, and crying duration were used to assess subjects' pain reaction. Data were analyzed using SPSS 18.0. The experimental and control group showed a statistically significant differences in NIPS score (F=28.89, p<.001), heart rate (F=14.03, p<.001), respiration rate (F=4.79, p=.001), oxygen saturation (F=2.69, p=.027), and crying duration (t=-8.78, p <.001) at each time points (during heel lancing, right after heel lancing, 1, 2, 3 minutes after heel lancing). The result suggest that oral administration of expressed breast milk is safe and natural agents for reducing procedural pain of neonates. Another clinical trial study with more samples is recommended.

• Child Health Nursing Research
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• v.5 no.3
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• pp.281-291
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• 1999

The purpose of this study was to compare the sleep characteristics between the prone and the supine position in healthy newborns. The 48 newborns were observed in the prone position and the supine position respectively on the 2nd day after birth. The data were collected from January to May, 1999. The state of a newborn was classified and categorized to 6 states (deep sleep. light sleep, drowsy, quiet alert, active alert, crying) by Barnard. The movements of eyes, face and extremities, pulse and arterial oxygen were observed and recorded continuously from the start of sleep after feeding until the time of being woken for the next feeding by a trained nurse The data was analyzed by using paired t-test. The results of this study were as follows; 1. There was no significant difference in the length of sleeping time between the prone and the supine position. 2. There was no significant difference in the length and frequencies of each states(deep sleep, light sleep, drowsy, quiet alert, active alert, crying) between the prone and the supine position But the frequency of light sleep in the supine position was significantly higher than that of the prone position. 3 There was no significant difference In the numbers or eyes movements between the prone and the supine sleep position. But the amount of facial and extremity movement in the supine position was significantly higher than those in the prone position 4. There was no significant difference in the arterial oxygen content between the prone and the supine sleep position. 5. There was no significant difference in the heart rates between the prone and the supine sleep position. The above results indicated that the newborns in the prone Position moved less and slept deeper than those in the supine position. though there was no difference in the length of sleep or arterial oxygen content between the prone and the supine sleep Position. But. Nurses and mothers should consider the relationship between the sleep Position and SIDS suggested by previous researches. The infant's 'awakening' during sleep is a normal process and rather valuable because it can provide an opportunity to promote a stronger relationship between mother and baby. So, It is suggested that the supine sleep position is better than the prone sleep position for infants.

• English & American cultural studies
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• v.9 no.1
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• pp.273-295
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• 2009

As Oedipa Mass, the heroine of Thomas Pynchon's The Crying of Lot 49, is apparently associated with Oedipus, the hero in Sophocles' tragedy, this paper aims to show some of their similarities in quest theme and plot development as well as in the use of dramatic irony. Oedipus the King opens with a priest's pleas to relieve the Theban people from a plague and the king's promise to rid its cause by avenging the murder of the former king, as told by the oracle. Lot 49 begins as a Los Angeles law firm informs Oedipa that she is named as the executrix in her former lover Inverarity's will to sort out the mogul's estate. Ironically, however, Oedipus' investigation reveals himself to be the very cause of the national disaster, the murderer for whom he searched. Likewise, Oedipa starts her inquiry dedicating herself to make sense out of what Inverarity had left behind, only to find that the legacy was America. Sophocles and Pynchon both employ dramatic irony to provide a controlling principle for plot development in their works. In Oedipus the King, Sophocles creates mounting tension as well as distance between the reader's knowledge and the protagonist's ignorance, compressing the play's action into the moment that Oedipus discovers his real identity. For dramatic irony, however, Pynchon tends to work through authorial comments and utilize allegorical meanings of the characters' names, directing his novel at illuminating Oedipa's discovery of Inverarity's legacy as well as the meaning of Tristero, an underground postal service system. Unlike Oedipus the King that proceeds on a single line of action, Lot 49 develops in esoteric, multi-layered allusions and intricately-interrelated double strains involving Oedipa's roles as executrix and quester. At the end of Sophocles' tragedy, Oedipus stabs his eyes and decides to live in exile, realizing that, blinded, he begot his children through his mother; Oedipa comes to a painful realization that she allowed her former lover to create death-orienting America without her diversity and moral system in old times. As Oedipa now discovers herself through her search for Tristero, her tragic spirit lies in her determination to confront her binary choices between two Americas: transcendence or entropy, the Tristero possibility or Inverarity's America. Ultimately, Oedipa tries to find who will be the bidder for the Tristero forged stamps designated as lot 49, awaiting the auctioneer's cry and the "crying" of a new-born America.

• Journal of the Korean Home Economics Association
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• v.50 no.6
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• pp.89-98
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• 2012

This study examined the consciousness of husbands and wives on babies' cries and its factors which have impacts on their emotional perceptions. For this study, infants' cries were recorded with the participation of 136 pregnant women and 76 husbands, and they conducted self-evaluations regarding their emotional perceptions and personal characteristics. The stimulus used to exhibit the cries of infants were from eighteen recorded cry sample under three situations (hunger, pain, and mother's absence) with six healthy infants (three male and three female) who are over six months. Also, this study dealt with the relationship between emotional assessment and the personal characteristics of mothers and fathers. As a result, the experience of child-rearing has a positive influence on the emotional cry perceptions of husbands and wives, and there was no sex difference in their emotional cry perceptions. A change of recognition, "being parents," has impacts on emotional cry perceptions, but the major factors increasing these impacts depend on the physiological changes of pregnant women and their personal characteristics.