• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.493-499
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• 2018

Objective: This study aimed to identify the effects of serum potassium and lactate on neurologic outcomes in out-of-hospital post-cardiac arrest adult patients. Methods: This study was a single center, retrospective observational study. We recruited out-of-hospital post-cardiac arrest adult patients admitted to an intensive care unit from 2011 to 2017. Primary outcome was good neurologic outcome at discharge. To evaluate the prognostic impact of serum potassium and lactate, univariate and multivariate logistic regression analyses were performed. Results: A total of 57 patients were included in this study. The number of patients with good neurologic outcome was 19 (33.3%). In the univariate analysis, good neurologic outcome patients showed a higher smoking rate, shorter pre-hospital transportation time, higher rate of percutaneous coronary intervention, and lower severity score (all P<0.05). The good neurologic outcome patients also presented higher pH, lower partial pressure of carbon dioxide, and lower potassium regarding laboratory findings on the first hospital day (all P<0.05). In the multivariate analysis, the independent factors favoring good neurologic outcome were pre-hospital transportation time (adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], 0.69-0.97; P=0.019) and lower partial pressure of carbon dioxide on the first hospital day (aOR, 0.95; 95% CI, 0.91-0.99; P=0.034). Conclusion: Serum potassium and lactate were not significantly associated with good neurologic outcome in out-of-hospital post-cardiac arrest adult patients. The prognostic factors for good neurologic outcome were pre-hospital transportation time and initial partial pressure of carbon dioxide.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.57-64
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• 2007

Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

• The Journal of Korean Society for School & Community Health Education
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• v.9 no.1
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• pp.85-97
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• 2008

Objectives: This study was designed to understand the oral health knowledge & conduct of middle-school students, search for the learning objective and the educational method in line with the subjects and of utilizing as the basic data for an effective oral health-care program. Methods: The samples to achieve the purpose of this research are composed of 139 students in middle-school, OO county. Chungcheongbuk-do, the number of male students 64, and female students 75. Data were statistically analyzed by frequency analysis, $x^2$-test or Fisher's exact test by using SPSS WIN Ver. 12.0. Results: Among items on oral-health knowledge in middle-school students. the awareness ratio on a cause and preventive method for oral disease was surveyed to be lower than the awareness ratio on symptoms of oral disease. As a result of examining by comparing knowledge and behavior on the time of tooth brush. both awareness and behavior were the level of 50% or less than it. In particular, 46.2% perceived after lunch. but practice just accounted for 33.0%. The frequency of tooth brush a day was the largest in a case(47.5%) of doing twice a day. However. there was also the response (5.8%) with saying of brushing once or not brushing even once. Thus, the practice of tooth brush was surveyed to be very low even if being a minority of students. The frequency of taking a light meal was 68.8% in less than twice a day. However, even students of taking more than five times were surveyed to be 9.8%. Out of the whole-body health in over 50%-59.9%. the oral health was surveyed to be perceived to be very important. Compared to the awareness level on importance of a tooth, the ratio of visiting a dentistry was analyzed to be very low. Conclusions: The study results suggest that the school oral-health project was examined to have the necessity of being expanded and carried out even in middle-and-high schools, by which the specific oral-health promotion program including oral-health education in this period is developed.

• Neonatal Medicine
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• v.18 no.2
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• pp.204-210
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• 2011

Purpose: Feeding intolerance is common in very low birth weight infants(VLBWI); however, research on the etiology is limited. We investigated the incidence of allergic enterocolitis (AEC) as a cause of feeding intolerance and present the clinical characteristics of VLBWIs. Methods: The medical records of VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center between January 2009 and July 2010 were retrospectively analyzed. AEC was defined as patients who had feeding intolerance with eosinophila and who responded to hypoallergenic feeding intervention. Feeding intolerance symptoms included blood tinged stools, abdominal distension, residual feeding and regurgitation. Eosinophilia was defined as an eosinophil count ${\geq}$700 cells/$mm^3$. Patients with feeding intolerance were divided into the AEC or non-AEC group. Results: Of the 181 patients, 161 (88.9%) had a feeding intolerance, and 119 (65.7%) had eosinophilia. Seventeen infants were diagnosed with AEC. No difference in mean gestational age, birth weight, antibiotics duration, TPN duration, hospitalization, or symptom onset day was observed between patients with AEC and non-AEC patients. The percentage of eosinophilia was significantly higher in patients with AEC than in non-AEC patients. Two patients (12%) improved with restricted breast milk, 10 patients (59%) with extensively hydrolyzed formula and five patients (29%) with free amino acid-based formula. Conclusion: Our results suggest that AEC should be considered in VLBWIs who have clinical features of feeding intolerance and eosinophilia. An aggressive increase in feeding would be possible through feeding intervention in VLBWIs with feeding intolerance.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.358-364
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• 2010

Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

• Research in Community and Public Health Nursing
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• v.10 no.2
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• pp.455-466
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• 1999

Western missionary nurses practiced in Korea from 1891. and the first trial to begin missionary public health nursing service in 1909 could not put into practice for short of nursing staff and budget. The main focus of missionary medical practice was not in public health program but in the management of missionary hospitals. A few of missionary western R.N. tried district nursing in 1910s. but their activities were personal and focused on the rescue of poor and sick patients. In 1917 the North American Methodist Church dispatched R.N. Elizabeth S. Roberts to begin district nursing in Korea. Roberts began maternal and child district nursing service. Her service was focused on teaching the method of bringing up children. bathing service, and home visiting for delivery. She could not but stop district-nursing service in 1918 to serve for a hospital in Siberia. The North American Methodist Church dispatched a few of R.N. to Korea in early 1920s and the missionary public health nursing of Korea could be activated. R.N. E. T. Rosenberger began public health nursing program in Seoul with Korean graduate nurse, Shin-gwang Han, and missionary M.D. Hall. Their public health nursing program was focused on maternal and childcare. They did home visiting in the morning, and served at a well baby clinic in the afternoon. The first baby competition began in 1925. and contributed to the teaching the method of bringing up children. They expanded public health nursing activity to school health nursing and milk station. Their public health nursing program was such a success that In 1929 Severance hospital. Eastgate Hospital. Taehwa Social Evangelistic center organized Seoul Child Health Union. Maren P. Bording, another missionary R.N. and midwife dispatched by the North American Methodist Church began public health nursing program at Kongjoo in 1924. Her program was focused on the maternal and childcare and close to that of Seoul. She started the first milk station in Korea in 1926. As she was a midwife and could get M. D. license in Korea, her program was more focused on maternal care than that of Seoul. The first day nursery school in Korea and the first graduate course for public health nursing in Korea began at Kongjoo in 1930. As the city of Choongcheongnam Province moved from Kongjoo to Daejeon in 1932, missionary public health nursing service in Kongjoo extended to Daejeon. There were lots of public health nursing program in Korea in 1920s and 1930s by missionary western nurses and Korean nurses. There were 13 missionary public health-nursing center in Korea in 1932. But in the late 1930s. Japan extended colonial war and drove out western missionaries. The missionary service in Korea was daunted. and the missionary public health nursing service could not but shrink.

• Korean Journal of Childcare and Education
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• v.6 no.1
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• pp.47-65
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• 2010

The current study aims to examine differences of mother's child-rearing attitude by background variables of infant's and mothers, the influence of mother's child-rearing attitude, temperament and goodness of fit of infant's on adjustment to childcare center, and relative influence among elements. Subjects for the study were 165 infant's of two year old attending 8 childcare centers in Seoul, Gyeonggi-do and Jeju-do, and their mothers and homeroom teachers at childcare centers. As a result of the study, it was found that there was no difference in background variables such as sex and order among siblings of infant's, childcare experience and average hours at childcare centers a day, and mother's age and job, while there were differences in mother's child-rearing attitude by mother's education, household's monthly income and mother's working hours per week. Also it was observed that mother's restrictive attitude, positive attitude and infant's regular temperament influenced their adjustment to childcare centers, and relatively influential elements on general adjustment to childcare centers were mother's restrictive attitude and positive attitude. That IS, it was found that as mother's restrictive attitude and positive attitude were high, infant's general adjustment to childcare centers became high. These study results show that if infant's learn basic rules and habits from parents at home by having positive relationship with mothers, getting appropriate educative instruction, having proper autonomy and obtaining positive assessment from their mothers, rather than strict restriction or bluff, can adapt themselves to childcare centers with no difficulty.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.2
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• pp.21-29
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• 2015

Objective : This study compares sensory processing ability of children with and without spastic diplegia. In addition, it investigates characteristics of sensory processing differentiated by developmental phase such as pre-school age versus school age. Methods : Participants in this study are ordinal children without specific condition and children with spastic diplegia who are aged 3 to 10 years olds. Using Short Sensory Profile (SSP), sensory processing function of the participants was measured. The survey was distributed to caregivers of the children from November, 2013 to February, 2014, and it was suggested that the caregivers to record the questionnaire directly after approval from a rehabilitation hospital, a university hospital, welfare center, day care center, preschool and elementary school to participate in our study. Results : Group of children with spastic diplegia showed lower score than group of children with no special condition in the total score and the each score of all items of Short Sensory Profile. There was significant difference between the two groups in terms of the total score of sensory processing and the 5 factors except tactile sensitiveness and taste/smell sensitiveness among the 7 factors of test. In the comparison of different age groups, pre-school age group showed lower total score than school age group. Conclusion : This study provides a foundational evidence that can be used when therapist evaluate sensory processing function of children with spastic diplegia. There is need for more study about sensory processing functions of various types of children with cerebral palsy.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.1
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• pp.73-84
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• 2019

Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.24 no.1
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• pp.37-42
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• 2024

Congenital adrenal hyperplasia (CAH) is a genetic disorder characterized by decreased cortisol secretion, with 21-hydroxylase deficiency being the most common type. It is uncommon for CAH to present primarily as cholestasis; therefore, when a patient presents with prolonged jaundice, it is difficult to suspect CAH immediately. In this report, we aim to share our experience with an exceptional case of 21-hydroxylase deficiency. A 28-day-old male visited the outpatient clinic due to prolonged jaundice and elevated 17α-hydroxyprogesterone (17-OHP) levels in the newborn screening test. Since he showed no other symptoms such as lethargy or vomiting, he underwent a routine blood test for jaundice and a retest of 17-OHP at the outpatient clinic. Two hours after the blood draw, he was found to have severe hyponatremia and hyperkalemia, so he was immediately admitted to the intensive care unit. After treatment with hydrocortisone, fludrocortisone, sodium chloride, and intravenous fluids, the cholestasis and electrolyte imbalances improved over time. He was diagnosed with 21-hydroxylase deficiency, salt-wasting type, which was confirmed by the ACTH stimulation test and genetic testing. It is important to make a prompt diagnosis of CAH to avoid missing critical timing. Therefore, CAH should not be overlooked, even if the patient does not exhibit typical symptoms.