• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.231-242
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• 2023

This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.

• Health Policy and Management
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• v.34 no.3
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• pp.271-281
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• 2024

Background: The unmet healthcare needs (UHNs) of people with disabilities (PWD) are not only detrimental to their quality of life but also can lead to serious health outcomes including death. A variety of factors including socioeconomic, personal, and environmental factors affect UHNs for PWD. Previous studies focused on individual socioeconomic and disability characteristics as influencing factors. Our studies included environmental factors that have a significant impact on the use of healthcare service by PWD. Methods: We analyzed the UHNs status and influencing factors among 4,326 adults with disabilities using the Korea Disability Life Data. Chisquare analysis identified differences in UHNs by general, disability, and environmental characteristics. Logistic regression determined factors affecting UHNs. Results: Those with low educational level (adjusted odds ratio [aOR], 1.229; 95% confidence interval [CI], 1.024-1.475), those with low income level (aOR, 1.416; 95% CI, 1.015-1.976), those who enrolled in private insurance (aOR, 1.234; 95% CI, 1.018-1.496), those who need help with daily living (aOR, 1.298; 95% CI, 1.059-1.592), those who did not go out (OR, 1.566; 95% CI, 1.274-1.924), those who use taxis (aOR, 1.407; 95% CI, 1.047-1.891) or call taxi for people with disabilities when going to the hospital (aOR, 1.370; 95% CI, 1.001-1.875), the communication disabled (aOR, 1.304; 95% CI, 1.029-1.651), those with poor subjective health status (aOR, 1.248; 95% CI, 1.043-1.494), those who felt the explanation of treatment results was insufficient (aOR, 4.035; 95% CI, 1.365-11.927), hose dissatisfied with healthcare services (aOR, 3.515; 95% CI, 2.741-4.508) were more likely to experience UHNs. Conclusion: Effective healthcare service provision for PWD requires not only financial assistance but also social support, along with education for healthcare staff, policies that consider the characteristics of disabilities.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.18-27
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• 2006

Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.643-652
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• 2002

As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF＜40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

• Journal of the Korean Society of School Health
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• v.9 no.1
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• pp.109-123
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• 1996

The study was designed to gain necessary basic data, in order to grasp the actual condition on personal hygiene of primary school students and to help school health education and child health education data development of parents of students, the survery was carried out through this reporter's interview for mothers who have primary school pupil in KyungBug area during the period of a month from 14 the April to 30 the April 1994. The results of this study can be summarized as follows. 1. As for general characteristics, the percent of answer mothers with 30~34 years 44.9%, and the percent of answer mothers with 35~39 years was 37.6%, 14.6% of answer mother was 40 years and over. The most house types was apartment house, that is 64.8% and independence house was 18.9%, 13.7% of answer mothers was multivalent house residents. As for level of school career, the percent of high school was 64.2% and the percent of university was 20.5%, 10.1% of answer mothers was finishment of middle school. As for religion a lack of religion was 38.4% and a Buddhist was 36.8%, a christian was 13.4%, 10.4% of answer mothers was a catholic. As for jobs, the percent of office was 33.9%, specialist and expert skiller was 17.3%, self-management was 16.0%, fishing and agrarian villiages was 11.6%, public service personnel and shool personnel was 9.1%. As for the number of sons and daughters, the percent of two was 70.5%, the percent of one was 16.0%, and the percent of male students was 54.1%. As for level of economic life middle level was 59.9%. 2. The percentage of washing hand after school hours was 66.8% and not washing hand after school hours was 33.2%. In washing hand after school hours family of independence house, mothers that have schoolcareer of university, female students, three and over of sons and daughters was high individually (p<0.05). 3. As for paring one's nails, once a ten days was 52.9% once a five days was 22.5% once a fifteen days was 19.0%, once a twenty and over was 5.6%. 4. 54.7% of primary school students of answer mother's take a bath once a few days and 31.6% take a bath once a week, 10.1% take a bath once a tendays. 5. The percentage of changing of underwear once a day was 60.9%, once a few days was 37.1%, once a week was 2.0%, as for changing of underwear, sons and daughters that has mothers with 29 years and downward, one number of sons and daughters, females students was high individually (p<0.01). 6. The percentage of haircut once a 20~30 days was 59.9%, once a 31~40 days was 17.9%, once a 40 days and over was 16.6%. As for the percentage of haircut once a 20~30 days apartment house residents, male students was high (p<0.01). 7. The percentage of experience in taking nutrition was 79.8% and the percentage of experience in taking restorative was 72.3%. As for taking nutrition, apartment house residents, one number of sons and daughters, male students was high individually (p<0.01). As for taking restorative apartment house residents, on number of sons and daughters, male students was high individually (p<0.05). 8. The percentage of habit of unbalanced diet was 44.0%, sons and daughters that have mother with 40 years and over apartment house residents, male students, one number of sons and daughters was high indivdually (p<0.05). 9. As for hygiene condition of sons and daughters, the percentage of good state of health was 65.2%, middle state of health was 3.5% bad state of health was 11.4%. In good state of health sons and daughters that have mothers with 29 years and downward, multivalent house residents, three numbers of sons and daughters, female students, high birth was high individually. 10. As for fattness of sons and daughters, existence was 18.2%. No existence was 81.8%. in existence sons and daughters who have mothers with 40 years and downward, independence house resident, special job and expert skill job, three and over number of sons and daughters, female students, low birth was high individually. 11. As for use aspect of medical facilities of sons and daughters, hospital doctors was 53.1%, drugstore was 42.3%, chinese medicine hospitals or health organization was 4.6%. In usage of drugstore, sons and daughters of mothers with 29 years, 40 years and over was 55.6%, 61.4% individully, inusage of hospital doctors 30~34 years, 34~39 tears was 64.5%, 49.1% individully (p<0.01), apartment house residents, one or two numbers of sons and daughters, male students was high individually. In the percentage of using drugstore, school career of middle school and downward, in occupation, three and over numbers of sons and daughters, low birth was high individually (p<0.05). According to the results mentioned above. An actual condition and a related matters on personal hygiene of primary school students must be used as the basis data of a health education program and a health data of a health education program and a health data related, a teaching materials development and must be helped to the health life education of parents of students and childs.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.280-287
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• 2007

Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.6-7
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• 1981

With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.39-46
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• 1989

Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.183-204
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• 2005

Objectives: Immunization program is essential public health service under the national responsibility. One of the immunization service of national immunization program is advertising and public relation service, but research for that was rarely conducted. Therefore we conducted the survey for developing advertising strategy of immunization program in 21th century. Methods: Our study subjects were 242 health workers in immunization service department of 169 health centers and 1,193 carers who visited community health center for receiving immunization service of their children. The major questions were general characteristics of the subjects, perceived importance of immunization program, experience of advertising, knowledge and perception about immunization, and items about advertising strategy. Results: Frequently exposed materials in both health workers and carers were TV, community newspapers, and pamphlets. Health workers had high professional knowledges of immunization and carers had high perceptions for need and importance of immunization. Health workers preferred pamphlets and posters as advertising materials and carerers preferred TV and community newspapers. Both health workers and carers preferred green and yellow as advertising posters' color, active and healthy style of immunization advertising, and positive messages of campaign's slogans. Conclusions: Further researches should be conducted for precising long-term immunization advertising strategy in 21th century, and for this we need to develop advertising materials based on public needs and strategy, and evaluate the materials. The national immunization program should be activated throughout more investment of the budgets and human powers.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1216-1220
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• 2009

Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.