• Childhood Kidney Diseases
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• v.1 no.1
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• pp.38-45
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• 1997

Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.117-121
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• 2005

Purpose: Elevated AST/ALT level in rotavirus gastroenteritis have been reported. We found elevated creatine kinase (CK) in those children. This study was carried out to define the relationship of major clinical presentation, laboratory findings, and level of creatine kinase. Methods: A retrospective analysis was made for thirty patients who were diagnosed rotavirus gastroenteritis from Jan 2001 to Mar 2005 in Department of Pediatrics, Gyeongsang National University Hospital. Serum creatine kinase was checked for the evaluation of high aminotransferase level among the patients. Results: Fourteen patients (8 males, 6 females) with high creatine kinase activity were included in this study. The mean age was $1.46{\pm}1.24year$ of age. The mean level of AST, ALT and CK were $127.5{\pm}136.2IU/L$, $126.1{\pm}154.3IU/L$, and $542.8{\pm}624.6IU/L$, respectively. Electrophoresis of CK isoenzyme was performed in four of them and the results revealed elevated CK-MM fraction (96~100%). Three of them revealed high serum creatine kinase acitivity (>1,000 IU/L) without acute renal failure and other symptom. However, none of them had muscular pain or trauma history. Elevated creatine kinase activity did not correlate with clinical implications (age, sex, vomiting, diarrhea, fever, symptom of URI, degree of dehydration or seizure) or laboratory findings. Conclusion: In this study, we found that serum creatine kinase acitivity also was elevated in infants with rotavirus gastroenteritis. This data support muscular damage due to rotavirus, but could not prove the mechanism of increased serum creatine kinase activity.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.67-75
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• 2012

Objectives: While there have recently been efforts to improve public health service at a governmental level, there is actually insufficient research on awareness of the roles related to public health service among hospital employees. This study examined role perception and function performance related to public health service among the medical staff in a national hospital. Methods: 15% were randomly sampled from each type of occupation among the medical staff in a national university hospital, a survey was conducted in 323 persons, and there were a total of 265 participants (80.2%): 103 doctors(38.9%), 98 nurses (37.0%), and 64 others (24.1%). Results: The hospital employees had insufficient awareness of their roles as public health service providers in terms of six required items for public health service: 1) services for supporting establishment, implementation, and assessment of public health service policies, 2) participation in the health service activities and support services by central or local governments, 3) technological support and educational services for private health service institutions, 4) health service for unprivileged brackets, 5) health service that requires association with other areas dealing with geriatric, disabled, and mentally-disordered people, and 6) health service for children and mothers. Conclusions: In general, since the hospital employees had insufficient awareness of their roles and responsibilities as public health service providers, it is necessary to secure manpower exclusively in charge of public health service and provide education about strategic public health service.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.138-142
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• 2005

Purpose : The purpose of the present study was to access the prevalence of orthostatic dysregulation(OD) and the frequency of each category for major and minor criteria among elementary school students using the OD questionnaire. Methods : We carried out inquiry by questionnaire as to the frequency of OD among two elementary schools with 725 students, 10 to 12 years of age, residing in Gwangju, Korea. The questionnaire was made according to criteria proposed by the Japan OD Study Group. Results : Of the 725 students(male 390; female 335) questioned, the OD was found in 338 students (53.5 percent). Prevalence of OD in males(59.2 percent) was significantly higher than in females(46.8 percent)(P<0.05). Palpitation with slight exercise(95.9 percent) was the most frequent major symptom. Headaches(85.8 percent) were the most frequent minor symptom among cases of OD. Conclusion : The prevalence of OD in elementary school students in this study(53.5 percent) was higher than in other studies. Contrary to studies from other countries, the male to female ratio was reversed. Because the diagnostic criteria seem to be dependent on subjective reporting of the symptoms, a newer diagnostic system based on more objective findings should be established.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.104-114
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• 1998

Purpose : Enteroviruses are the most common cause of aseptic meningitis. The epidemics of aseptic meningitis in 1993 and 1996 were mostly caused by echovirus type 9. Identification of the causative virus of aseptic meningitis in epidemics, is very important not only for diagnosis but also for epidemiologic purpose. The purpose of this study was to identify the causative virus and investigate the relationship between aseptic meningitis, prevailed in Masan and surrounding areas in Kyoungsangnamdo in 1997, and its clinical manifestations. Methods : One hundred twenty eight cerebrospinal fluid(CSF) and 239 stool specimens were obtained from 239 patients(213 children and 26 adult patients) with aseptic meningitis were admitted to Masan Fatima Hospitals from March to October 1997. Viral isolation and serotype identification was performed by cell culture and immunofluorescent test. Enteroviruses not typed by immunofluorescent test was confirmed by reverse transcription-polymerase chain reaction(RT-PCR). Results : 1) The peak incidence was noted in June. 2) The age of 239 patients(pediatrics-213 cases, internal medicine-26 cases) that were diagnosed ranged from neonate to 35 years, the age of the patients of pediatrics ranged from neonate to 15years(mean 4.9 years), the age of the patients of internal medicine (above 16 years) ranged from 16 years to 35 years(mean 24.2 years). 3) Fifty-three(41.4%) of 128 CSF specimens were positive for enteroviruses, and 163(68.2%) of 239 stool specimens were positive for enteroviruses respectively. 4) Serotypes of 53 enteroviruses isolated from CSF were 16(30.2%) of echovirus type 30, 6(11.3%) of echovirus type 6, 1 of echovirus type 4, 4 of untyped echovirus, 1 of coxsackievirus type B5, and 24 isolates of untyped enteroviruses. Of 163 enterovirus isolated from stool were 72(44.2%) of echovirus type 30, 21(12.9%) of echovirus type 6, 1 of echovirus type 4, 17(10.4%) of undetermined subtyped echovirus, 1 of coxsackievirus type B5, 2 of A24, 3 of undetermined subtyped coxsackievirus type B, and 46 isolates of untyped enterovirus. Conclusion : There were epidemics of aseptic meningitis in the central areas of Kyoungsangnamdo from March to October 1997. The main causative organism was thought to be the echovirus type 30, and echovirus type 4, 6, coxsackievirus B5 and A24 were also thought to contribute to the epidemics.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.23-29
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• 2003

Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.198-206
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• 2019

Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.139-145
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• 2002

In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.1
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• pp.151-161
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• 2014

As concerns have been raised about the increasing number of children with food allergies, the management of food allergies through the consideration of school meals is an emerging issue. This study investigated the perception and practices regarding food allergy of elementary and middle school nutrition teachers in the Jeonnam area. A total of 236 nutritionists/nutrition teachers participated in the survey and completed questionnaires. The foods most reported to cause allergic reactions were peach, eggs, peanuts, shrimps, mackerel, and milk. Participants reported that the major tasks to be completed for management of food allergies: the estimated number of students with food allergies, the offering of allergy-free or alternative foods and informing families of foods that may cause an allergic reaction. A majority of the participants (94%) recognized that the nutrition teacher has the primary role in managing students with food allergies in school. To manage these students, nutrition teachers mostly reported informing of allergic foods/ingredients in the school menu and the estimation of students with food allergy. The percentage of participants who experienced education programs on food allergies was 16.9%, whereas 97% of participants answered that a good professional education regarding allergies for nutrition teachers is required. The knowledge level evaluated with objective questions was significantly higher than the self-estimated knowledge level. In conclusion, nutrition teachers understood the tasks regarding food allergy thoroughly and that, the tasks are relatively under-practiced. To improve the management of food allergies in school meals, professional education programs regarding food allergies should be provided for nutrition teachers.

• Journal of East-West Nursing Research
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• v.5 no.1
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• pp.90-101
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• 2000

The study attempts to examine the degree of cognition and demand on health promotion center of oriental nursing. It puts unique nursing intervention using traditional health promotion connected with oriental medicine to practical use for residents' health promotion and prevention of disease. With the study design of cross-sectional descriptive study, 516 residents who live in 26 Dongs, Dongdaemoon-gu were selected. The tool of study consists of 30 questions which the study team made for the degree of cognition and demand on health promotion center of oriental nursing. Cronbach's $\alpha$ in the degree of cognition was .8028. Collection of research data had been done from October 1 to October 30, 1999 with help of Dongdaemoon-gu office after pretest from 20 residents. Collected data were analyzed into the number and percentage in the characteristic of a subject and connected with demand on the establishment of center, the mean and the standard deviation in the degree of cognition and F-tests in the difference of the degree of cognition by characteristics. The results were as follow; 1) The characteristic of subject of this study was male 50.6%, and average age was 38.5 years old and 30-39 years old occupied the highest percentage with 31.6%. The married were 71.8%, over high school graduates was 85.6%, monthly income from 500 thousand won to 2 million won was 86.1%. 50.8% was the type living with parents, children and sibling. 2) When they were sick, the institution which residents used at first was a pharmacy(69.2%) and hospital(27.5%), but oriental medicine hospital was just 1.4%. As for subjective health condition, 82.5% answered over average, and 28.7% answered that they had chronic illness such as arthritis, chronic digestion problem, hypertension and so on. As for information collection on health, mass communication(34.9%) and medically concerned people(28.1%) occupied relatively high rate. Free health diagnosis system(36.8%) and establishment of health promotion center(31.5%) among welfare programs that residents want to enjoy were high ranked. The rate using a special institution for health was 17.8%, and among these institutions, the rate using aerobic exercises, health center(7.0%) and steamed room(5.4%) was high. Besides, other institutions such as breathing at the abdomen, finger-pressure therapy, meridian massage, foot massage, and so on were being used. 3) As the average of the degree of cognition on health promotion center of oriental medicine was 2.92, the degree of cognition was medium. The description, "health promotion center of oriental medicine is necessary for health keeping of healthy people, including people who have a problem in health" showed the highest degree of cognition(3.04, ${\pm}0.64$). 4) As for the intention on using health promotion center of oriental nursing, 61.4% said "yes", "no" was just 1.4%. The services that people relatively high wanted to be served from the center were measures reducing stress(68.0%) (relaxation therapy, meditation, breathing at the abdomen and so on), acupuncture(66.5%), finger-pressure(61.6%), moxibustion(57.6%), meridian massage(44.2%), postpartum care(40.3%) and so on. 5) As for the degree of cognition on the establishment of health promotion center of oriental nursing by characteristics of subject, there was significant difference(F=4.03, p=.046) between male(3.01) and female(2.91). But there was no significant difference by age, marital status, level of educational achievement and monthly income. As the above result, cognition on the establishment of health promotion center of oriental nursing was relatively low because people were not familiar with about the health promotion center of oriental nursing yet. However once the center will be established, the degree of demand on the center will be relatively high. So positive advertisement will be necessary, and the management of useful programs will be also required in order to make people recognize the advantage when they actually will use the center. On the other hand, as the subject of the study consists of many young people of below 30, the health problem came to be low. And in the case of sampling, the study using random sampling that can represent population will be required.