• Child Health Nursing Research
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• v.7 no.2
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• pp.245-257
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• 2001

This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4％) were mothers. Among them 89.6％ were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36％), followed by 28％ from Kyung Gi Province, and 20％ were from the Kyung Sang area. Among 8,261 callers, 72.8％ were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5％) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3％), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25％ and 23.3％ respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3％ with diaper rash being the second highest among the skin problems. About 80％ of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.85-90
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• 2009

Introduction: There has been an increasing interest in the relationship between sleep and suicidality. In addition, suicidal patients habitually report their sleep problems. Although sleep-related complaints and electroencephalographic changes are generally encountered in psychiatric disorders, sleep complaints such as insomnia, hypersomnia and nightmares are more common in suicidal patients. In current study, we aimed at investigating the relationship between self-reported sleep duration and suicidality in general population. Methods: One thousand general population (male:female=500:500, mean age=$39.6{\pm}11.6$ years, ranged age=20-77 years) completed Center for Epidemiologic Study-Depression (CES-D), Beck Suicide Intent scale (BSI), Spielberger State-Trait Anger Expression Inventory (STAXI), Barratt Impulsiveness Scale (BIS), Morningness-Eveningness Scale (MES) and brief questionnaire of sleep habits. Results: After controlling for age and sex, score of BSI was correlated positively with the score of CES-D, STAXI and BIS on partial correlation analysis ($r_p$=0.251; p<0.001, $r_p$=0.352; p<0.001, and $r_p$=0.175; p<0.001, respectively). In addition, score of BSI was inversely correlated with the score of MES (rp=-0.066; p=0.037). However, score of BSI showed no significant correlation with sleep duration. However, regression analysis revealed that short (<6 hrs) or long (>10 hrs) sleep duration, the family history of psychiatric illness, the score of CES-D, and the score of STAXI predicted higher score of BSI significantly in total subjects (F=17.837, adjusted $R^2$=0.166; p=0.003, p=0.003, p<0.001, and p=0.003, respectively). This model was explained better in depressed subjects with 16 or higher score of CES-D (F=9.920, adjusted $R^2$=0.298). Conclusion: Current result suggested that not only short sleep duration (<6 hrs) but also long sleep duration (>10 hrs) might be related to suicidality.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.147-156
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• 2001

Membership qualifications and recognition of the subspecialty training programs by the Korean Association of Pediatric Surgeons(KAPS) have been determined by criteria based on the number of neonatal and total pediatric surgical cases registered, since 1989 (Index cases). The numbers are based on a survey of the 14 founding members of the society by Jung et al. in 1987. The current survey is to review the present status of the index cases from 1997 to 1999 among 36 members of the KAPS. Two surveys were undertaken for this study. In the first survey, cases were collected by the registration form, composed of neonatal(N), important pediatric surgical cases (I), tumor and other similar operations(T) and other common pediatric surgical cases(O). Thirty members responded. and the result was discussed at the Topic Discussion section of the 15th Annual Congress of KAPS, 2000. The second survey analyzed additive data, proposed during discussion at the Congress. Twenty-three members responded. This report is the analysis of the both surveys. The average numbers of the cases/year/surgeon of N, I, T, O and total were 19.5, 51.8, 9.5, 77.1 and 356.5. respectively. The number of index cases(N+I+T)/year/surgeon was 80.8. The ratio of (N+I+T)/total cases was 0.3. Seventeen of 30 members have more than 20 cases of N per year. Twelve members have more than 150 cases, and 13 do more than 100 cases of I per year. Fourteen members have more than 10 cases of T per year. Nineteen and 10 members experienced more than 150 and 100 of index cases(N+I+T) per year. A new list of the index cases and coding system are proposed for the future regular update.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.484-488
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• 1994

Background : The antigen-specific receptor on the surface of most peripheral T lymphocytes is a disulfide-linked heterodimer composed of $\alpha$ and $\gamma$ subunits, noncovalently associated with CD3 polypeptides. Recently, a novel type of CD3-associated heterodimer was described on a T cell subset that does not express CD4 or CD8 molecules. This second type of TCR dimer is composed of chains encoded for by the $\gamma$- and $\delta$-TCR genes. These cells may exert both cytotoxic and lymphokine producing functions. Although it was reported that some ${\gamma}{\delta}$-TCR might recognize an MHC-linked determinant, the funεtion or physiologic ligand for this new receptor is not yet clear. It was found that ${\gamma}{\delta}$-TCR can react with 65 kD heat shock protein of M. tuberculosis, which suggests the possible protective role of ${\gamma}{\delta}$ T lymphocytes against tuberculosis. In our previous study, there was neither the increase in number nor the functional activation of ${\gamma}{\delta}$ T cells in the peripheral blood from patients with pulmonary tuberculosis. Now we report the distribution of ${\gamma}{\delta}$ T cells in the regional sites of M. tuberculosis infection, especial1y tuberculous lymphadenitis. Methods : Lymph nodes from patients with pathologically-proven tuberculous lymphadenopathy (n=5) and reactive hyperplasia (n=3) were used. Tissues were frozen in liquid nitrogen immediately after removal and stored below $-70^{\circ}C$. The cryostat sections of these frozen specimens were stained with anti-Leu-4 Ab, Identi-T TCR ${\delta}1$, and Identi-T ${\beta}F1$. The number of positively stained cells were counted at high power field. Results : The infiltration of ${\gamma}{\delta}$ T cells was significantly higher in the lymph nodes from patients with tuberculous lymphadenopathy than that with reactive hyperplasia ($16.3{\pm}10.3%$ vs. $1.7{\pm}1.5%$). Conclusion : These results suggest that ${\gamma}{\delta}$) T cells may play a role in the defense against M. tuberculosis infection, especially in the regional sites of infection.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.234-241
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• 2004

Background : There has been a gradual increase in the number of newly diagnosed cases of Mycobacterium avium complex (MAC) pulmonary disease. However, the optimal therapeutic regimen for the disease has not yet established and there is no report about the treatment outcome of MAC pulmonary disease in Korea. This study examined the effect of clarithromycin-based regimen in patients with pulmonary MAC disease without a HIV infection. Materials and Methods : Fifty-six patients with pulmonary MAC disease were diagnosed according to the American Thoracic Society criteria from January 2000 to December 2003 at this hospital. Of these patients, 15 were treated with clarithromycin, rifampin, and ethambutol for more than 6 months, together with streptomycin initially (first 6 months) in 8 patients. Results : Six months after the treatment, the sputum cultures converted from positive to negative in 8 patients (53%) and the radiological findings improved in 10 (67%). At 12 months 4 patients (44%) achieved sputum negative conversion and 6 patients out of 9 patients (67%) who were treated for more than 12 months showed radiological improvement. Overall, the sputum findings converted to negative in nine patients (60%) who underwent medical treatment. A pulmonary resection was successfully performed in one patient. Only one patient discontinued the treatment due to side effects such as gastrointestinal intolerance and optic neuritis. Conclusion : A combined regimen containing clarithromycin is relatively safe and tolerable even in the elderly outpatients. However, the results of this combined chemotherapy were unsatisfactory and new companion drugs for MAC pulmonary disease are needed. A resection may be considered for localized disease.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.274-282
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• 2003

Background : Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. Method : From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen(2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/7HER). Result : Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5 mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between the two groups. Conclusion : These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.320-329
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• 2003

Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.290-296
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• 2006

Background : IS6110 DNA fingerprint is a very useful tool for investigating the transmission of tuberculosis. The aim of this study was to identify the epidemiological situations within a given area (one province). Methods : The 681 Mycbobacterium tuberculosis isolates from patients, who were registered at health centers in Gyeonggi Province from May to December in 2004, were subjected to IS6110 DNA fingerprinting. Patients belonging to clusters were interviewed by health-workers to determine their previous contacts or household TB history. Results : The number of IS6110 copies of the 681 isolates showed diverse fingerprint patterns from 0 to 21 of which the most prevalent copy number was 10 from 120 isolates (17.6%). Thirty-three isolates (4.8%) belonged to the K strain, and 128 isolates (18.8%) belonged to the K family. There were 180 (26.4%) isolates belonged belonging to fifty clusters, of which two clusters were within household transmission. Forty-three (23.9%) out of 180 patients resided in an area under the same health center control. The rate of clusters in those aged 60-70 was higher than in any other age group ( 95% CI of RR : 1.072 ~ 1.988). Conclusion : This is the first report of an epidemiological survey based on a whole province using a DNA fingerprinting technique for M. tuberculosis. These results will be helpful in developing a program or policies to prevent the transmission of TB.

• Progress in Medical Physics
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• v.8 no.2
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• pp.3-17
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• 1997

Because a wedged beam consists of attenuated primary photons and scattered radiations from wedge, the spectrum of the wedged beam does not coincide with that of an open beam with same geometry. The aims of current report are to get exact information about whether effects of 15-60$^{\circ}$ wedge for 4 -10 MV photon beams should be considered for dose calculation or not, and to suggest a reference condition for measurement of wedge transmission factor. Percent depth dose of both open and wedged fields with angles of 15, 30, 45, 60$^{\circ}$ for beams of 4 MV(Clinac 4/100, Varian), two 6 MV(Clinac 6/100 and Clinac 2100C, Varian), 10 MV(Clinac 2100C, Varian) X-rays were measured to 30cm deep in water using ionization chambers. Hardening factors of photon beams were calculated with measured PDDs. Both field size factors and transmission factors of wedge filters were measured at d$_{max}$ in water. Beam hardening factors of wedged fields of 4 and 6 MV X-ray were larger than 1 for all wedge angles, field sizes and depths deeper than d$_{max}$ Beam hardening factors for wedge angles 15, 30, 45, 60$^{\circ}$ for 10$\times$10cm were respectively 1.010, 1.014, 1.023 and 1.034 for 4MV X-ray, 1.005, 1.008, 1.019, and 1.024 for 6MV X-ray of Clinac 6/100, 1.011, 1.021, 1.032, 1.036 for 6MV X-ray of Clinac 2100C, and 1.008, 1.012, 1.012 and 1.012 for 10MV X-ray. Beam hardening factors of 10MV X-ray were 1 within 1.2％ difference for all wedge angles, depths and field sizes. It was made clear that for 6MV X-rays, the beam hardening factor depends on treatment machine. The relationship of the factor and depth was linear. Field size factor at d$_{max}$ was independent of wedge angle except for the field of 15$\times$15cm. and maximum difference of the field size factors for the field size was 1.4％ for 4MV X-ray. When the wedge factor is determined, dependence of the factor on field size is negligible at d$_{max}$ but should be considered at deeper depth. Calculating dose distribution or MU, the beam hardening factor should be applied for 4~6MV X-ray beams, but might not be considered for 10MV beam. When wedge transmission factor was determined at d$_{max}$ or in air, field size factors for open field are also applicable to wedged fields, but otherwise, field size factor for each wedge or wedge factor depending on field size should be applied.

• Asian Oncology Nursing
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• v.3 no.2
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• pp.133-144
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• 2003

This study is carrying out a before and after experiment design for the non-equal comparative group to identify the effects of the breast self-examination education on breast self-examination participant education compliance and health promotion in women. The subject of this study was 58 women residing in Chungju. Their age ranged from 20 to 40. These women were not pregnant or did not breast feed, as well as they did not have any breast disease, at the time of survey. They were available for the response to the questionnaires, and understood the purpose of this study. They also agreed to participate in the study, and responded to the 3rd time questionnaires to the end. Thus, brochures and lectures were provided side by side to a group of 19 of those women, and only brochures were provided to another group of 39 of those women. With regard to education, a brochure and a program using a breast model were applied. Then, the frequency of the breast self examination compliance, breast self examination capability and the relations between the breast self examination and activities to promote health were measured, before the education, after 4 weeks of education and after 12 weeks of education. Before education and after 4 weeks of education. I collected the questionnaires myself visiting them, and after 12 weeks of education, the questionnaires were collected by mail. In relation to the study tool, the breast self examination activity was measured by two measuring tools: breast self examination activity frequency and breast self examination compliance capability. As for the frequency, the number of self examination for the period of 3 months, before the questionnaire survey, was measured in the form of self report. In relation to the tool to measure the breast self examination capability, the BSEPRI tool, which was developed by Wood in 1994, was used. Here, as the score was higher, the capability was indicated to be higher. The translated and revised version of Health Promoting Lifestyle Profile II (Walker, Sechrist & Pender. 2002) was used as a tool for health promotion. As the measured score was higher, the health promoting activity was indicated to be higher. The results of this study were as follows: 1. As a result of checking the breast self examination compliance frequency between the experiment group that received the breast self examination participant education and the comparative group that did not receive the education, there was a significant difference in interaction between groups by time, as time passed by. 2. As a result of checking the breast self examination compliance capability between the experiment group and the comparative group, there was a significant difference in interaction between groups by time, as time passed by. 3. As a result of carrying out a repetitive measurement analysis, between the experiment group that received the breast self examination education and the comparative group that did not receive the education, which was carried out to validate the hypothesis that the former would have higher health promoting activities than the latter, there was no significant difference after the breast self examination education was conducted.