• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.76-82
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• 2003

Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.306-318
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• 2008

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto-chemistrical observation, with collagen type Ⅰ, fibronectin, integrin ${\alpha}_2{\beta}_1$ and integrin ${\alpha}_5{\beta}_1$ antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type Ⅰ collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type Ⅰ collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin ${\alpha}_2{\beta}_1$ and Integrin ${\alpha}_5{\beta}_1$ expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.372-387
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• 1995

One-hundred eighty four medical doctors and 349 nurses out of 6 university hospitals and 1 general hospital were surveyed from Mar. 3, to Mar. 31, 1995, in order to appreciate the extent of their understandings on the clinical nurse specialist system. The difference was analyzed by the subjects' age, their position and department, the expected benefits of the system. the assigned department, the position and qualification, the required special educational organization and program, and the extent of autonomy of the function of clinical nurse specialists and the special nursing field. The results were as follows ; 1. The perception about the expected benefits of the introduction of clinical nurse specialist system was significantly different among the age groups of medical doctors, and the age group of 40s among them showed the most positive perception. 2. The extent of acquaintance with clinical nurse specialist was the higher in the older age groups of respondent nurses. Meanwhile, the experience of participation with clinical nurse specialists was the more in the older age group of medical doctors. 3. The opinion about the required position of clinical nurse specialists was significantly different by the age and position of the respondent nurses. The rank of head nurse was suggested by the respondent nurses of older age and higher positon, while the level of in-charge nurse was suggested by the staff nurses. Also, the duration of clinical experience required of clinical nurse specialists was the most frequently responded as 6 to 10 years by nurses, as 2 to 5 years by medical doctors. 4. The degree of educational background required of clinical nurse specialists was differently responded by the various position of medical doctors and nurses. Of the medical doctors, professors frequently responded bachelor degree and medical residents frequently responded master degree as the required educational background. Of the nurses, nursing administrators more frequently responded that master degree was required of clinical nurse specialists than staff nurses and clinical nurse specialists did. 5. The extent of acquaintance with clinical nurse specialist system was different among the various department of medical doctors, which was the highest in the doctors of psychiatry, internal medicine and pediatrics, respectively. The doctors of surgery were the least acquainted of clinical nurse specialist. 6. The nurses of special parts, of surgery and of obstetrics & pediatrics responded more frequently that clinical nurse specialists should belong to the nursing department than the nurses of internal medicine and of others did. 7. The Special parts that necessitate clinical nurse specialists were responded to be the more important by nurses than by medical doctors. Clinical nurse specialists were responded to be the more necessary in the parts of diabetics, oncology, pyschiatry, dialysis, organ transplantation, intensive care, and in cardiovascular part. They were responded to be the less important in the parts of intravenous therapy, computer informatics, nursing administration, the improvement of nursing quality.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.261-266
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• 2004

Although significant progress has been made in the surgical treatment of esophageal carcinoma as well as in the detection of early stage esophageal carcinoma by diagnostic techniques, the prognosis of the esophageal carcinoma patients remain poor. The p53 gene product is known to regulate cell growth and proliferation. And the nm23 gene was identified originally as an anti-metastatic influence whose expression was correlated inversely with tumor metastatic potential in murine melanoma cell lines. This experiment was intended to know the relationship among the p53 and nm23 gene expression versus clinicopahologic characteristics of the esophageal cancer. Total 40 cases were collected from patients who had undergone esophagectomy at St. Mary's Hospital, Catholic university of Korea. Immunohistochemical stain for p53 mutant-type protein and nm23 protein was graded as <10% positive tumor cells: negative; 10∼30% positive tumor cells: ＋ ; 30∼50% positive tumor cells: ＋＋, and >50% positive tumor cells: ＋＋＋. The tumor invasion was grades as none:－ ; mild:＋ ; moderate:＋＋ ; severe: ＋＋＋. Overexpression of p53 protein and nm23 was not associated with the survival and cliniocopathologic characteristics of the esophageal cancer. Moreover, the combination analysis of p53 and nm23 revealed that there was no relationship between the gene expression and the clinicopatholic characteristics of the esophageal cancer.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.148-153
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• 1998

Objectives：This study investigated the severity and frequency of depression in mothers with autistic children and the correlation between K-BDI score of mothers with autism and severity of autistic symptoms of their children. Methods：The subjects for this study consisted of 45 autistic children and their mothers. The severity of autistic symptoms of children were evaluated by K-CARS and severity of depressive symptoms of mothers with autistic children evaluated by the K-BDI. Results：1) Total K-BDI scores of mothers with autistic children were $17.3{\pm}10.9$ and this score was belonged to subclinical depression on the K-BDI STEN score. There were significant differences of total KBDI score between in mothers with autistic children and in those of normal control. The 26.7% of 45 mothers with autistic children were depression. 2) There was no correlation between total K-BDI score and each factor of mothers with autistic children and K-CARS score of the their children. Conclusion：There were many depression in mothers with autistic children than in those of normal control. This result suggested that the education and the supportive psychotherapy for mothers with autistic children is as important as the treatment for autism.

• Korean Journal of Human Ecology
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• v.16 no.4
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• pp.849-854
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• 2007

Body fat proportion is a major issue in health. The prevalence of obesity in childhood has been increasing on thesedays. A series of indirect estimates of body fat have been developed. There are hydrodensitometry, BIA and anthropometry equation for body fat. Hydrodensitometry has been regarded as a common criterion method. BIA made it possible to analyze body fat mass more related to hydrodensitometry than anthropometry. The purpose of this unvestigation were to compare body fat and other body composition between boys & girls and to know which anthropometry equation for body fat was most closely associated with BIA in boys & girls respectively. The subjects were 148 4th grade elementary school students(male:70, female:78). They underwent BIA(InBody 3.0, Biospace Korea)to determine body fat and other body composition. Anthropometric measurements were taken of height, weight, skinfolds and circumferences. The results obtained are summarized as follow: 1) Weight, BMI and Rohrer index were $39.9{\pm}7.2kg$, $20.5{\pm}8.0$, $138.2{\pm}17.0$ for boys and $35.9{\pm}6.7kg$, $18.2{\pm}2.6$, $96.6{\pm}13.6$ for girls. 2) Total body fat and percent body fat determined by BIA were $10.3{\pm}4.3kg$, $25.4{\pm}6.6%$ for the boys group and $9.3{\pm}3.8kg$, $25.1{\pm}6.0%$ for girls. 3) Mean triceps skinfold thickness was $20.5{\pm}6.1mm$ in boys, $17.0{\pm}5.1mm$ in girls and mean WHR was $0.88{\pm}0.4$ in bodys, $0.82{\pm}0.4$ in female and the values were significantly different by sex. 4) Correlational nanlyses showed that estimation of body fat by BIA measurement seemed to be closely associated with Rohere index(boys r=0.854, girls r=0.909). Kim's equation was highly correlated with the body fat in girls(r=0.910) but less correlated in boys(r=0.710). We need to develop specific anthropometric equations based on age and sex to determine body fat for children.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.206-212
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• 2008

Purpose: To evaluate the effectiveness of pilot program on standard curriculum of hospice palliative care education; a basic training program for physician, nurse, social worker and clergies at hospice institute. Methods: To develop an educational program, we used the Education in Palliative and End-of-life Care (EPEC) program as a paradigm and modified it to be suited in our situation: The standard curriculum consists of 19 modules, and it is designed to be applied to the teaching methods, including lecture, interactive lecture, small group discussions, and role play. To verify its contents and teaching methods, we implemented a pilot program which consisted of 3 modules, using various teaching methods; trigger video tapes, interactive lecture, small group discussions, and role play. Results: Overwhelming majority were satisfied with the teaching methods and learner-centered methods, and agreed that the contents were clinically relevant to the care of dying patients. They also indicated that their attitudes would likely change as a result of the education. Conclusion: The effects of the pilot program on standard curriculum of hospice and palliative care are very positive and has broader implications for improving hospice palliative care education. For successful implementation of the program, trainers must also be prepared to teach effectively. Also it must be accompanied with train-the trainer program.

• Journal of the Korean Society of Radiology
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• v.6 no.3
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• pp.183-189
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• 2012

Ultrasonography is one of the fields on the imaging studies within intra-abdominal organs. A blood test is a typical method of clinical chemical examination on the in vivo test of clinical symptoms. Fatty liver is performed simultaneously two kinds of diagnostics methods, intra-abdominal ultrasound and blood tests. At an implementing this, the standard of blood tests value was the TBIL, TC, AST, ALT, ALP, GGT, TG, HDL-C, GLU. In this study analyzing the accuracy of the two kinds of test, ultrasonography and blood test, on patients with fatty liver. From January to March 2012, patients 459 determined fatty liver within 1350, who received health examination simultaneously on the intra-abdominal ultrasonography and blood tests. Same result of ultrasonography and blood test's patients were 459 ie, 60.8%. and different result of those examinations was 280 ie, 39.2%. Consequently diagnostic accuracy was 60.8%. It presumably caused by differences in the diagnostic performance of ultrasound professionals(Radiologist or Radiological Technologist). In order to overcome this, ongoing educational and study will be needed.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.91-97
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• 2016

Background: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. Methods: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. Results: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second ($FEV_1$, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator $FEV_1$: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). Conclusion: Emphysema severity measured by CT and post-bronchodilator $FEV_1$ are important risk factors for the development of pneumonia in COPD.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.10 no.1
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• pp.115-125
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• 2000

Three major hospitals with over 500 beds located in and near Seoul were surveyed for airbone microorganisms from February 1, 1998 to February 18, 1998. The purpose of the study was to identify and quantify microbiological organisms circulating in the air of three different areas in the hospitals. For the study, a RCS air sampler was utilized equipped with two different collection media, the agar strip GK-A for bacteria and the agar strip HS for fungi. The areas investigated were the intensive care unit (ICU) in the Department of internal medicine, the Newborns room in the Department of Obstetrics, and the microbiology laboratory. The results were as follows; 1. The average numbers of general microbiological particles collected on the agar strip GK-A media were $205CFU/m^3$, $232CFU/m^3$, and $128CFU/m^3$ in each hospitals. The highest concentration of $387CFU/m^3$ was found in the ICU of A hospital at 15:00 during the day. Further analysis of the collected bioaerosols by gram staining, revealed that there were gram positive cocci (89.5%), gram positive bacilli (7.2%), gram negative bacilli (2.8%), and fungi (0.5%), in descending order of frequency. 2. Ten different genes were identified from the agar strip GK-A. The most frequently identified organisms were: the Coagulase negative staphylococcus (55.0%), Micrococcus (21.4%), Enterococcus species(10.4%), and Bacillus species (7.2%). A series of antibiotics susceptibility test were conducted against the aforementioned four(4) organisms. Ninety percent of coagulase negative stapylococcus were sensitive to Penicillins. Pathogenic microbes isolated include: Staphylococcus aureus, Acinetobacter species, Klebsiella pneumonia, Klebsiella oxytoca, and Pseudomonas aeroginosa. 3 Although 56.8% of the microorganisms grown on the strip HS media for fungi could not be identified, some of them were successfully identified. The most frequently found fungi were Aspergillus (35.3%), Yeast or Molds (6.2%), and Penicillium (0.7%). Based on the results obtained from the study, it was concluded that some areas in the hospitals had abnormally high bioaerosol concentrations which could be attributed to human activity. Therefore, it is recommended that periodic assessments of indoor bioaerosols aiming to identify the possible sources should be conducted in order to maintain clean indoor environment in the hospitals.