Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.10
no.2
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pp.244-251
/
1999
Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.
Journal of the korean academy of Pediatric Dentistry
/
v.46
no.4
/
pp.362-368
/
2019
The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018. Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2nd referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2nd referral was relatively delayed with increased ratio of 'during treatment'. These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Purpose: The purpose of this study was to identify predictors of spiritual well-being and meaning in life for adolescents with leukemia. Methods: Participants were 102 adolescents (11-21 years) recruited at C university hospital from June to August in 2014. The eligible participants were diagnosed with leukemia and are on follow-up care at the outpatient clinic. Participants were assessed for spiritual well-being, meaning in life, self-esteem, and social support. Results: Levels of spiritual well-being and meaning in life for these adolescents with leukemia were 3.69 out of 6 and 3.10 out of 4, respectively. Self-esteem and social support from family were factors affecting spiritual well-being. Self-esteem, existential well-being and social support from family and friends were predictive for meaning in life and accounted for 68% of total variance. Conclusion: The results show that there are several factors affecting spiritual well-being and meaning in life in adolescents with leukemia. Therefore, nursing intervention programs for adolescents with leukemia should include strengthening self-esteem and social support as well as considering the spiritual aspect of life in order to find meaning in life beyond leukemia.
The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.
Park, Sun Hyo;Jeon, Yong June;Kwon, Kun Young;Han, Seung Beom
Tuberculosis and Respiratory Diseases
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v.63
no.1
/
pp.94-99
/
2007
The spontaneous regression (SR) of cancer is defined as the complete disappearance of a malignant disease without adequate treatment. SR is a very rare biological event, particularly in a pulmonary sarcoma. We report the first documented case of an endobronchial sarcoma that regressed spontaneously in Korea. We encountered a rare case of a 72-year-old woman with an undiagnosed intrapelvic cystic mass, who presented with a smooth surfaced endobronchial tumor obstructing the orifice of the right lower lobe bronchus on a bronchoscopic examination. She had a prior history cervical cancer and adenocarcinoma in the right middle lobe lateral segment of her lung for which she had undergone radiation therapy. The tumor was diagnosed as an endobronchial sarcoma by the histopathology findings and immunohistochemistry. It was unclear if the tumor was a primary sarcoma of the lung or a metastatic lesion of an intrapelvic cystic mass because she refused a diagnostic exploratory laparotomy. Two months later, obstructive pneumonia of the right lower lobe with parapneumonic effusion developed with fever above 38.5degrees C for 10 days. After recovering from pneumonia, she was followed up regularly in the outpatient clinic without any specific treatment. One year later after treating the obstructive pneumonia, the follow-up bronchoscopy revealed complete SR of endobronchial sarcoma. It is believed that the obstructive pneumonia accompanied by fever above 38.5degrees C for 10 days might have played a role in this SR.
Eighty-eight strain3 o~methicillin resistant Stopllylococcus awecis were Isolated from pus (64.7%); spuhm (26.2%), blood, fluid, andurine of 83 patients at Dong-A Hospital in P~~san to invesligate theil-coagulase typ- Ing, and multi-drug resistaut ppattems. The presence of niec A gene confe~~ing melhicillin resistance was tested by polymerase chain reaction (PCR) with uwo mec A gene specific primers using purified clromosonlal DNA as templates. DNA fragments of expected size wel-e detected frorn 86 strains, but not from two strains. !i coagulase typmg, the 86 isolates were assigned to 5 coagulase lypes, I, 11, lll. 1V, VI, VII, VIlI, but there was no isolate helong lo type V. The most abundant coagulase type was type TI(50 %), lollowed by type IV Rest ofthe coagulase types were ininor; ranging fmm 4.5 to 12.5 '% Most of the type I1 ~netlucillin resistant Stapl\ulcorneryiococcus nwem (MRSA) strams were isolated from the generd sulzely ward, but major strains of type IV were Isolated from the otorhinolq~ngology of the hospital's outpatient clinic center. All of the 88 st~nins were sensitive to vancomycin and teicoplanin, but 71 (81%) strains showed multi-drug resitant to penicillin, cephalotl~n, eiythroinycin, gentan~ycin, imipenem, clindamycin, ciprofloxacin and ooxacillin. Yo relationship was found between the antibiotic resistance pattems aud the coagulase typing patterns.
Song, Hyun Beom;Lee, Deokho;Jin, Yan;Kang, Jinwoo;Cho, Shin-Hyeong;Park, Min Sun;Park, Jin-Ho;Song, Woo-Jung;Kang, Hye-Ryun;Lee, Sang Hyub;Hong, Sung-Tae;Choi, Min-Ho
Parasites, Hosts and Diseases
/
v.58
no.4
/
pp.413-419
/
2020
Eosinophilia occurs commonly in many diseases including allergic diseases and helminthic infections. Toxocariasis has been suggested as one cause of eosinophilia. The present study was undertaken to examine the prevalence of toxocariasis in patients with eosinophilia and to identify the risk factors for toxocariasis. This prospective cohort study recruited a total of 81 patients with eosinophilia (34 males and 47 females) who visited the outpatient clinic at Seoul National University Hospital from January 2017 to February 2018 and agreed to participate in this study. The prevalence of toxocariasis was examined by T. canis-specific ELISA, and the various risk factors for toxocariasis were evaluated by a questionnaire survey. Among 81 patients with eosinophilia, 18 were positive for anti-T. canis antibodies (22.2%); 88.9% were male (16/18) and 11.1% were female (2/18). Multivariate statistical analysis revealed that males (OR 21.876, 95% CI: 1.667-287.144) with a history of consuming the raw meat or livers of animals (OR 5.899, 95% CI: 1.004-34.669) and a heavy alcohol-drinking habit (OR 8.767, 95% CI: 1.018-75.497) were at higher risk of toxocariasis in patients with eosinophilia. Toxocariasis should be considered a potential cause of eosinophilia when the patient has a history of eating the raw meat or livers of animals in Korea. A single course of albendazole is recommended to reduce the migration of Toxocara larvae in serologically positive cases with eosinophilia.
Purpose: The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. Methods: Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0‰ for children aged ${\geq}6$ years and 7‰ for children aged <6 years. Results: A total of 2,530 children (1,191 boys) with a mean age of $10.0{\pm}3.0years$ (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and ${\geq}12$ years of age (p=0.018). Conclusion: The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those ${\geq}12$ years old.
Han, Ga Hee;Chung, In Kwon;Lee, Do Hyung;Kim, Jin Hyoung;Seo, Ji Won
Journal of The Korean Ophthalmological Society
/
v.59
no.12
/
pp.1181-1184
/
2018
Purpose: To present a rare case of tear drainage since birth from a lacrimal ductule fistula, which is the first report in the Republic of Korea. Case summary: A 3-month-old female who presented with discharge of clear fluid from a small skin opening lateral to the right upper eyelid since birth visited the outpatient clinic. The patient was healthy and was receiving no medication. She was born on gestation age 35 weeks and 3 days. No other specific history or other ophthalmic abnormality was found. On examination, a small skin orifice approximately 2 mm diameter and no sign of infection or discoloration was observed. To relieve this symptom, the patient underwent a fistulectomy under general anesthesia. Histopathological examination of the surgical specimen was performed. The patient's symptom subsided postoperatively without recurrence. Conclusions: This is the first report in the Republic of Korea of tears draining from a lacrimal ductule fistula since birth and the subsequent clinical treatment procedures.
Kim, Chang Hyeun;Lee, Chi Hyung;Kim, Young Ha;Sung, Soon Ki;Son, Dong Wuk;Lee, Sang Weon;Song, Geun Sung
Journal of Korean Neurosurgical Society
/
v.64
no.6
/
pp.891-900
/
2021
Objective : Vertebral artery dissecting aneurysm (VADA) is a very rare subtype of intracranial aneurysms; when ruptured, it is associated with significantly high rates of morbidity and mortality. Despite several discussions and debates, the optimal treatment for VADA has not yet been established. In the last 10 years, flow diverter devices (FDD) have emerged as a challenging and new treatment method, and various clinical and radiological results have been reported about their safety and effectiveness. The aim of our study was to evaluate the clinical and radiological results with the use of FDD in the treatment of unruptured VADA. Methods : We retrospectively evaluated the data of all patients with unruptured VADA treated with FDD between January 2018 and February 2021 at our hybrid operating room. Nine patients with unruptured VADA, deemed hemodynamically unstable, were treated with FDD. Among other parameters, the technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcomes were evaluated. Results : Successful FDD deployment was achieved in all cases, and the immediate follow-up angiography showed intra-aneurysmal contrast stasis with parent artery preservation. A temporary episode of facial numbness and palsy was noted in one patient; however, the symptoms had completely disappeared when followed up at the outpatient clinic 2 weeks after the procedure. The 3-6 months follow-up angiography (n=9) demonstrated complete/near-complete obliteration of the aneurysm in seven patients, and partial obliteration and segmental occlusion in one patient each. In the patient who achieved only partial obliteration, there was a sac 13 mm in size, and there was no change in the 1-year follow-up angiography. In the patient with segmental occlusion, the cause could not be determined. The clinical outcome was modified Rankin Scale 0 in all patients. Conclusion : Our preliminary study using FDD to treat hemodynamically unstable unruptured VADA showed that FDD is safe and effective. Our study has limitations in that the number of cases is small, and it is not a prospective study. However, we believe that the study contributes to evidence regarding the safety and effectiveness of FDD in the treatment of unruptured VADA.
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