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Pediatrician Perspectives on the Evaluation and Treatment of Acute Gastrointestinal Infections, Jeonbuk, South Korea, 2002 (전라북도 소아과 개원의의 급성 위장염 환자에 대한 인식 조사)

  • Lim, So Hee;Koe, Yang Sim;Jo, Dae Sun;Lee, Sin Jae;Hwang, Pyoung Han;Kilgore, P.;Nyhambat, B.;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1217-1223
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    • 2003
  • Purpose : This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. Methods : This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. Results : The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). Conclusion : Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.

Golf activity after total knee arthroplasty (슬관절 전치환술 후 골프활동)

  • Kim, Hyung-Jun;Cha, Seung-Han;Nam, Kyoung-Mo;Kim, Dong-Heon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.51-56
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    • 2012
  • Purpose: Golf is a popular sports activity after total knee arthroplasty in old age patients. We evaluated golf and implant loosening through the radiologic method. We also evaluated correlation of patterns of golf activity and clinical outcome to suggest guidelines to the patients. Materials and Methods: We carried out a retrospective case-control study of 80 patients (80 knees) who underwent TKR between 2005 and 2008, and followed up more than 3 years. We divided patients who played golf after TKR as a study group and who did not participate sports activities as a control group. We calculated the sum of width of radiolucent line in 7 sections around femoral component, 7 sections around tibial components and 5 sections in patella component using American Knee Society Roentgenographic Evaluation and Scoring system respectively. The inclusion criteria, was BMI (body mass index) was between 25 and $30kg/m^2$, and UCLA activity-level rating System score was between 5 and 8. We also got the information of patients' patterns of golf activities such as 1. the interval from surgery to return to golf activity. 2. the frequency of golf activities 3. using spike or cart. We obtained the information from patient's questionnaire and telephone interview. We compared with the VAS (visual analogue scale) respectively. And handicaps and driving distance was evaluated as well. Results: The study group's mean sum of radiologic score was 0.84 mm and 0.69 mm in control group. This is not statistically significant (p=0.22). Too early returning to golf (p=0.01) and left knee replacement (p<0.01) were statistically significant factors affecting clinical outcomes of golf activities after total knee arthroplasty. Conclusion: We concluded that golf activities after total knee arthroplasty is not correlated with radiographic loosening, and we need to give an explanation to the patients about increased pain when returing to golf too early and left side arthroplasties.

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Effects of Minor Stressful Events on Sleep in College Students (대학생에서 스트레스가 수면에 미치는 영향)

  • Kang, Seung-Gul;Yoon, Ho-Kyoung;Ham, Byung-Joo;Choi, Yun-Kyeung;Kim, Seung-Hyun;Joe, Sook-Haeng;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.48-55
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    • 2002
  • Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

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A Study on the Relationship between the Experience of Sanhujori, the Traditional Postpartal Care in Korea and Present Health Status of Chronic Arthritis Female Patient (만성관절염 여성 환자의 산후조리 경험과 건강상태와의 관계)

  • Yoo, Eun-Kwang;Lee, Sun-Hyae;Kim, Myoung-Hee
    • Women's Health Nursing
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    • v.4 no.2
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    • pp.217-230
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    • 1998
  • The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

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Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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Clinical Features of Pulmonary Langerhans Cell Histiocytosis in Korea (국내 폐 랑게르한스세포 조직구증(Pulmonary Langerhans Cell Histiocytosis)의 임상양상)

  • Kim, Chul;Jeong, Sung Hwan;Shim, Jae Jeong;Cha, Seung-Ick;Son, Choonhee;Chung, Man Pyo;Park, Hye Yoon;Kim, Young Whan;Park, Jong Sun;Uh, Soo-Taek;Park, Choon Sik;Kim, Dong Soon;Cho, Kyung Wook;Song, Jin Woo;Jegal, Yang Jin;Park, Moo Suk;Park, Byung Hoon;Lee, Jin Hwa;Hur, Jin Won;Yum, Ho-Kee;Lee, Hong-Lyeol;Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.98-103
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    • 2009
  • Background: Pulmonary Langerhans cell histiocytosis (PLCH) is characterized by a proliferation of Langerhans cells and this results in granulomas that involve multiple organs of the body. Because the incidence of PLCH is very low in Korea and worldwide, collecting the clinical data of patients with PLCH nationwide is needed to determine the clinical features of Korean patients with PLCH. Methods: The patients with PLCH confirmed by biopsy at any body site were included and the patients should have lung lesions present. A questionnaire that had items on the symptoms, lung function tests, the roentgenographic findings and the treatment was collected retrospectively at a Korean ILD Research Meeting. Results: A total of 56 cases were collected. The number of males and females was 48 and 8, respectively, and their median age was 43 years (range: 18-67 years). The patients were current or ex-smokers in 79% of the cases. The most frequent symptom was coughing (39%), followed in decreasing order by dyspnea (38%), sputum (20%) and chest pain (20%). Pneumothorax was observed in 16 (29%) patients. Lung function tests showed a normal, restrictive, mixed or obstructive pattern in 26 (61%), 7 (16%), 7 (16%) and 3 patients (7%), respectively. Nodular-cystic lesion was most frequently observed in 59% of the patients on HRCT. The lung lesions were located in the middle and upper lobes in almost the cases. The median follow-up period was 90 months (range: 1-180 months) and only two patients died during this period. Conclusion: This study provides a national survey of the patients with PLCH during a long follow-up period.

A Follow up Study on the Acceptors of the Sterilization and Intra-uterine Device (영구불임수술 및 자궁내피임장치시술 수용자의 추후조사)

  • Woo, Im-Soo;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.39-49
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    • 1995
  • This study was attempted to investigate the acceptive status of 428 persons who had taken the vasectomy and the tubal ligation and the intra-uterine device(IUD, copper-T). It defined the complications after the contraceptive procedures and the effects of the supporting of the government for contraception. The target population was identified from the list of the 105 females taken tubal ligation, and 109 males vasectomized, 214 IUD acceptors covered by Gumi Health Center from January 1990 to December 1992. Data was collected from the target population by the questionnaire and medical records between March 1 and April 30, 1993. Among the study subjects, 56.0% of vasectomized males was between 30 and 34 years of age and the highest percentages of tubal ligation and IUD acceptors were between 25 and 29 years of age. The highest percentage of occupation of vasectomized males was officials and that of tubal ligation and IUD acceptors was in no occupational status. 81.2% of respondents were more than high school in educational level, educational level of vasectomized males was more higher than that of females. The percentage contraceptive acceptors with one or two children was 90.8% for vasectomized males, 80.1% for females with tubal ligation, and 93.9% for IUD acceptors. The most people accepted the contraception as they felt the need rather than other's persuasion. The major reasons of contraception were having the wanted children and alleviating the economic burden for the raising and the educating their children. Among the vasectomized males, 11.0% complained the side reaction and the most common symptoms were the inflammation around the wound and sexual declination. Among the tubal ligation females, 46.7% complained the side reaction and the most common symptoms were vaginal discharge, the menorrhagia, back pain and lethargy. The IUD acceptors were similar to them. The regretting rate of tubal ligation and the IUD acceptors was higher than the vasectomized males. The major reason of their regretting was the side reaction in the tubal ligation and the IUD. But the vasectomized males had the insecurity that they couldn't have their own children any more, and sexual declination. The main reason of the females accepted the tubal ligation and the IUD were the fears about toward induced abortion. The most contraceptive acceptors(83.2%) wanted to be offered by the government, but if they pay the expense in their own money, they would accept the contraception in 86.9%.

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The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

Analysis of Sports Injuries in Kendo (검도 운동에서 발생된 스포츠 손상의 분석)

  • Song, Hyun-Seok;Park, Sung-Jin;Han, Suk-Ku;Nah, Ki-Ho;Cheung, Hyung-Kook;Choi, Woo-Hyuk;Choi, Nam-Yong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.122-127
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    • 2005
  • Purpose: To study the mechanism of injuries or discomfort during kendo and to analyze the causes of injury, injured parts of body, treatments modalities, and degree of return to the pre-injury activity level. Materials and Methods: We studied ninety-eight kendo players who had played at three gymnasium of Korean Kumdo Association, were older than high-school age, had been playing kendo for more than six months, and had any pain or discomfort after playing kendo. We analyzed the questionnaire and interviewed the patients concerning the injured parts of body, symptoms, treatments. Results; The mean age was 30.2 years old, and the onset of symptoms was between two weeks and six months after starting the kendo. Many of them were injured during attacking(32.2%). The injuries of feet were increased on players who exercised for less than 1 year. Only fifty-nine players(60.2%) were treated within one month. Among them, thirty-eight percent were treated by oriental medicine or other departments and only thirty-six percent were treated by orthopaedic surgeons. The prevalence of injuries of the foot and ankle was highest(38.8%), and there were the wrist(13.1%), shoulder(11.9%), knee(11.9%) in order of prevalence. Fifty percents of them could return to the pre-injury activity level. Conclusion: The prevalence of injuries of the foot and ankle was highest(38.8%), and were increased on players who exercised for less than 1 year. Sixty percents of players were treated with any proper modalities, and only thirty-six percent were treated by orthopaedic surgeons.

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Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea (1998년 경주시 한 초등학교 학생과 인근 주민에서 발생한 세균성이질)

  • Jung, Cheol;Bae, Geun-Ryang;Hur, Yeong-Joo;Lee, Sang-Won;Jeong, Eun-Kyeong;Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.1-9
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    • 2000
  • Objectives : This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of 'M' primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. Methods : The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of 'M' primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. Results : The attack rate of diarrhea was 28.7% in the subjects from Sept.24 to Oct. 24, 1958. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of 'M' primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of 'M' primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that 'M' primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, $1\sim3$ days (72.5%) in duration, $2\sim3$ times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). Conclusions : The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess fools should be done thoroughly.

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