• Advances in pediatric surgery
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• 제4권2호
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• pp.110-116
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• 1998

This is a clinical review of 2,191 pediatric surgical patients under the age of 15 years, operated upon at the Division of Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The total number of operations in the pediatric age for all specialties were 13,144(13.2 %). The total operations including those performed on adults were 99,555. The most common age group operated upon was under 5 year of age(44.4 %). The number of operations in Division of General Pediatric Surgery were 2,191(16.7 %) out of total 13,144 operations in all pediatric specialties. The patients under 1 year of age in general pediatric surgery was 42.9 %(941/2,191). The most common diseases in neonates were anorectal malformation(20.6 %) and hypertrophic pyloric stenosis(20.3 %). Infants older than neonates most commonly were operated upon for inguinal hernia(32.4 %) and intussusception(19.6 %). The total mortality rate in the neonatal intensive care unit was 31.3 %. Gastroschisis had the highest mortality.

• 대한간호학회지
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• 제29권2호
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• pp.346-360
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• 1999

The purpose of this research was to identify nursing interventions performed by hospital nurses in Korea. The sample consisted of 311 nurses working in three hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Eighteen interventions were performed at least daily. Interventions in the Physiological : Basic domain were most frequently used at least daily. No interventions in the Family and Behavioral domains were used by nurses at least once a day. The most frequently used interventions was Documentation, followed by the interventions Medication : Parenteral, Intravenous(IV) Insertion, Temperature Control, and Shift Report. The intervention performed least often was Reproductive Technology Management. Nurses working in intensive care units on the whole performed interventions most often, while nurses working in obstetric, gynecological, and pediatric units performed them least often. The nurses working in intensive care unit, medical and surgical care units performed the interventions in the Physiological : Basic domain more often than the nurses working in obstetric, gynecological, and pediatric units. The nurses working in obstetric, gynecological, and pediatric units used the interventions in the Family domain more often than the nurses working in the other three units. This study contributes to the documentation of nursrs' work in Korea. Further study will be needed to validate nursing activities of each NIC intervention.

• 대한간호학회지
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• 제35권1호
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• 대한간호학회지
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• 제51권5호
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• pp.573-584
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• 2021

Purpose: This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19. Methods: This study adopted the double diamond process of service design comprising the discovery, defining, and development stages. Results: We developed an untact visit service based on an application that considered the child's status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder. Conclusion: Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child's information in real-time, and provide one-stop service without increasing healthcare providers' work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

• Advances in pediatric surgery
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• 제16권1호
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• pp.37-42
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• 2010

Tracheal injury is a rare complication of endo-tracheal intubation. However in neonates, the rates of morbidity and mortality are high. Recommendations for treatment are based on the several reports of this injury and are individualized. Conservative management can be effective in some cases. We describe the case of a neonate who presented with subcutaneous emphysema after intubation in a neonatal intensive care unit. This patient suffered full VACTERL syndrome and had 1.7 mm diameter subglottic stenosis. Conservative management resulted in no further increase in subcutaneous emphysema and after 10 days the patient was stable.

• Clinical and Experimental Pediatrics
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• 제52권8호
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• pp.851-855
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• 2009

Death is not only a medical problem; it is also an ethical problem. When doctors face a dying neonate, their knowledge of bioethics and the opinions of ethical specialists and religious leaders are helpful for them and the family of the dying baby. In recent years, due to the increase of surviving babies who have suffered from severe illness, those born too small or too early, and those with severe anomalies in neonatal intensive care unit (NICU), we have met with complicated bioethical problems frequently. To lessen the burdens of doctors and the parents of the dying baby, I reviewed medical, ethical and religious articles about bioethics in adult death. My suggestions are listed as follows: 1) regular bioethical education and activation of bioethical committees in NICU, 2) a well-controlled nationwide database, 3) a hospice unit space and programs for dying baby in NICU, and 4) social support for pregnant women and financial support for the NICU.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.481-488
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• 2011

In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU) beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.

• Clinical and Experimental Pediatrics
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• 제45권8호
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• pp.1000-1006
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• 2002

목 적 : 혈액-종양 환자에서 항암화학요법으로 치료하는 과정 중에서 중증 폐 질환 합병증이 발생할 수 있다. 그 원인으로는 감염성 또는 비 감염성의 원인들이 있고 특히 이들 환자에서 폐 질환 합병증 또는 호흡부전으로 인한 인공환기 치료시에는 예후가 나쁘다고 알려져 있다. 저자들은 본원 소아 중환자실에 입원한 혈액-종양 환아에서 면역 저하상태(절대 호중구수 < $1,000/mm^3$)의 지표의 하나인 호중구 감소증과 폐합병증의 유무에 따른 원인과 예후를 분석하였다. 방 법: 1997년 1월부터 2001년 5월까지 서울중앙병원 소아 중환자실에 입원한 혈액-종양 환아 95명의 의무기록을 후향적으로 분석하여 폐 합병증의 원인과 진단 방법, 호중구 감소상태와 폐 합병증의 유무에 따른 사망률을 분석하였다. 결 과 : 연령 분포는 생후 2개월에서 18세까지 평균 8.5세였고, 원인 혈액-종양 질환으로는 급성 림프성 백혈병 31명, 급성 골수성 백혈병 9명, 림프선 종양 11명, 뇌종양 8명, 고형종양 25명, 그 외 혈액질환이 11명이었다. 95명의 환아 중 중환자실 입원당시의 원인으로는 패혈증 23명(24%), 패혈증을 동반한 폐렴 22명(23%), 급성 호흡부전 12명(12.5%), 의식소실 16명(17%), 급성 신부전, 심부전의 기타 질환이 15명(16%)이었다. 이들 중에서 폐 합병증을 동반한 환아는 42명(44%), 동반하지 않은 환아는 53명(56%)이었다. 폐 합병증으로는 폐렴, 늑막삼출, 급성호흡부전, 기흉이 있었다. 폐 합병증이 있는 환아 중 호중구 감소상태의 환아는 29명(69%), 호중구 감소상태가 아닌 환아는 13명(31%)이었다. 원인으로는 감염성인 경우가 37명(88%), 비 감염성인 경우가 2명(5%)이었고, 구분이 어려운 경우가 3명(7%)이었다. 시행된 각각의 검체에서 균이 검출된 빈도를 비교하면 혈액배양검사는 42명중 15명(36%), 객담검사는 42명 중 7명(16%), 소변 배양검사는 42명 중 3명(7%), 인공환기요법 중인 환아에서 시행한 기도내 분비물 배양검사는 28명 중 5명(18%)이었다. 주요 원인균으로는 Candida species 12명(33%), MRSA 6명(17%), Pseudomonas aeruginosa 4명(11%), Klebsiella pneumoniae 4명(11%)이었다. 골수이식술을 받은 환자는 모두 10명으로 이중 7명에서 폐 합병증이 있었고, 원인균이 동정된 경우는 모두 3명으로 각각 S.maltophilia, K.pneumoniae, Parainfluenza virus이었다. 10명의 환아 중 8명이 사망하였고 사망 원인으로는 폐혈증이 5명, 급성호흡부전 증후군이 2명, 뇌출혈이 1명이었다. 전체 사망률은 56.8%였고, 사망률을 보면 이중 폐 합병증이 있고 호중구 감소상태의 환아는 76%(22명), 폐 합병증이 있으나 호중구 감소상태가 아닌 환아는 69% (9명), 폐 합병증이 없으나 호중구 감소상태의 환아는 46%(7명), 폐 합병증이 없으며 호중구 감소상태가 아닌 환아는 43%(16명)이었다. 결 론 : 중환자실에 입원한 혈액-종양 환아에서 폐 합병증의 원인으로 감염성인 경우가 많았다. 사망률은 폐 합병증이 있는 경우가 없는 경우에 비해 높았으며, 특히 폐 합병증이 있는 환아 중 호중구 감소상태의 환아에서 사망률이 높았다. 이 결과로 미루어 폐 합병증이 있는 혈액-종양 환자에서 더 적극적인 원인 규명과 치료를 시도해야 할 것으로 생각된다.

• Perspectives in Nursing Science
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• 제15권1호
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• pp.18-28
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• 2018

Purpose: This study was designed to explore the levels of physical activity and fatigue among nurses and to identify the relationship between these variables. Methods: Participants were 89 nurses working at an intensive care unit and an operating room in a children's hospital. Data were collected using self-reported questionnaires including the International Physical Activity Questionnaire and Brief Fatigue Inventory. Results: Most of the nurses' physical activity was work related, and there was a significant difference according to the working unit. Nurses with higher work stress and lower job satisfaction showed higher levels of fatigue than their counterparts did. Work-related physical activity and the interference of fatigue with relationships were related positively, whereas transport and leisure time physical activity were negatively related to usual fatigue and the interference of fatigue with life enjoyment. Conclusion: The levels of physical activity and fatigue of nurses were higher than those observed among other populations. The appropriate level of physical activity for these nurses needs to be investigated carefully. Also, in the intervention for nurses' fatigue, their level of work-related and leisure-time physical activity should be considered separately, and their work environment and psychological satisfaction level should be included.

• Clinical and Experimental Pediatrics
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• 제50권7호
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• pp.698-701
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• 2007

Cryseobacterium meningosepticum은 흙, 병원, 수돗물을 포함한 물이 있는 환경에서 발견되는 그람 음성 막대균으로, 미숙아, 노인과 같이 면역성이 결여된 인체에 기회감염을 일으키고, 미숙아에서는 패혈증, 뇌수막염과 같은 중증 질환을 유발하여 사망률과 합병증 발생이 높다. 특히, 균주가 병원내 배수관, 기계장비등을 통해 오염되어 신생아실에서 폭발적 유행이 가능하다. 저자들은 미숙아에서 발생한 다항생제 내성 C. meningosepticum에 의한 패혈증, 뇌수막염을 ciprofloxacin으로 치료한 1례와 동기간에 무증상 보균상태를 보였던 1례와 성공적인 환경검사와 조절에 대해서 보고하는 바이다.