• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1224-1229
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• 2003

Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.372-376
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• 2008

Purpose : To identify clinical characteristics of severe respiratory syncytial virus (RSV) in neonatal period and early infancy and provide information in clinical practice. Methods : Twelve neonates and young infants (<6 months) who were infected by respiratory syncytial virus and required mechanical ventilation between March 2005 and July 2007 were enrolled. Diagnosis of RSV infection was made based on the positive results by rapid antigen immunoassay or polymerase chain reaction. Results : There were four premature infants, of whom three were near-term. Birth weight of subject patients was $2.8{\pm}0.6kg$, gestational age was $37{\pm}2weeks$ and the age at the time of admission was $35{\pm}15days$. Nine of them showed apnea and in five patients, apnea itself was an indication for mechanical ventilation. In seven of the apneic patients, apnea was the first manifestation of RSV infection. In three of these seven apneic patients, apnea preceded definite respiratory distress signs or typical stethoscopic findings by 1-3 days. Mean duration of mechanical ventilation was $3{\pm}2days$, and mean duration of stay in intensive care unit was $6{\pm}2days$. Conclusion : RSV is a major cause of severe respiratory tract infection in term or near-term infant younger than 2 months. For apnea could be the first manifestation of the RSV infection, high level of suspicion is required in practice of neonates or young infants who show any upper respiratory infection symptoms during RSV season.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.11-14
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• 2012

Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.434-440
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• 2009

Background: Surgical closure of a patent ductus arteriosus (PDA) can be considered when conservative medical treatment is ineffective or contraindicated. Low weight and earlier gestational age neonates who are treated with conservative medical therapy generally showed a higher failure rate. The morbidity of surgical PDA closure in such extremely low birth weight (ELBW) neonates is also high. Here we present the early results of a new technique for approaching the PDA through a dorsal minithoracotomy. Material and Method: From March 2006 to November 2008, 24 premature neonates underwent surgical PDA closure. The procedures were performed in the newborn intensive care unit via a 2 cm long dorsal minithoracotomy with the baby in the prone position with the left hemithorax elevated 30$^{\circ}$. Bimanual cotton swab blunt dissection completed the extrapleural accesstothe PDA and then two clips were applied. Tube thoracostomy was avoided if there was no meaningful pleural laceration. Result: The infants mean gestational age was 26.5$\pm$2.1 weeks (range: 23 to 30 weeks) and the average age at operation was 11$\pm$11 days. The mean body weight at operation was 933$\pm$271 grams (range: 570 to 1,700 grams). Eight patients expired, but there was no procedure-related death. Postoperative echocardiography revealed two cases of residual shunt but none of these shunts were detected on the follow up echocardiogram that was performed on the post operative 5 and 59 days. Conclusion: We concluded that the technique described here is an effective procedure in view of the satisfactory operative exposure and the low rate of complications.

• Journal of Korean Academy of Nursing
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• v.19 no.1
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• pp.40-62
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• 1989

This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t＝.54, df＝58, p＝.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t＝1.93, df＝154, p＝.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t＝6.40, df＝79.90, p＝.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t＝1.79, df＝118, p＝.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t＝-2.6, df＝13.22, p＝.02, t＝2.41, df＝23.85, p＝.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F＝5.17, df＝3/153, p＝.00, t＝ -2.39, df＝154, p＝,01, f＝5.91, df＝2/153, p＝.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.53-61
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• 2005

Background : Cardiac troponin I (cTnI) is a specific marker of myocardial injury. It is known that a higher level of cTnI is associated with a poor clinical outcome in patients with acute coronary syndrome. An elevation in cTnI is also observed in various noncardiac critical illnesses. This study evaluated whether cTnI is useful for predicting the prognosis in noncardiac critically ill patients. Methods : From June 2003 to July 2004 at Gyeongsang National University Hospital, we enrolled 215 patients (male:142, female:73, mean age:$63{\pm}15$ years ) who were admitted for critical illness other than acute coronary syndrome at the medical intensive care unit(ICU). The severity score of critical illness (SAPS II and SOFA) was determined and serum cTnI level was measured within 24 hours after admission to the ICU. The mortality rate was compared between the cTnI-positive (${\geq}0.1{\mu}g/L$) and cTnI-negative ($cTnI<0.1{\mu}g/L$) patients at the $10^{th}$ and $30^{th}$ day after admission to the ICU. The mean cTnI value was compared between the survivors and non-survivors at the $10^{th}$ and $30^{th}$ day after admission to the ICU in the cTnI-positive patients. The correlation between cTnI and the severity of the critical illness score (SAPS II and SOFA) was also analyzed in cTnI-positive patients. Results : 1) The number of cTnI-negative and positive patients were 95(44%) and 120(56%), respectively. 2) The mortality rate at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the cTnI-positive patients (29%, 41%) than in the cTnI-negative patients (12%, 21%)(p<0.01). 3) In the cTnI-positive patients, the mean value of the cTnI at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the non-survivors ($4.5{\pm}9.2{\mu}g/L$, $3.5{\pm}7.9{\mu}g/L$) than in the survivors($1.8{\pm}3.6{\mu}g/L$, $2.0{\pm}3.9{\mu}g/L$) (p < 0.05). 4) In the cTnI-positive patients, the cTnI level was significantly correlated with the SAPS II score (r=0.24, p<0.001) and SOFA score (r=0.30, p<0.001). Conclusion : The cTnI may be a useful prognostic marker in noncardiac critically ill patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.2
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• pp.203-211
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• 2013

The purpose of this study was to investigate the perception of aseptic foods (sterilized foods with radiation technology) in cancer patients in Busan. The subjects were 192 cancer patients at a hospital. This study was performed through interviews using questionnaires. Patients had perception scores on the need to develop aseptic foods (4.30 points out of 5.00), use aspetic foods (4.06/5.00), and intake aseptic foods (4.04/5.00). Patients less than 59 years old had significantly higher perception scores than those over 60 years old (p<0.05). The scores on aseptic food indicated the importance of various factors, including sanitation (4.86/5.00), good materials (4.82/5.00), nutritional value (4.79/5.00), unused of monosodium glutamate (MSG) (4.66/5.00), taste (4.61/5.00), and reasonable prices (4.60/5.00). The patients who were college graduates showed significantly higher scores and importance in good materials, proper packaging unit, simple cooking methods, food diversity, and familiar foods (p<0.05). In the aseptic menu items, patients wanted to include seasoned raw vegetables (4.11/5.00), a set menu (including cooked grain, soup, and a side dish) (4.08/5.00), seasoned cooked vegetables (4.04/5.00), low sodium kimchi (3.98/5.00), and fermented sauces (3.92/5.00). The patients with gastrointestinal cancer and other cancers (e.g. breast, thyroid, and renal cancer) had significantly higher necessity scores than lung patients for stew, seasoned raw vegetables, salad, low sodium kimchi, and a set menu (p<0.05).

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.65-77
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• 1999

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

• Korea Journal of Hospital Management
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• v.7 no.2
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• pp.52-79
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• 2002

The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as an important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The purpose of this study is to find the organizational effectiveness of the administrative personnel in hospitals. The survey data involved in the study was derived from 229 personnels working in 3 medium and small sized hospitals and 1 university hospital in Inchon area. The major finding are as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of over 31 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in are higher, general hospital's organizational efficiency is higher in comparison with those of university hospital. 2. The organizational efficiency in accordance with satisfaction and the psychological motive contributional factors is higher as much as the high satisfactory level in every hospitals in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance. In as much as job standard level is higher and the more job responsibility the higher organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as older age, management of organization and the job level are satisfied, the higher structural formalization level, the smooth intercommunication have affected as major influence factors of organizational efficiency. 6. In the university hospitals is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. In the general hospitals is also satisfied the management and job level of hospital organization and psychological motive contributional factors is higher, it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of administrative personnel in hospitals, the management and job level as well as personal relation are preferably satisfied, whereas formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on four hospitals in Inchon area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially. as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the university and general hospitals.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.70-85
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• 2006

A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.