Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.
Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.
Purpose : The aim of this study was to evaluate myocardial injury in children treated with adriamycin by echocardiography, which is non-invasive and safe measurement for children. Methods : Left ventricular dimensions, wall stress, and contractile function were determined by echocardiographic methods in 17 patient recepients with adriamycin chemotherapy at rest(group 1) and during stress(group 2). Twenty age-matched normal subjects were established as control group. Results : End-diastolic dimension was decreased in both groups(group 1; $92{\pm}7%$ of normal, group 2; $87{\pm}8%$ of normal, P<0.05). Left ventricular end diastolic volume and wall mass were also decreased in both groups(group 1; $96{\pm}12mL/m^2$ and $145{\pm}18g/m^2$, group 2; $87{\pm}8mL/m^2$ and $137{\pm}16g/m^2$, respectively, P<0.05 and P<0.05) and group 2 showed lower values than group 1. Meridional end systolic stress(ESSm) was increased in both groups but there was no significant difference between the two groups(group 1; $52.6{\pm}6.2g/cm^2$, group 2; $63.5{\pm}8.5g/cm^2$, P<0.05, normal value $45.7{\pm}3.5g/cm^2$). The load-independent relation of rate-corrected circumferential fiber shortening velocity(Vcfc) to ESSm has a significant abnormal change in 7 out of 17(41%) in group 1 and 12 out of 17(71%) in group 2. Conclusion : The load-dependent systolic index, such as fractional shortening, may fail to show abnormality because of the compensatory changes in preload and afterload which can mask the impaired contractility. Therefore, systolic performance also should be monitored by a load-indepedent contractility index such as slope value of the end-systolic pressure-dimension relation and the position of the left ventricular stress-fiber shortening velocity after exercise.
Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
Clinical and Experimental Pediatrics
/
v.46
no.6
/
pp.576-584
/
2003
Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
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.
Shin, Su A;Kim, Yong Joo;Lee, Jae Whan;Kim, Nam Su;Moon, Soo Ji
Clinical and Experimental Pediatrics
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v.46
no.12
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pp.1248-1252
/
2003
Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.
Lee, Il Ro;Byun, Kisik;Cho, Sung-Yong;Kim, Kyung Pil;Park, Jae Woo
Journal of the Korea Academia-Industrial cooperation Society
/
v.21
no.8
/
pp.187-194
/
2020
The T&E (Test and Evaluation) results were applied for a judgment basis to decide the developmental process of system engineering for efficient weapon system R&D (Research and Development). During the OT&E (Operational Test and Evaluation) and DT&E (Development Test and Evaluation), an environmental test is essential for weapon system development owing to their highly exposed operational conditions. Based on the MIL-STD-810, MIL-HDBK-310, and AECTP 200, the ROK armed forces recommended operating temperatures for the ROK weapon system and applied this to the DT&E and OT&E. This study examined the compatibility of Korean temperature guidelines for stockpile material considering recent climate change. Moreover, this study analyzed the data from hourly measured temperatures on 101 observatories during 60 years, from 1960 to 2020, and percentage (0.5%, 1%, 5%, and 10%) and the 𝜎 (3𝜎, 2𝜎, and 1𝜎) frequency of occurrence on rigorous hot (August) and cold (January) periods, respectively. The results indicate that the highest temperature was 41℃, and the 0.5% frequency of occurrence was 37.0℃. In the case of the cold period, the lowest temperature was -32.6℃ and the 0.5% frequency of occurrence was -21.1℃. By considering the previously recommended operating temperature range for a general ground system, -30 ~ 40℃, regional operation probability is recognized 99.999%. Despite the recent abnormal climate change from global warming, the Korean temperature guidelines are compatible with the stockpile material environmental test.
Modern enterprises should concentrate their efforts on continuous improvements in focusing their development in the core areas of business and to reduce their expenses and to enhance the quality of service for customers. The enterprises should focus on their core business while outsourcing the non-core areas of business to external specialists for the purpose of reducing cost. In South Korea, the enterprises are becoming increasingly interested in outsourcing their logistics function, especially in using IT technologies to the 3PL. The underlying reason for this trend is because the logistics costs of Korean businesses are much higher than that of other advanced countries. This higher logistic costs weakens the price competitiveness of Korean companies in the overseas export markets and even dampening the balance of international trade. Domestically, the higher logistics costs have the effect of raising prices in the local markets and thus affecting the local economy. Therefore a solution is urgently needed to save the logistics costs for the Korean companies in the interest of increasing national competitiveness. Outsourcing to the 3PL is becoming an attraction solution to this problem. Thanks to the increasing supply of professional logistics companies, many of the enterprises are switching to the Third Party Logistics. Nevertheless the enterprises do not yet utilize the integrated third-party logistics services on a full scale. This study analyzes present conditions and problems of the domestic third-party logistics market and suggests directions for future development. To solve the problems in the domestic third-party logistics market, four actions are recommended. First there should be new supporting policies in the laws and regulations and a system for small and medium sized companies to grow. Solutions to structural problems such as abnormal multilevel merchandising, illegal operation of private cars, and freight dumping should be implemented concurrently. Furthermore, standards for new companies entry into the market should be enhanced to allow only the competitive distribution companies to enter the market. Second, development of variety of educational programs is needed through establishing human-resource development system and specialized formal educational institution focused on this market. Third, the third party distribution companies, which seek long-term relationships with the owners of goods, should endeavor to strengthen their communications capability. Fourth, adoption of high-tech distribution system and the advent of U-Logistics, making use of RFID is urgent. This study has the limitation of objectivity because it does not include various comparative case studies about companies relating to the Third Party Logistics and domestic franchise companies. However, this study is significant to the extent that it analyzes the general present conditions and the problems of domestic Third Party Logistics and suggests recommendations for revitalization of Third Party Logistics. For future studies, analyzing the successful cases of international third party logistics companies' empirical data and studying the application into domestic franchise companies would improve the objectivity of the results. This would assist the domestic third party logistics companies not only to perform excellent domestic logistics function but also to enter into the global market for international logistics.
A case of juvenile onset generalized demodicosis of one year old, intact female Japanese Chin dog weighing 3.1kg was presented to the Small Animal Clinic of the College of Veterinary Medicine of Kyungpook National University. The diagnosis was made based on the physical examination, deep skin scrapings, hematology, serum chemistry, endocrinologic evaluation and bacterial culture. Numerous D. canis mites of various stages were observed in multiple skin scraping samples. CBC, serum chemistry, $T_3$, $T_4$ and free $T_4$ values were within normal range and Staphylococcus intermedius was isolated in bacterial culture of pustules. The dog was healthy other than skin lesions at the presentation. The three different treatment protocols were tried for the case. No clinical improvement was observed during 13 weeks of orally given daily basis ivermectin therapy at 600ug/kg and 2 weeks of spot-on weekly basis selamectin therapy at 30 mg/kg with cephalexin given orally twice a day at 25 mg/kg. However, a remarkable remission was seen by 0.1% amitraz dip on weekly basis with 4% chlorhexidine bath given twice a week. The secondary staphylococcal infection and accompanied pruritus was almost disappeared in two weeks and she was recovered clinically normal in 9 weeks of therapy. The therapy was continued for 4 more weeks to prevent relapse. The dog is clinically normal and being monitored for development of any abnormal dermatological signs for the time being.
The purpose of this study is to contribute to improvement of educational environment by analysing all problems related to environment around the school. To accomplish this purpose, this study was carried out by examining the problems in controlling the areas required for cleanup with 220 teachers in charging the cleanup duties of the primary and secondary schools in Taegu between June 1 and July 15, 1993 and by actually surveying the prejudical business stores around 72 primary schools between August 10 and September 20, 1993. Although most teachers answered to the questionnaires that it is necessary to cleanup the bad environment around the school, the duties of its cleanup tend not to be considered as an important matter. The teachers considered that the most prejudical business store around the school is totally the game room, and in such order as comic books' store, liquor selling shop and causing noise and pollution. 57.3% of total respondents answered that the present cleanup movements have resulted in failure mostly because of both supervising authorities' careless promotion and store owners' excessive commercial transactions. The result of actual survey in environmental and sanitary cleanup area around 72 primary schools showed that the greatest number of 1,258 prejudical stores was the video tapes shop, and then in such order as lodgings, and game rooms, while the number of prejudical store by the schools was 17.5 stores per school on the average which showed a various distribution from zero to 77 places. In general, these prejudical stores were mainly located around the schools in Jung-gu and Seo-gu areas. In addition, it was shown that the more the number of students, the more the number of the prejudical stores. In order to improve the environment around the school, it is necessary to strictly carry out the zoning system relating to the usage of land, to strongly restrict the stores without permit and abnormal stores and to establish the basis asking the city development authorities to go through the environmental evaluation. Moreover, it is absolutely required to make efforts to establish the national right sense of education, and to closely cooperate with the related authorities.
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