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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • 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.

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Assessment of Left Ventricular Function with Echocardiography in Patients Treated with Adriamycin : A Load-Independent Index of Myocardial Contractility and Comparisons between Rest and Exercise (Adriamycin을 사용한 환아에서 심초음파를 이용한 좌심실 기능의 평가 : 심근 수축력의 부하 비의존족 지표 및 휴식시와 운동시의 비교)

  • Park, Pyoung Soo;Park, Hye Young;Lee, Hae Yong
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.214-222
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    • 2002
  • 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.

Clinical Study of Group B β-Hemolytic Streptococcal Meningitis (B군 연쇄상구균 뇌막염에 대한 임상적 고찰)

  • Lee, Seo-Young;You, Sou-Jeong;Kim, Deok-Soo;Ko, Tae-Sung
    • 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.

A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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Clinical Features of Pulmonary Tuberculosis In The Elderly (노인 폐결핵의 임상적 특정)

  • Lee, Jae-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Chun-Taek;Kim, Yeong-Hwan;Han, Sung-Koo;Shim, Young-Soo;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.334-345
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    • 2001
  • Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

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Fundamental Studies for the Breeding of Marine Algae 3. Effects of Plant Hormones on the Growth of Porphyra-fronds (해조의 육종을 위한 기초적 연구 3. 김 엽체에 미치는 식물호르몬의 생장효과)

  • KIM Joong-Rae;JO Young-Won;HAN Chang-Yeal;LEE Man-Sang
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.14 no.2
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    • pp.79-85
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    • 1981
  • As one of the fundamental studies for the breeding of marine algae, the effects of several plant hormones (IAA, Gibberellin, 2.4-D, NAA, Kinetin) on the growth of Porphyra-fronds, P. tenera Kjell. form tamatsuensis Miura, were investigated from January 21 to February 21 1981. The fronds used for the experiment were dissected out at $25mm^2$ size, and cultured in modified Provasoli's ESP medium supplemented with various concentrations of each plant growth regulators. The culture was kept under constant water temperature of $5^{\circ}C$ in 14 hrs. photoperiod and illuminated with 2,400 lux by fluorescent light. Based on the results of first experiment, the culture of fronds for the secondary experiment was carried out at $5^{\circ}C\;and\;10^{\circ}C$ in medium containing various levels of Kinetin from April 6 to 24, and compared the growth of two groups at each concentrations with each other, The results obtained are summarized as follows : (1) The best growth efficiencies were observed at 5.0mg/1 of each plant hormones except Gibberellin. Among them, the highest growth-rate was $312.5\%\;(345.3\%\;in\;frond\;size)$ in contrast with control at 5.0mg/1 of Kinetin, and was followed by $257.5\%\;(236.1\%)$ in 2.4-D,$166.7\%(147.6\%)$ in IAA and $141.7\%\;(167.7\%)$ in NAA, but that in Gibberellin was $247.9\%(241.9\%)$ at 10.0mg/l. (2) Especially, the fronds cultured at 5.0mg/1 of Kinetin were deep black-brown in colour, and had vivid, healthy chloroplasts in their all cells. On the contrary, the fronds cultured in other media were discoloured to light black-brown or green-drown, and almost all cells were vacuolated or shrunk gradually into death.(3) There was an obvious difference between the best growth-rates of the fronds cultured at 5.0mg/l of Kinetin at $5^{\circ}C$ and those at $10^{\circ}C$. The former was $366.7\%$, the latter $318.8\%$ but the difference was little at lower concentrations. (4) Many abnormal cells grown up to $25.0-27.5\mu$ in diameter were found among the marginal cells of fronds which showed the best growth in Kinetin, and the fronds wire $41.0-42.0\mu$ in thickness which was thicker by $10.0\mu$ or so than the others. (5) In two fronds at 1.0mg/1 of Kinetin cell-divisions were observed, which might developed into antheridium, but it was doubtful whether due to the efficiency of Kinetin.

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A Study on Health Status of the 1,559 Korean Applicants Applying for the Coal Miners in West Germany during the Year of 1972 and 1973 (우리나라 독일광부(獨逸鑛夫) 지원자(志願者)에 대(對)한 건강상태(健康狀態)에 관(關)한 조사연구(調査硏究))

  • Jun, Hyun-Sook;Choi, Sam-Sup
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.383-393
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    • 1974
  • The importance of the health care for the miners not only concerns the productivity of the enterprises but also as a fundamental human right, it has to be secured and protected by the society and the government. The Korean coal miners began to find their works at overseas since 1963 when the Korean government selected and dispatched its miners to West Germany. As years go by, the demand and the supply of the coal miners, the program of the coal miners health care became the important tasks to be solved and the further studies and research were necessary to support these tasks achievement. The writers made a statistical analysis on health status of the 1,559 Korean applicants applying for the coal miners in West Germany during the year of 1972 and 1973 by the using of the data of physical examination which were directed by the Korea Overseas Development Cooperation. The standard of physical examination which was applied for coal miners applying the jobs in West Germany was authorized by the Government Office of Labor in 1967. The results are as following; 1. The applicants were from the various provinces throughout Korea; Gang Weon 50.2%, Jeon-Nam 16.8%, Chung-Nam 13.7%, Gyeong-Nam 10.5%, City of Seoul 5.4%, and others 3.7%. 2. The ages of the applicants were from 20 to 44. The age group of 25-29(36.3%) and of 30-34(55.2%) together occupied the 91.5 per cent of the total applicants. 3. Among the 1,559 applicants 52.1 per cent passed the physical examinations. The tendency were shown that as the age increased, the passing rate decreased, and the married applicnts had lower passing rates compared to the unmarried applicants. 4. The height of the applicants averaged $168.4{\pm}4.74(cm)$ and the weight averaged $61.3{\pm}5.65(kg)$. 5. The average vision of the left eye of the applicants was $0.92{\pm}0.23$ and the right eye was $0.91{\pm}0.30$. 6. The mean value of the systolic blood pressure of the applicants was $145{\pm}13(mmHg)$ and the diastolic blood pressure was $85{\pm}8(mmHg)$. 7. Fifteen hundred and fifty-nine applicants were taken chest X-ray and 17.2 per cent were found abonrmal. For each 1,000 applicants, 46 Pulmonary calcification and fibrosis, 45 chronic bronchitis, 27 pleural thickening and adhesion, 20 pulmonary tuburculosis, 11 anomalies of the rib, 10 pulmonary infiltration and 21 others diseases were found. 8. Lumber X-ray examination showed that 23.9 per cent (372 applicants) were found abnormal. For each 1,000 applicants, 77 osteoarthritis, 56 lumbarization, 15 fracture of vertebrae, 15 spondyloarthritis, 14 deformity of vertebrae, 13 spina bifida, 12 sacralization, 12 spondylolysis, and 5 others diseases were found. 9. In total, 47.9 per cent of 1,559 applicants failed the physical examinations, and the main causes for the failure were shown to be 7.1% of anomalies of spine, 6.3% of osteoarthritis, 4.7% of pulmonary calcification and fibrosis, 4.6% of chronic brochitis, 3.6% of hypertension (only), 3.4% of fracture of vertebrae. 3.1% of underweight(under 57.0kg), 2.0% of spondyloarthritis, 2.0% oe pulmonary tuberculosis, 1.7% of pleurisy, 1.0% of spina bifida, 1.5% of syphilis, 1.5% of color blindess, and 1.0% of underheight(under 160.0cm).

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The Study of Estimation of Chromatin Abnormality of Ogye Rooster Sperm and Activity by Diff-Quik Staining Method (Diff-Quik 염색방법에 의한 오계 닭 정자의 염색질 이상과 운동성 추정에 관한 연구)

  • Kim, Sung Woo;Choi, Ahreum;Choe, Changyong;Kim, Dongkyo;Seong, Hwan-Hoo;Kim, Jae-Hwan;Kim, Chongdae
    • Korean Journal of Poultry Science
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    • v.42 no.2
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    • pp.109-116
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    • 2015
  • Ogye rooster sperm chromatin status can be detected using well established sperm assays. In this paper, a simple and fast method to monitor rooster sperm chromatin status could be employed in field for assessment of chicken sperm quality. Using standard bright field microscope, Diff-Quik stains can be reproducibly, easily and routinely monitored with simple staining. The presence of abnormal chromatin staining of rooster sperm was determined by darker stain in head. In the fresh semen, the viabilities of three tested Ogye spermatozoa were 93.53%, 82.42% and 90.63% and normal chromatin rates were 87.96%, 74.25% and 85.10% respectively. However, after freezing, the rates of viability of thawed semen were reduced to 69.58%, 61.98% and 72.20% and normal chromatin rate also reduced to 58.91%, 48.49% and 63.34%. A significant correlation between live sperm and normal sperm nuclei was 0.875 in fresh semen and 0.513 in frozen semen. After incubation of sperm at $37^{\circ}C$ for 5min, the rates of viability, chromatin normality and sperm head activity were shown as $90.63{\pm}1.28%$, $82.44{\pm}8.09%$ and $66.68{\pm}10.29%$ in fresh semen. However, the rates of thawed semen were reduced to $67.92{\pm}7.55%$, $56.92{\pm}12.15%$ and 47.32{\pm}5.02%, respectively. The relationship between chromatin normality and sperm head movements in fresh and thawed semen were 0.564 and 0.540, respectively. With these results, the chicken sperm normality could be assessed by the Diff-Quik staining that could be used for chromatin status of sperm head and activated morphology of live spermatozoa, as a simple and rapid staining method.

DEVELOPMENT OF ALLOTRANSPLANTED TOOTH GERMS AT VARIOUS DEVELOPMENTAL STAGE INTO THE WHITE RAT'S EXTRACTION SOCKET (흰쥐의 발치와에 이식한 단계별 치아싹의 발육 과정)

  • Jung, Hwi-Hoon;Jung, Han-Sung;Kim, Seoung-Oh;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.205-215
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    • 2008
  • The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.

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The Effect of Postnatal Dexamethasone Treatment on Hypoxic-Ischemic Brain Injury in Neonatal Rats (신생쥐의 저산소성 허혈성 뇌손상에서 손상 후 덱사메타손의 투여 효과)

  • Park, Chang Ro;Park, Kyung Pil;Kim, Heng Mi;Sohn, Yoon Kyung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.989-995
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    • 2003
  • Purpose : Dexamethasone is frequently administered to prevent or treat chronic lung disease in human neonates who are also prone to hypoxic-ischemic(HI) insults. Recently, meta-analysis of the follow-up studies reveals a significantly increased odd ratio for the occurrence of cerebral palsy or an abnormal neurologic outcome, and there is conflicting evidence regarding the impact of dexamethasone exposure on HI brain injury. This study was conducted to explore the effect of post-HI dexamethasone administration on neuronal injury in neonatal rats. Methods : HI was produced in seven-day-old rats by right carotid artery ligation followed by two hours of 8% oxygen exposure. At the end of HI, the animals were injected intraperitoneally either with dexamethasone(0.5 mg/kg) or saline. Neuronal injury was assessed seven days after the HI by the area of infarction, TUNEL reactivity, Bcl-2 and Bax expression in brain. Results : Post-insult dexamethasone administration resulted in reduction of weight gain and a higher mortality rate during seven days after HI. Dexamethasone treatment revealed no effect on the size of brain infarction induced by HI. Bax protein expression increased in dexamethasone treated brain but Bcl-2 protein expression and TUNEL reactivity revealed no significant differences between dexamethasone treated and non treated brain. Increased Bax protein expression suggest upregulation of the apoptosis by dexamethasone. Conclusion : The result suggests the adverse role of Post-HI administration of dexamethasone in neonatal HI.