• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.992-997
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• 2008

Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

• Journal of Music and Human Behavior
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• v.5 no.1
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• pp.67-90
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• 2008

This case used MI techniques that give an imagery experience to depressed client's mental resource, and that makes in to verbalism. Also those images are supportive level therapy examples that apply to positive variation. MI is simple word of 'Music and Imagery' with one of psychology cure called GIM(Guided Imagery and Music). It makes client can through to the inner world and search, confront, discern and solve with suitable music. Supportive Level MI is only used from safety level music. Introduction of private session can associate specification feeling, subject, word or image. And those images are guide to positive experience. The First session step of MI program is a prelude that makes concrete goal like first interview. The Second step is a transition that can concretely express about client's story. The third step is induction and music listening. And it helps to associate imagery more easily by used tension relaxation. Also it can search and associate about various imagery from the music. The last step is process that process drawing imagery, talking about personal imagery experience in common with therapist that bring the power by expansion the positive experience. Client A case targets rapport forming(empathy, understanding and support), searching positive recourse(child hood, family), client's emotion and positive support. Music must be used simple tone, repetition melody, steady rhythm and organized by harmony music of what therapist and client's preference. The client used defense mechanism and couldn't control emotion by depression in 1 & 2 sessions. But the result was client A could experience about support and understanding after 3 sessions. After session 4 the client had stable, changed to positive emotion from the negative emotion and found her spontaneous. Therefore, at the session 6, the client recognized that she will have step of positive time at the future. About client B, she established rapport forming(empathy, understanding and support) and searching issues and positive recognition(child hood, family), expression and insight(present, future). The music was comfortable, organizational at the session 1 & 2, but after session 3, its development was getting bigger and the main melody changed variation with high and low of tune. Also it used the classic and romantic music. The client avoids bad personal relations to religious relationship. But at the session 1 & 2, client had supportive experience and empathy because of her favorite, supportive music. After session 3, client B recognized and face to face the present issue. But she had avoidance and face to face of ambivalence. The client B had a experience about emotion change according depression and face to face client's issues After session 4. At the session 5 & 6, client tried to have will power of healthy life and fairly attitude, train mental power and solution attitude in the future. On this wise, MI program had actuality and clients' issues solution more than GIM program. MI can solute the issue by client's based issue without approach to unconsciousness like GIM. Especially it can use variety music and listening time is shorter than GIM and structuralize. Also can express client's emotion very well. So it can use corrective and complement MI program to children, adolescent and adult.