• Clinical and Experimental Pediatrics
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• 제58권5호
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• pp.194-198
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• 2015

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.123-142
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• 2010

Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

• 대한족부족관절학회지
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• 제22권1호
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• pp.32-37
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• 2018

Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.

• 동의신경정신과학회지
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• 제23권4호
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• pp.133-152
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• 2012

Objectives : The purpose of this study is to investigate the effect of Sihogayonggolmoryeo-tang on the anxiety of Hwa-byung. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Sihogayonggolmoryeo-tang or controlled medication for anxiety of Hwa-byung. Hamilton Anxiety Scale (HAM-A) was measured as the 1st evaluative instrument, and Korean State-Trait Anxiety Inventory (STAI-K), Likert scale for major symptom of Hwa-byung, Hwa-Byung Scale Score, Korean Beck's Depression Inventory (BDI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), Insomnia severity Index (ISI), Instrument of Oriental Medical Evaluation for Hwa-Byung, WHO Quality of Life Avvreviated (WHOQOL-BREF), genral self-Efficacy Scale (GSES), Rosenberg Self-Esteem Inventory (SRE) and Heart Rate Variability (HRV) were also measured as the 2nd evaluative instrument before treatment. Results : Clinical characteristics-vital signs and demographic characteristics showed no significant difference between both groups. The characteristics of disease-chief complaint, pattern Identification, period, etiological factor, and etc, also showed similarity of distribution in both groups. The results of Chest PA, EKG and clinicopathologic examination showed no significant difference between both groups. There were no significant difference between both groups in all valuation scales; HAM-A was measured as the first evaluative instrument, and STAI-K, Likert scale for major symptom of Hwa-byung, Hwa-Byung Scale Score, BDI-K, STAXI-K, ISI, Instrument of Oriental Medical Evaluation for Hwa-Byung, WHOQOL-BREF, GSES, SRE and HRV. Conclusions : We considered that establishment of the experimental group and controlled group was objective and worth conducting this research. In addition, this methodology is expected to be applied to the subsequent research. Further, we hope to make up for this study through various study and discussion.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권6호
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• pp.521-530
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• 2020

Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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• pp.51-65
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• 1996

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.

• 식물병연구
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• 제17권1호
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• pp.59-65
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• 2011

토마토반점위조바이러스(Tomato spotted wilt virus, TSWV)에 대한 고추 유전자원 및 시판품종 등 100점의 병징 유형과 저항성 반응을 조사하였다. 병징 유형과 TSWV 감염률은 접종 후 9, 12, 14, 45일에 각각 육안으로 조사하였으며, 접종 14일에는 효소면역항체법을 이용하여 실험에 사용한 모든 개체의 비 접종 상엽에서 바이러스 감염 유무를 검정하였다. 감염된 대다수의 개체에서 잎 말림 증상이 가장 빈번하게 관찰되었으며, 국내 상용 $F_1$ 품종과 재래종고추에서는 황화 증상이, 야생형 수집종에서 줄기괴사 증상이 특이적으로 관찰되었다. TSWV의 전형적인 병징으로 알려진 원형반점은 조사한 일부 계통에서 관찰되었고, 계통 내 개체간 바이러스 병징 발현 정도는 상이하였다. 상용 F1 4품종(Kpc-35, -36, -57, -62)과 야생형 고추 8계통(PBI-11, C00105, PBC076, PBC280, PBC426, PBC495, PBC537, PI201238)은 유묘기에 기계적 접종했을 때 TSWV에 대해 고도의 저항성을 보였다.

• Journal of Chest Surgery
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• 제35권2호
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• pp.113-117
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• 2002

기계판막이나 조직판막을 이용한 인공판막 치환술의 한계가 인식되면서부터 대동맥판막 성형술은 판막치환술의 대안으로 관심을 끌어왔다. 대상 및 방법: 1999년 7월부터 2000년 7월까지 대동맥판막 폐쇄부전으로 설상절제술(triangular resection)을 시행 받은 8명의 환자를 대상으로 수술합병증 및 수술 전후의 심초음파 소견을 비교하였다. 8례 중 남자와 여자는 각자 4명이었으며, 평균 연령은 18.4$\pm$12.6세였다. 술전 시행한 심초음파검사에서 대동맥판막 폐쇄부전의 정도는 평균 3.570.5였다. 6례에서는 심실중격결손증을 동반한 삼첨판인 대동맥판막이었고, 2례에서는 이첨판이었다. 수술방법은 탈출된 판엽을 nodule of Arantius를 중심으로 다른 엽보다 길어진 만큼 설상절제하고 교련술을 시행하였다. 이첨판인 경우는 raphe를 제거하였다. 결과: 기사망이나 합병증은 발생하지 않았다. 평균 추적기간은 11.9$\pm$3.6개월이었으며, 술후 항응고제는 사용되지 않았다. 수술전, 퇴원전 그리고 마지막 추적 검사시 시행한 심초음파검사에 의한 대동맥판막 폐쇄부전의 정도는 각각 grade 3.5$\pm$0.6, grade 0.6$\pm$0.5 그리고 grade 0.8$\pm$0.6으로 통계적으로 유의하게 감소하였다(p value=0.01). 마지막 추적검사에서의 대동맥판막 폐쇄부전의 정도는 grade 2가 1명이였고, 나머지 환자들에서는 grade 1이거나 경도 미만한 정도였다. 결론: 설상절제술은 만족할만한 조기결과를 보여주지만,오랜 기간의 추적검사가 필요하리라 본다.

• 한국초지조사료학회지
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• 제6권1호
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• pp.65-70
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• 1986

본시험(本試驗)은 sudangrass의 Piper를 공시품종(供試品種)으로 하고 질소수준(窒素水準)을 20, 30 및 40kg/10a으로 하여 난괴법(亂魁法) 4반복(反復)으로 1984년(年) 축산시험장(畜産試驗場) 사료작물시험포(飼料作物試驗圃)에서 실시(實施)하였다. Sudangrass에 발생(發生)하는 주요(主要) 병원균(病原菌)을 분잡(分雜) 동정(同定)하고 이중 매문병(煤紋病)의 이병정도(罹病程度)에 따른 양적(量的) 및 질적손실(質的損失)을 연구검토(硏究檢討)한 바 그 결과(結果)를 요약(要約)하면 다음과 같다. 1. Sudangrass에서 분잡(分雜)된 주요병원균(主要病原菌)은 3종(種)으로 Helminthosporium turcicum과 Collectotricum graminicolum이 동정(同定)되었으며 1종(種)의 병원균(病原菌)의 미동정(未同定)되었다. 2. 매문병(煤紋病)(Helminthosporium turcicum PASS)은 6월(月) 20일(日) 조사(調査)에서 처음 확인(確認)되었으며 $7{\sim}9$월(月)의 고온기(高溫期)에 심(甚)하게 발생(發生)되었다. 1차생육기(次生育期)보다 예취후(刈取後)의 재생식생(再生植生)에서 매문병발생(煤紋病發生)이 심(甚)하게 나타났으며 질소시비량(窒素施肥量)과 이병율간(罹病率間)에는 정(正)(+)의 상관(相關)이 있었다(P<0.01). 3. 매문병발생(煤紋病發生)으로 생초(生草) 및 건물수량(乾物收量)은 크게 감소(減少)해 각각(各各) 47% 및 38%의 손실(損失)이 있었다. 4. 조지방(粗脂肪) 및 조단백질함량(粗蛋白質含量)은 매문병(煤紋病)이 발생(發生)된 식물(植物)에서 감소(減少)되었으나 조회분(粗灰分), 조규산(粗珪散) 및 리그닌함량(含量)은 이병율(罹病率)이 증가(增加)됨에 따라 비례적(比例的)으로 증가(增加)하였다. 또한 건물(乾物) 및 유기물소화율(有機物消化率)은 이병율(罹病率)이 증가(增加)됨에 따라 감소(減少)되었다(P<0.01).

• Journal of Trauma and Injury
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• 제23권2호
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• pp.113-118
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• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.