• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.7-16
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• 1998

Various difficulties and inconveniences arise from having a mentally handicapped child in a family and these place many demands on mothers. There are few studies in Korea on these demands nor on what mothers go through with their mentally handicapped daughters' menarche and puberty. The purpose of the study was to examine the experiences of mothers of mentally handicapped daughters, as it relates to their daughters' menarche and the beginning of puberty. With indepth interviews, both in person and by telephone and participant observation the study used a qualitative research methodology to attempt to understand the experiences of these mothers. The data were gathered from October 1995 to April 1996. The subjects for the research included nine mothers of mentally handicapped daughters whose ages ranged from 12 to 18 and who attended one of three special schools located in either Inchon or Seoul. The data were recorded and analyzed : meaningful statements were grouped according to subjects raised by the mothers. Content Analysis was also applied to identify similar content and confirm common experiences. and to highlight concepts and categorized them. The results of this study are as follows. Five categories were identified : mothers' emotional responses to their mentally handicapped daughters' menarche and menstration were of severe despair accompanied by anxiety, guilt, fear, anguish, shame and pity because the mothers were afraid their daughters would not be able to use appropriate hygienic measures during menstration and the mothers felt heavily burdened in having to look them. The mothers also had negative feelings about their daughters' physical development. The experience of mothers related to their daughters' possibilities for marriage and pregnancy were of powerlessness, distress, withdrawal, fear. pity and desperation and they were afraid that their daughters might be violated sexually. The mothers rejected the possibility of marriage and pregnancy for their daughters and instead planned very restricting futures for them. The mothers used various coping methods to bring meaning to their lives. Because the negative emotional responses of the mothers. nurses need to work to empower mothers to overcome these negative responses. Sex education can also play an important role especially for the daughters especially through the use of visual aids. Further, nurses should understand the tearing difficulties of mentally handicapped daughters, what mothers need and also what they experience with their mentally handicapped daughters. In conclusion, nurses should understand the negative experiences of the mothers in relation to their mentally handicapped daughters' menarche, help the mothers cope with the negative. emotions through real life education and counselling. In addition, there is a need for nursing interventions and an administrative system which will minimize the prejudices of society towards handicapped people.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.262-270
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• 2011

Objectives : The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. Methods : The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. Results : Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. Conclusion : Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.

• Korean Journal of Social Welfare
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• v.53
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• pp.75-104
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• 2003

This study was performed to analyze the process and develop the pattern of school dropout in the context of the Korean educational systems. Participants were 30 adolescents experiencing dropout one more times and their age ranged from 16 to 23. A major category derived and analysed from a grounded theory method of Strauss and Corbin(1990). The qualitative analysis indicated that dropout is contradictory experiences in Korea. Because it is emancipation from various distress of school systems as well as loss of various benefit as students, Main causes of dropout were identity problems, school frustrations(failure in school achievements), environmental disadvantaged and delinquencies. Sometimes these various causes are emerged at the same time. Most important condition of context which was decided was whether dropout was voluntary and considered. After dropout from school, it was important if there were resources such as emotional and informative supports. Especially informative support was critical to adjust after dropout. Dropout experience was divided largely into 4 patterns such as type of 'searching the identity', 'being disorganized', 'escaping' and 'frustration'. In chronological analysis resulted in 4 stages including 'stage I. loss of motivation', 'stage II. escaping from school', 'stage III. trial and error', 'stage IV changing the meaning of dropout in the life.

• Korean Journal of Social Welfare
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• v.56 no.3
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• pp.37-59
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• 2004

Short Michigan Alcoholism Screening Test for Fathers(F-SMAST) and Mothers(M-SMAST) is to measure the presence of an alcohol use disorder in one's father and/or mother. The purpose of this study is to evaluate the Korean version of the F-SMAST and M-SMAST. A total of 241 college students, who resided in Seoul and two other cities, participated in this study. The internal consistency of the Korean version of the F-SMAST and M-SMAST was assessed using alpha coefficient. The alpha coefficient of both the F-SMAST and the M-SMAST was 0.82. Standard Errors of Measurement(SEM) were also computed. SEMs of the F-SMAST and the M-SMAST were quite low. With a cut-off score of 3, the F-SMAST correctly identified 91 percent of respondents who were presumed to be children of alcoholics and correctly identified 81 percent of respondents who were presumed not to be children of alcoholics. Sensitivity and specificity of the M-SMAST with a cut-off score of 1 are 0.33 and 0.81, respectively. Several variables were examined in relation to the F-SMAST and the M-SMAST to examine convergent and discriminant validity. It was found that the F-SMAST and the M-SMAST were significantly correlated with most of convergent variables(average amount of drinking per day, AUDIT, distress) and had not statistically significant relationships with discriminant variables(demographic variables). This study suggests that the Korean version of the F-SMAST and the M-SMAST be repeatedly assessed across different sample in order to confirm the findings of this study.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.723-730
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• 1995

Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.473-478
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• 2006

Transfusion related acute lung injury (TRALI) is a serious, potentially life-threatening complication of transfusion therapy that is sometimes under diagnosed and under reported. Patients with TRALI present with dyspnea/respiratory distress and fever. The symptoms, signs and chest radiological findings in TRALI are similar to transfusion associated circulatory overload, which makes it is difficult to distinguish it from circulatory overload. Although the mortality rate in cases of TRALI is relatively low, TRALI is the third most common cause of fatal transfusion reactions next to ABO blood type incompatibility and hepatitis. Mild-to-moderate cases of TRALI may be misdiagnosed as volume overload. Recently, we encountered two cases where the patients suffered from dyspnea and fever after a transfusion. and review of the relevant literature.

• Child Health Nursing Research
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• v.6 no.1
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• pp.32-50
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• 2000

A descriptive exploratory design was used in this study to evaluate the effects of sponge bathing on physiological(heart rate, heart period, vagal tone, oxygen saturation, respiration) and behavioral responses in newly born 40 preterm infants from intensive care unit of S University Hospital in Seoul. Data has been collected from October, 1997 to March, 1999. The infants were between 27-33 weeks gestational age at birth, and were free of congenital defects. The subjects entered the protocol when they were medically stable (determined by initiation of feeding and discontinuation of all respiratory support) but still receiving neonatal intensive care. The infants' physiologic parameters were recorded a 10 - minute before, during, and after bathing. Continuous heart rate data were recorded on a notebook computer from the infant's EKG monitor. The data were digitized off-line on software(developed by Lee and Chang in Wavelet program) which detected the peak of the R wave for each heart beat and quantified sequential R-R intervals in msec(i.e. heart periods). Heart period data were edited to remove movement artifact. Heart period data were quantified as : 1) mean heart period; 2) vagal tone. Vagal tone was quantitfied with a noninvasive measure developed by Porges(1985) in Mxedit software. To determine behavioral status, tools were developed by Scafidi et al(1990) were used. Collected data were analyzed with the SPSS program using paried t-test, ANOVA, and Pearson correlation. The result were as follow. 1. The results of the ANOVAs indicated that vagal tone were signifcantly lower during bathing than baseline and post-bathing. There were significant differences in heart period and heart rate levels across the bathing. But the mean oxygen saturations and respirations were no differences. Also, there were no significant differences on behavioral sign, motor activity, behavioral distress, weight changes, morbidity, and hospitalization period. 2. To evaluate the relation between vagal tone and subsequent parameters, the two groups (the high group had 19 subjects and low group had 21subjects) were divided by the mean baseline vagal tone. Vagal tone measured prior to bathing were significantly associated with respiration before bathing, vagal tone during bathing, and the magnitude of change in both vagal tone. But, other subsequent reactivities were no differences in two groups. 3. Correlations were also calculated between vagal tone and the subsequent physiological reactivities from baseline through after- bathing. Correlations were significant between baseline vagal tone and baseline heart rate, between baseline vagal tone and baseline heart period, between baseline vagal tone and oxygen saturation after bathing. In summary, the bathing in this study showed a stressful stimulus on premature infants through there was significance in the physiological parameters. In addition, our study represents the documentation that vagal tone reactivity in response to clearly defined external stimulation provides an index of infant's status.

• Journal of Life Science
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• v.19 no.7
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• pp.878-885
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• 2009

Serum ferritin levels are elevated in subjects with acute lung injury (ALI), and abnormalities in plasma and lung iron chemistry have also been demonstrated in ALI and acute respiratory distress syndrome (ARDS). Stress-inducible heme oxygenase-1 (HO-1), as well as ferritin, had shown anti-inflammatory actions. Biomarkers for early detection in patients who are likely to develop ARDS would give several therapeutic chances to the patients. In order to verify the predictability in severe hemorrhage-induced ALI in rats, we measured serum ferritin and HO-1 concentrations before and after hemorrhage. Severe hemorrhages significantly increased the number of leukocytes in bronchoalveolar lavage (BAL) fluid and lung tissue myeloperoxidase activity. Both serum ferritin and HO-1 levels increased following hemorrhage, but ferritin levels were elevated earlier than HO-1. In BAL cell immunohistochemical studies, ferritin and HO-1 expressions increased after hemorrhage and localized in the cytoplasm of leukocytes. These findings suggest that inflammatory leukocytes in BAL fluid can secrete ferritin and HO-1, and serum ferritin levels might be more valid factor in predicting ARDS than HO-1 levels in hemorrhage-induced ALI.

• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.62-66
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• 2010

Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.72-77
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• 2007

Antiphospholipid syndrome (APS) causes recurrent thromboses and morbidity during pregnancy, including fetal loss. This malady is associated with the persistent presence of anticardiolipin antibody or lupus anticoagulant. The pulmonary manifestations of antiphospholipid syndrome include pulmonary thromboembolism, pulmonary hypertension, acute respiratory distress syndrome, etc. Pulmonary thromboembolism is often the initial manifestation of antiphospholipid syndrome and a timely diagnosis is critical due to the high mortality rate. We herein report on a 19-year-old man with pulmonary thromboembolism that was caused by primary antiphospholipid syndrome. He presented with blood-tinged sputum, fever and epigastric pain, and his chest computerized tomography showed pulmonary thromboembolism. The other possible causes of pulmonary thromboembolism were excluded and the diagnosis of primary antiphospholipid syndrome was confirmed by the lupus anticoagulant that was present on two occasions six weeks apart. We also discuss the nature and management of antiphospholipid syndrome, along with a brief review of the relevant literatures.