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Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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Clinical Features of BCG Lymphadenitis (BCG 림프절염의 임상양상)

  • Kwon, Hyo Jin;Song, Doo Il;Kim, Yun Kyung;Jang, Gi Young;Choi, Byung Min;Lee, Jung Hwa
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.80-86
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    • 2009
  • Purpose : This study was performed to determine the clinical course of BCG lymphadenitis. Methods : Between May 2005 and April 2009, the medical records of 33 patients with BCG lymphadenitis were retrospectively reviewed. If needed, needle aspiration was recommended without surgical resection or antituberculous medication. Results : Of the 33 patients who were identified, 21 were males and 12 were females. Among the 33 patients, 32 were full-term babies. The mean age was 6 months (range, 2-35 months) and the most prevalent site of the lesion was the left axilla. BCG lymphadenitis was observed 1-34 months after BCG vaccination, mostly 1-6 months after vaccination. The size of the enlargement was generally 1-3 cm. The strains were identified as French (n=14), Danish (n=7), and Tokyo (n=12). BCG lymphadenitis regressed spontaneously in 19 patients. After 1-5 needle aspirations, 14 patients recovered completely. Complete regression of lymphadenitis was recorded over an average period of 4 months. Conclusion : Clinicians need to be aware of the clinical features of BCG lymphadenitis. For management of BCG lymphadenitis, regular follow-up with observation should be the mainstay. Needle aspiration is a safe and easy treatment for suppurative BCG lymphadenitis.

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The Seosan County Family Planning/Maternal & Child Health Service Research Project, Korea -Project Design and Findings of the Baseline Survey- (가족계획(家族計劃) 및 모자보건사업(母子保健事業)의 효율적 통합방안(統合方案)에 관한 연구(硏究)(서산군(瑞山郡)) -기초조사보고(基礎調査報告)-)

  • Bang, S.;Cho, T.H.;Lee, S.J.;Han, S.H.;Lim, K.J.;Ahn, M.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.163-192
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    • 1983
  • In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

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Clinical Comparison of $Henoch-Sch\"{o}nlein$ Purpura Nephritis in Children and Adults (소아와 성인 $Henoch-Sch\"{o}nlein$ Purpura(HSP) 신염의 임상적 비교)

  • Kim Ki-Eun;Shin Youn-Ho;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.157-165
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.

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Perinatal outcomes according To chorionicity in Twin Gestations (쌍생아 임신의 융모막과 주산기 결과)

  • Choi, Eun-Jin;Yun, Hyun-Jin;Hyh, Jae-Won;Hong, Yong-Hong
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.67-74
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    • 2008
  • Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

Arthroscopic Rotator Cuff Repair For Partial Articular-Surface Tendon Avulsion (PASTA) Lesion (회전근 개 관절내 부분 파열 환자의 관절경적 봉합술)

  • Lee, Bong-Gun;Cho, Nam-Su;Park, Keun-Ho;Moon, Seong-Cheol;Rhee, Yong-Girl
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.242-248
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    • 2009
  • Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

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Views of Public Dental Hygienist about Oral Health Hub Center - In the Area Not Implemented (구강보건센터 미설치 보건소 치과위생사의 구강보건센터 설치 및 운영에 관한 견해)

  • Kim, Kyung-Mi;Yoo, Eun-Mi;Heo, Sun-Soo;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.675-681
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    • 2012
  • Korean Ministry of Health and Welfare started to implement oral health hub center to provide oral health preventive program and dental treatment to public, especially dental vulnerable class in 2006. But, there is no applicant area to implement it regardless of national budget arrangement in 2012. This study is aimed to investigate the reason not to be implemented and requirements of implementation. 293 among 1,000 public dental hygienists in the area where have not implemented oral health hub center were surveyed in Korea from April to July in 2012 through convenience sampling. The questionnaire consisted of the reason why oral health hub center have not been implemented, the requirement of implementation, duty area and duty position et al. After removal of insufficient responses, 217 questionnaires were analyzed by t-test and ANOVA using SPSS 20.0. The reason why oral health hub center have not been implemented were deficiency of the priority list as compared with other health program (72.4%), space insufficiency (71.4%), regional budget insufficiency (70.5%), will insufficiency of oral health promotion (70.5%) and manpower insufficiency (62.7%). The first requirement of implementation were space expansion and regional budget expansion, followed by reduction of record-originated and administrative tasks, understanding on oral health program of higher ranking public officials in health center, manpower expansion, reduction of other tasks than oral health program and volunteer source expansion. Budget insufficiency and manpower insufficiency in Metropolis were ranked higher than other area (p<0.05). The group not to discuss oral health hub center graded each reason not to be implemented significantly higher than the other group (p<0.05). We suggested that to promote the importance of public oral health program be needed to public and higher ranking public officials to implement oral health hub center. In addition, we insisted that more dental manpower and budget be needed for reduction of oral health inequity in metropolis.

Study on the Protective Effect of Nelumbo nucifera GAERTN Extract on Cultured Cerebral Neuroglial Cells Damaged by Hexavalent Chromium (연꽃추출물이 6가 크롬으로 유도된 세포독성에 대한 보호효과에 관한 연구)

  • Seo, Young-Mi;Park, Yun-Jum;Choi, Yu-Sun
    • FLOWER RESEARCH JOURNAL
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    • v.17 no.4
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    • pp.242-245
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    • 2009
  • In order to investigate the cytotoxic effect of hexavalent chromium ($Cr0_3$) and the protective effect of Nelumbo nucifera GAERTN (NNG) extract, cultured cerebral neuroglial cells (C6 glioma cells) were treated with $4{\sim}55{\mu}M$ concentrations of $Cr0_3$ for 48 hours. Cell viability was measured by XTT assay. The superoxide dismutase (SOD)-like activity for the antioxidant effect was also examined on the extract of NNG stamen. In this study, $Cr0_3$ significantly decreased cell viability dose-dependently. The cytotoxicities of $XTT_{90}$ and $XTT_{50}$ determined with $10{\mu}M$ and $55{\mu}M$ of $Cr0_3$, respectively, showed that the $Cr0_3$ had highly toxic effect on cultured C6 glioma cells by the cytotoxic criteria. In the protective effect of NNG extract, the cell viability was significantly increased by the treatment of NNG extract, and NNG extract increased SOD-like activity. From these results, it is suggested that $Cr0_3$ showed highly toxic effect on cultured C6 glioma cell s and NNG extract was very effective in the protection of $Cr0_3$-mediated cytotoxicity by antioxidative effect in these cultures.

Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area (구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구)

  • Chae, Hyun-Seok;Wang, Yuan-Kun;Lee, Jung-Jin;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.342-349
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    • 2019
  • Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

A Statistical Study of the Foreign Bodies in the Food and Air Passages for past 4 years and 5 months (과거 4년 5개월간 본교실에서 취급한 식도 및 기도이물의 통계적 고찰)

  • 전지일;김성일;조현상;김정원;최태규;김진구;최병익;임현준;김영학
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.87.4-88
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    • 1976
  • The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

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