• The Journal of Pediatrics of Korean Medicine
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• v.19 no.2
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• pp.197-213
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• 2005

Objective : The purpose of this study was to investigate chief complaints of pediatric outpatients .Fin the oriental hospital and search for a trend of patients and their symtoms. Method : The study was composed of 2,915 new patients aged between 0 and 20 who had been visited pediatrics in ${\bigcirc}{\bigcirc}$ university oriental hospital from 2001 to 2004. Results : The percentage of new patients decreased every year with 30.7% in 2001, 25.5% in 2002, 24.1% in 2003, 17.8% in 2004. The age distribution showed 9.9% in infancy patients, 62.6% in early childhood, 16.8% in late childhood, 10.6% in adolescence. The percentage of infants decreased every year with 13.3% in 2001, 9.4% in 2002, 8.8% in 2003, 7.1% in 2004. The percentage of adolescents increased every year with 8.0% in 2001, 9.6% in 2002, 12.8% in 2003, 13.5% in 2004. Systemic division of chief complaints was respiratory symtoms(37.6%), general symtoms(26.1%), digestive symtoms(19.2%), skin symtoms(6.8%), nervous and mental symtoms (6.1%), urinary symtoms(2.2%), musculoskeletal symtoms(1.3%) and others(0.7%) in order of frequency. The main chief complaints were nasal mucus/obstruction(17.5%), weakness(16.9%), cough(12.8%), loss of appetite(9.8%), inappropriate growth(4.3%), atopic skin problem(3.4%), repeated common cold(2.4%), abdominal pain(2.4%), vomiting (2.2%), diarrhea(2.0%) and fever (1.9%). Loss of appetite, inappropriate growth and repeated common cold increased every year. Diarrhea and convulsion decreased every year. Conclusions : The two main causes of visit of patients were respiratory problems and improvement of general condition. More data of patients should be accumulated for further study. Not only analysis according to chief complaint, but also analysis according to diagnosis will accomplish more aaccurate information about disease of childrens in the future.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.206-215
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• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.