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A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL (종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰)

  • Kim Yeoung-Rang;Hong Sungdo D.;Lee Sang-Sin;Lim Seong Hu;Park Jeoung Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.72-78
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    • 2005
  • Objectives : This study is to investigate the clinical characteristics of psychiatric consultation for children and adolescents in a general hospital. Methods : Hospital records of 302 children and adolescents who were referred for psychiatric consultation in a general hospital over 4 years were reviewed and analyzed. Results : The mean referral rate for psychiatric consultation for school age children and adolescents was $2.15\%$. While more girls were referred in middle and high school age group, more boys were referred in pre-school age group. Fifty percent of the consultation was requested from department of internal medicine and pediatrics. Main reason for requesting psychiatric consultation was fur the assessment of the patients from psychiatric point of view $(31.1\%)$, followed by the management of depression $(11.6\%)$ and anxiety $(11.3\%)$. Most frequently rendered psychiatric services for the treatment was psychosocial education and supportive therapy $(21.2\%)$. Conclusion : There are differences in clinical nature of psychiatric consultation and referral patterns between adult patients and child and adolescent patients. Future research is needed to strengthen the services for child and adolescent psychiatric consultation.

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A study on the experience of daily life and chronic disease management of elderly living alone : Focus group interview (독거노인의 일상생활 및 만성질환관리의 경험: 포커스그룹 인터뷰)

  • Lim, Hyo Nam;Lee, Byunglim;Cha, Tae-Hyun;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.9 no.4
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    • pp.111-118
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    • 2018
  • This study is a qualitative analysis that conducted a focus group interview to analyze the experiences of daily life of the elderly living alone and their chronic diseases management, and to explore the meaning, nature, and difficulties associated with. The subjects of this study were elder who lives alone without cognitive impairment and over 65-year-old. There were total 31 people and divided into 5 groups and they had 60 minutes interview. By this study, there were four themes of 'difficulties of daily life', 'suffering from chronic diseases', 'fear of the future', 'acceptance of life'. In conclusion, the elderly living alone felt difficulty in daily life due to physical aging and chronic illnesses, and they felt that they were accepting life at the same time while feeling the fear of the future situation. Therefore, in order to improve the life satisfaction and life quality of elderly people living alone, it is necessary to provide institutional devices that enable daily life such as meals and laundry to be maintained and to develop of an intervention program in order to maintain physical health. In addition, an intervention program should be developed to reduce the fear of future uncertainty and positively accommodate the life.

The Medical Study on the Development of Pediatrics in Myeong(明) Dynasty (명대(明代)의 소아과학(小兒科學)에 관(關)한 연구(硏究))

  • Park, Hyun-Kuk;Kim, Ki-Wook;Yi, Yeong-Seok
    • Journal of Korean Medical classics
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    • v.21 no.3
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    • pp.1-25
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    • 2008
  • Myeong(明) Dynasty Period put together clinically various medical theory in Song(宋) Dynasty and Geum-Won(金元) age, organized medical system. They have been developed in theory, which thought of Byeonjeungronchi(辨證論治) more important, and clinical part which included diagnosis, therapy, prevention. In that age reactional medical thought was in fashion because of affect of Ihak(理學), therefore pediatrics have been affected from them. Especially, looking at the symptom of Byeonjeungronchi doctors, Manjeon(萬全), Nobaeksa(魯伯嗣), Wangdaeryun(王大綸), Wanggeungdang(王肯堂), Nuyeong(樓英) had succeed to Jeoneul(錢乙)' the five viscera Byeonjeung(辨證) system. Manjeon advocated Samyuyeosabujokron(三有餘四不足論) about Jangbu(臟腑) and organized the curative principle about Ojangheosil(五臟虛實). Gupyeong(寇平), commented on diagnosis of five viscera and classification of disease of five viscera. Wangdaeryun in the close of Myeong Dynasty Age explained main pulse, pulse of illness in detail according to weakness or strength of five viscera, pathological or physiological features of five viscera and Saenggeuk(生克) relation of Ohaeng(五行) in the book of "Yeongdongryuchwe(嬰童類萃)". Wanggeungdang and Nuyeong had organized system of argument which classified disease as a result of symptom of five viscera. "Yugwajeungchijunseung(幼科證治準繩)" and "Uihakgangmok(醫學綱目) Soabu(小兒部)" had been written by this principle. Nobaeksa had arranged the principle of cure about five viscera and explained method of common use about each organ's disease. Besides, Seolgi(薛己), Janggyeong-ak(張景岳), insisted about Myeongmun(命門) because he thought of Bisin(脾腎) of children and vigor by nature importance. Seolgi had applied and used very well Bojung-ikgitang(補中益氣湯) based on Idongwon(李東垣)'s Biwiseol(脾胃說) and controled and helped spleen and stomach. At the same time, he took a serious view about supplementing children's Sin-gi(腎氣) according to so many spleen and stomach disease was fallen because they couldn't make warm the spirit of Jungju(中州), result of weakening Hwa(火) of Myeongmun. Also Janggyeong-ak took a serious view strengthen of Bisin, so he assorted and used Insam(人蔘) and Buja(附子) to supplement children's weaken energy in kidney Jeonggi(精氣).

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Difference of Clinical Features according to Hypoalbuminemia in the Children with Pleural Effusion (흉수가 있는 환아에서 저알부민혈증의 정도에 따른 임상 양상의 차이)

  • Sung, Min-Jung;Park, Hee-Ju
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.523-526
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    • 2005
  • Purpose : Hypoalbuminemia is a rare cause of pleural effusion. The relationship between the severity of hypoalbuminemia and the clinical course of pleural effusion is unclear. The aim of this study was to evaluate the change of clinical course according to the severity of hypoalbuminemia due to pleural effusion in children. Methods : A total of 96 patients admitted to Pusan National University Hospital with pleural effusion from August 1998 to August 2004 were studied retrospectively. The 79 patients who had only infectious causes were evaluated according to their albumin levels. They were divided into the two groups : group 1 had serum albumin levels of ${\leq}2.5g/dL$; group 2 : >2.5 g/dL. The clinical courses of each group were compared. Results : The nature of pleural effusion was transudates in seven cases and exudates in 89 cases. The most commom causes of transudates were renal failure(four cases) and the most common causes of exudates were parapneumonic effusion(58 cases). There was no statistical significance in mean ages, BUN, creatinine, potassium, bilirubin and WBC in each group. Four patient in group 1 and 26 patients in group 2 improved after medication of antibiotics or anti-tuberculosis agents only. Fourteen patients in group 1 and 26 patients in group 2 improved after thoracostomy with use of antibiotics. Eight patients in group 1 and one patient in group 2 had ventilator care with use of antibiotics therapy. Conclusion : Children who were diagnosed as pleural effusion with low serum albumin levels on admission had poorer prognoses than those with normal levels. We conclude that lower serum albumin level on admission is an important prognosis factor in a patient with pleural effusion.

Is Target Oriented Surgery Sufficient with Borderline Ovarian Tumors? - Role of Accompanying Pathologies

  • Gungor, Tayfun;Cetinkaya, Nilufer;Yalcin, Hakan;Ozdal, Bulent;Ozgu, Emre;Baser, Eralp;Yilmaz, Nafiye;Caglar, Mete;Zergeroglu, Sema;Erkaya, Salim
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6749-6754
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    • 2014
  • Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

Efficacy of Antiepileptic Drug on the Benign Childhood Epilepsy with Centro-Temporal Spikes (중심-측두엽 극파를 보이는 양성 소아 간질 환자에서 항경련제 투여의 유효성)

  • Oh, Mee Hye;Kim, Soo Young;Seo, Won Hee;Pee, Dae Hun;Choi, Byung Min;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.893-897
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    • 2003
  • Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.

The phenomenological study of self-management intervention among breast cancer survivors: Non-pharmacological approaches (유방암 생존자들의 자가관리에 대한 현상학적 연구: 비약물적 접근방법을 중심으로)

  • Heo, Seok-Mo;Heo, Narae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.270-284
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    • 2016
  • The purpose of this study was to understand the essential structure and meaning of self-management intervention for breast cancer survivors by using non-pharmacological approaches. The study participants were 10 breast cancer survivors who were completing cancer treatment that involved surgery, chemotherapy, and radiation therapy. Data collected between August 2014 and February 2015 at E Hospital in S city were analyzed by using Colaizzi's phenomenological method. Outcomes were classified into seven essential themes: 1) application of comfort measures to alleviate ongoing symptoms, 2) movement to change physical conditions, 3) special herbal intake to prevent recurrence, 4) a specially designed diet plan for health self-management, 5) constant awareness of complementary and alternative medicine, 6) unmet needs treated by one's own doctor's prescription, and 7) future life toward a nature-friendly environment. The study results contribute to a deeper understanding of self-management interventions in the daily lives of Korean breast cancer survivors. In addition, results provide an essential resource, based on actual self-management styles, that will help survivors to obtain guidance and participate in appropriate programs.

AN EXPERIMENTAL STUDY OF ELECTROPHYSIOLOGICAL AND HISTOLOGICAL ASSESSMENT ON THE INJURY TYPES IN RABBIT INFERIOR ALVEOLAR NERVE (가토의 하치조 신경 손상 형태에 따른 전기생리학적 및 조직학적 변화에 관한 실험적 연구)

  • Lee, Jae-Eun;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.679-700
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    • 1996
  • Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

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Central, Extraventricular and Atypical Neurocytomas: a Clinicopathologic Study of 35 Cases from Pakistan Plus a Detailed Review of the Published Literature

  • Ahmad, Zubair;Din, Nasir Ud;Memon, Aisha;Tariq, Mohammad Usman;Idrees, Romana;Hasan, Sheema
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1565-1570
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    • 2016
  • Background: Central neurocytomas are rare neuronal neoplasms with a favorable prognosis. They are typically located in the lateral ventricles of the brain and mostly histologically correspond to WHO grade II with a Mib 1 labelling index of <2%. Similar tumors located in the cerebral hemispheres and spinal cord, for example, are called "extraventricular neurocytomas". A few tumors histologically show atypia, mitoses, vascular proliferation and/or necrosis and a Mib 1 index >2 % and are designated as "atypical neurocytomas. Aim: The aim of our study was to describe the common as well as unusual morphologic features and the role of various immunohistochemical stains in the diagnosis of these rare tumors. Materials and Methods: We retrieved and reviewed 35 cases diagnosed between 2001 and 2015. Results: Sixty percent of patients were males, and the mean age was 26 years. 31 cases (88.6%) were intraventricular and 4(11.4%) were extraventricular. Histologically, 6 cases (17.1%) were compatible with "atypical neurocytomas". All cases showed the classic morphology comprising nests and sheets of uniform, round cells with uniform round to oval nuclei with finely speckled chromatin and perinuclear cytoplasmic clearing (halos). All cases also showed delicate, fibrillary, neuropil-like matrices. Other common histologic features included capillary-sized blood vessels in a branching pattern in 57.1%, foci of calcification in 34.3% and perivascular pseudorosettes in 20%. Rare findings included Homer-Wright or true rosettes in 8.6% and ganglioid cells in 2.9%. Synaptophysin was the most consistent and valuable marker, being positive in almost all cases. GFAP positivity in tumor cells was seen in 25.7% of cases. Follow up was available in 13 patients. Of these 9 had histologically typical and 4 had atypical tumors. Only 1 (with an atypical neurocytoma) died, probably due to complications of surgery within one month, while 12 (including 3 with atypical neurocytomas) remained alive. Recurrence developed in 1 of these 12 patients (histologically consistent with typical morphology) almost 9 years after surgery. Only 4 patients, including 2 with atypical tumors, received postoperative radiotherapy, all with surgery in 2010 or later. Overall, prognosis was excellent with prolonged, recurrence free survival and most patients, even without receiving radiation therapy, were alive and well for many years, even a decade or more after surgery, without developing any recurrence, indicating the benign nature of these neoplasms.

In Vitro Differentiation-induced hES Cells Relieve Symptomatic Motor Behavior of PD Animal Model

  • 이창현;김은경;이영재;주완석;조현정;길광수;이금실;신현아;안소연
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2002.11a
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    • pp.95-95
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    • 2002
  • Human embryonic stem (hES) cells can be induced to differentiate into tyrosine hydroxylase expressing (TH+) cells that may serve as an alternative for cell replacement therapy for Parkinson's disease (PD). To examine in vitro differentiation of hES (MB03, registered in NIH) cells into TH+ cells, hES cells were induced to differentiate according to the 4-/4+ protocol using retinoic acid (RA), ascorbic acid (AA), and/or lithium chloride (LiCl) followed by culture in N2 medium for 14 days, during which time the differentiation occurs. Immunocytochemical stainings of the cells revealed that approximately 21.1% of cells treated with RA plus AA expressed TH protein that is higher than the ratio of TH+ cells seen in any other treatment groups (RA, RA+LiCl or RA+AA+LiCl). In order to see the differentiation pattern in vivo and the ability of in vitro differentiation-induced cells in easing symptomatic motor function of PD animal model, cells (2 $\times$ 10$^{5}$ cells/2${mu}ell$) undergone 4-/4+ protocol using RA plus AA without any further treatment were transplanted into unilateral striatum of MPTP-lesioned PD animal model (C57BL/6). Following the surgery, motor behavior of the animals was examined by measuring the retention time on an accelerating rotar-rod far next 10 weeks. No significant differences in retention time of the animals were noticed until 2 weeks post-graft; however, it increased markedly at 6 weeks and 10 weeks time point after the surgery. Immunohistochemical studies confirmed that a reasonable number of TH+ cells were found at the graft site as well as other remote sites, showing the migrating nature of embryonic stem cells. These results suggest that in viかo differentiated hES cells relieve symptomatic motor behavior of PD animal model and should be considered as a promising alternative for the treatment of PD.

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