• Journal of Trauma and Injury
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• v.18 no.2
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• pp.119-126
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• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

• Journal of agricultural medicine and community health
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• v.33 no.3
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• pp.324-334
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• 2008

Objectives: The purpose of this study was to develop and execute the village heath worker(VHW) training program which based on short term overseas medical volunteer and medical mission. Methods: Through case studies of previous VHW program and review articles about the state of medical volunteer and medical mission, we developed the VHW training program. Pilot test of the program was carried out in Tugeugarao city, Phillipines on July, 2008. The subject were 32 persons from 15 villages around Tuguegarao city. After training we surveyed regarding the satisfaction of training and the degree of getting knowledge and skills. Results: Through article review, we got the common subjects of previous VHW training program and the limitations of overseas medical volunteer and medical mission. We developed VHW training program aiming to community health promotion through community participation and community change. The main text was "Where There Is No Doctor" of Hesperian Foundation. The program executed through 1 day intensive lecture and practice. The satisfaction of the program was 8.95±1.70 on 10 point rating scale. Conclusions: We strongly expect VHW training program can be available as new model of short overseas medical volunteer as well as medical mission if we could systemize it with the confirming subject before training , management after training and continuous support through connection with the field.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.93-97
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• 2014

Purpose: Gastroesophageal reflux in infant is a physiological process. However, surgery is performed in high risk infants with severe gastroesophageal reflux disease (GERD) when medical management fails. This study focuses on efficacy and safety of Nissen fundoplication for GERD in infants under age 12 months. Methods: This study was a retrospective case analysis of 11 neonates and infants under 12 months of age who underwent Nissen fundoplication following a failure of medical treatment between June 2010 and June 2013 at Pusan National University Children's Hospital. The records were reviewed to determine the effect of fundoplication on symptoms and post-operative complications. Results: A total of 11 infants consist of four males and seven females. Mean birth weight was $2,305.5{\pm}558.6g$ (1,390-3,130 g). They had some underlying disease, which are not related with GERD such as congenital heart disease (54.5%), prematurity (45.5%), neurologic disease (18.2%), respiratory disease (18.2%), and other gastrointestinal disease. Mean body weight at surgery was $3,803.6{\pm}1,864.9g$ (1,938.7-5,668.5 g). Mean age at operation was $99.9{\pm}107.6days$ (17-276 days). Duration from operation to full enteral feeding was 10.9 days. Symptoms related GERD disappeared in all patients including one who got reoperation. One infant died of congenital heart disease unrelated to surgery. There were no complications related to fundoplication. Conclusion: Fundoplication is effective and safe treatment in the neonates and infants with severe GERD.

• The Journal of Korean Medicine
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• v.35 no.4
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• pp.104-109
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• 2014

Objectives: To present the case of a 76-year-old man diagnosed with idiopathic interstitial pneumonias (IIPs) treated exclusively with traditional Korean medicine (TKM). Methods: The patient was treated with the revised Sasammaekmundong-tang (rSMT), acupuncture, and pharmacopuncture from September 2013 to May 2014 in our outpatient clinic. We prescribed rSMT three times a day for 4 months. Acupuncture and pharmacopuncture were performed twice a week for 9 months. To evaluate therapeutic efficacy, we recorded the patient's chief complaints at each visit, and pulmonary function test was performed at intervals of three months. Chest radiography and chest computed tomography were performed before and after treatment, respectively. Results: During the course of the treatment, dyspnea, cough, sputum, and overall pulmonary function improved. Conclusions: We suggest that traditional Korean medicine (TKM) for IIPs patients might be effective in the control of the main symptoms of IIPs and in the recovery of respiratory function.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.192-194
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• 2003

A neonate born at 38 gestational weeks was admitted due to generalized tonic-clonic seizure and cyanosis. The neonate was born six days previously at home through normal delivery and the umbilical cord was cut using scissors sterilized in boiling water. The neonate weighed 3,180 g at admission. Physical examination revealed cyanosis, opisthotonus, trismus and reactive muscle spasms. Laboratory exam, brain sonogram and EEG showed no significant abnormal findings. Based on her history and physical examination, the neonate was diagnosed with tetanus and put in an incubator isolated in a quiet, dark room. Treatment with tetanus human immunoglobulin along with antibiotics (penicillin G) were started immediately, and mechanical ventilation, administration of neuromuscular blocking agent and muscle relaxant were also started off. The frequency of seizure episode decreased gradually, and on the 32nd hospital day, mechanical ventilatory support was stopped along with extubation two days later. Thereafter, the neonate was in continuous generalized hypertonic state and showed feeding difficulty, but there was gradual improvement. She was dismissed on the 49th hospital day and is currently under OPD follow-up, doing well with no special problems. Respiratory management is critical to neonatal tetanus. We report here a case of tetanus treated with inhibition of self-respiration, neuromuscular blocker and application of ventilator, and present this method as a useful direction for future treatment of neonatal tetanus.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.4
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• pp.525-533
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• 2015

Objectives: Alongside smoking, occupational exposure is an important risk factor for chronic obstructive pulmonary disease. The purpose of this study was to evaluate factors associated with occupational pulmonary function decline that can be used to create guidelines for the health management of shipyard workers Materials: This study analyzed spirometry from 10,597 male shipbuilding workers. Functional decline in spirometry was defined as FEV1/FVC <70% and logistic regression for work duration and occupational hazard exposure was performed Results: Among the subjects, 4.2% showed an obstructive pattern in pulmonary function. The odds ratios for hazard exposure were 1.67(indirect) and 3.54(direct), and for work duration 1.97(10-18 years), 2.29(19-27), and 5.02(28+). After adjusting for smoking and work-related factors, the odds ratios for work durations of over 10 years were 1.73(10-18 years), 1.99(19-27), and 4.09(28+), but for hazards exposure was 1.71(direct) alone after adjustment. Conclusions: Occupational COPD is insidious and chronic, and thus long-term hazard exposed(especially over 10 years) shipyard workers with functional decline in spirometry need to prevent and manage COPD. This study is important for establishing guidelines to manage hazard exposure among shipyard workers and prevent COPD.

• Journal of Environmental Science International
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• v.15 no.2
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• pp.101-106
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• 2006

The work of hairdressers includes washing, coloring, bleaching, permanent waving, conditioning, and cutting hair. Hairdressers are subjected to a number of physical and toxicological hazards. The toxicological hazards are those resulting from exposure to a wide range of chemicals that are usually classified active processes. In this study, twenty beauty shops were selected to assess the exposure to indoor air pollutants such as VOCs and particulate matter $(PM_{10})$ during one month from September 1 to September 30, 2003. Indoor air quality of beauty shops might be worse by vehicle emissions because the beauty shops were generally located near roadways. Personal exposures to VOCs and $PM_{10}$ were related to indoor concentrations of beauty shops. According to the questionnaire, hairdressers complained of sore throat, eye irritation, and nervousness as physical symptoms. The measured mean concentrations of respiratory particulates were $30.5ng/m^3$ in indoor, $30.5ng/m^3$ in outdoor and $44.0ng/m^3$ on personal levels. The personal concentration was found higher than indoor and outdoor concentrations. The heavy metals mean concentrations were shown as indoor (Na>Zn>Cr), outdoor (Cr>Zn>Pb), and personal (Na>Cr>Zn) levels. Conclusively, customers as well as workers in the beauty shops might be highly exposed to air pollutants from indoor and outdoor sources. Therefore, proper management should be taken to improve the indoor air quality in beauty shops.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.70-76
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• 2000

Congenital biliary atresia with progressive sclerosis of the intra- and extra-hepatic duct system occurs in 1 : 10,000 live births, and has a poor prognosis with an expected survival of less than 5 years. Etiology of biliary atresia is unclear, however, it is believed a genetic or developmental cause. The clinical characteristics include pronounced jaundice, hepatosplenomegaly, pruritus, steatorrhea, xanthomas, growth retardation, portal hypertension, bleedings, ascites and respiratory infections. Oral manifestations have seldom been reported in patients with biliary atresia, but there may be enamel hypoplasia, delayed tooth eruption, and green teeth. Early diagnosis and surgical intervention have decreased morbidity. returned growth and development to normal and improved the prognosis for survival. Authors report the clinical and radiologic characteristics, proper managements about two cases with biliary atresia.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.273-279
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• 2015

Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.545-550
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• 2010

Freeman-Sheldon Syndrome (FSS, also known as "Whistling Face Syndrome") is a rare genetic condition which characteristically includes a small "whistling" mouth, a flat mask-like face, club feet, joint contractures usually involving the fingers and hands, and under-development of the cartilage of the nose. Intelligence is usually normal. Most of the features of this syndrome are due to muscle weakness. The patient, 11 years old boy was consulted from pediatrics to pediatric dentistry due to dental management. After clinical & radiographic examinations, severe multiple problems were found. Dental problems were microsomia(whistling mouth) & micrognathia, perioral muscle contracture, restricted mouth opening, poor oral hygiene & care, generalized dental caries, high palatal vault, severe malocclusion & crowding. And Orthopedic problems, ophthalmic & respiratory, anesthetic problems were found. Then He also had psychiatric problem, hospital(dental) phobia due to previous medical history(frequent hospitalization). And he had genital problem, cryptochidism, too. Due to these intricate problems, he suffered with feeding, swallowing difficulties and showed growth retardation. For enhancing patient's oral health, pediatric dentist, orthodontist, oral surgeon, pediatrician, psychiatrist, orthopedist, they all agree with early, cautious intervention and treatment. So, he has been treated by multidisciplinary care, now he is recovering general health maintenance.