• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.23-37
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• 2002

We have plenty of study of adults diseases, but not much has been said about children. 79 children who had visited in the weak children of Dongeui Oriental Medical Hospital from March, 2002 to October, 2002, were the respondents of the Weak Child Questionnaire. The results obtained were as follows: 1. Their symptoms have been observed with sequences of respiratory diseases, Digestive diseases, Psycho-neurological diseases. 2. Distribution of sex and ages : male 38 cases, female 41 cases. $0{\sim}6$ years 60 cases, $7{\sim}12$ years 17 cases, $13{\sim}18$ years 2 cases. 3. The texture of complexion was resulted in face color and the region of the face : whitish-2/ cases. yellowish-27 cases, darkish-22 cases, blue-2 cases, flushed face-l case. Sangeun(山根)-blue : 59 cases, a lower eyelid- dark or light brown : 54 cases. the rests of color on face region didn't mean. 4. The texture of tongue was ended in tongue state : tongue form-not plump not haggard patten(57 cases), a pricky patten(12), a map patten(7), a fissured patten(3). tongue color- pink (57 cases), red(16), light white(6). coating color- thin white(61 cases), thin yellow(l0), lack(6), deep and white(2). tongue coating substance-thin(72 cases), moisten(5), dry(1), deep(1).

• Clinical and Experimental Pediatrics
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• v.46 no.4
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• pp.385-388
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• 2003

Pulmonary sequestration is a rare congenital mass of nonfunctional pulmonary tissue that lacks a normal-connection with the bronchial tree or the pulmonary arteries. It is clinically asymptomatic but when it is complicated with recurrent infection, it needs to be treated. Conventionally, surgical removal was recommended, but these days we are trying new and less invasive techniques, such as arterial embolization. There were several reports about successful cases of pulmonary sequestration treated by embolization, but mostly all of them were done to newborns or infants. We report a case of a 15-year-old boy with an asymptomatic pulmonary sequestration on whom was performed coil embolization, and in the follow-up computed tomography(CT), the size of the lesion was decreased. He did not suffer severe respiratory symptoms.

• Clinical and Experimental Pediatrics
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• v.58 no.10
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• pp.380-385
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• 2015

Purpose: Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. Methods: The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ${\leq}18years$ presenting with croup or epiglottitis. Results: We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were $2.2{\pm}2.0$ and $5.6{\pm}5.8years$, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05). Conclusion: Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.962-967
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• 1990

The anomalous pulmonary venous return of the entire left lung was an extremely rare congenital anomaly. The reported surgical experience with correction of this disorder was limited. The 3-year-old female patient underwent an operation upon the unilateral total anomalous pulmonary venous return from the left lung, in which the left superior pulmonary vein drained into innominate vein and the left inferior pulmonary vein into the coronary sinus, in Yeungnam University Hospital. The symptoms were nonspecific except frequent upper respiratory infection. Cyanosis was not seen. On auscultatory findings, a grade 2/6 systolic ejection murmur was audible over left second intercostal space of left sternal border and second heart sound had an increased pulmonary component which was widely splitted. The electrocardiogram demonstrated a right ventricular hypertrophy and right axis deviation and chest X-ray showed slightly increased pulmonary vascularity and bulged pulmonary conus. The echocardiogram demonstrated increased right atrial, ventricular, and pulmonary arterial dimension, and also secundum atrial septal defect and enlarged coronary sinus. The cardiac catheterization confirmed the left-to-right with a Qp/Qs of 2.0: 1 and oxygen step-up was seen in pulmonary artery, right ventricle, right atrium, and left innominate vein, and the catheter was not been introduced into the left pulmonary vein. A median sternotomy incision was done. Left superior pulmonary vein was drained to the innominate vein through anomalous vertical vein and the left inferior pulmonary vein drained to right atrium through the coronary sinus. The diversion of the left inferior pulmonary vein to posterior wall of left atrium was done after division in the proximity of coronary sinus. The anomalous vertical vein was diverted to base of left atrial auricle and then a atrial septal defect was sutured directly. The postoperative course was uneventful and she was discharged on the eleventh postoperative day. In the postoperative follow-up-2 months, she has been well without specific problems.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.610-616
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• 1994

Myasthenia gravis is a rare condition, affecting only 1/75000. It is characterized by weakness and fatigue of the voluntary muscles due to impaired neuromuscular transmission at the acetylcholine receptor site. It is probably caused by an autoimmune mechanism leading to reduction of the available nicotinic acetylcholine receptors at the neuromuscular junction. A relationship between the thymus and myasthenia gravis was suggested by Weigert in 1901, and Blalock was the first to report the efficiency of thymectomy in the treatment of myasthnia gravis in 1939. Since that time, thymectomy has become increasingly important in managing patients with myasthenia gravis. Fourteen patients with myasthenia gravis underwent thymectomy between September 1987 and March 1994 and got the following results; 1. The sex distribution was 10 females and 4 males with ages ranging from 15 to 51 years[mean, 34.8 years]. 2. Clinical manifestation of ocular symptoms were seen in all cases, dysphagia in 12[85.7%], extremity weakness in 11 [78.6 %], and dyspnea in 3 [21.4 %]. 3. According to the modified Osserman`s classification, 8 patients were in group IIb, 3 in IIa, 2 in I and 1 in IIc, respectively. 4. Histopathologic examination of the resected thymuses revealed hyperplasia in 8 patients, benign thymoma in 3, and malignant thymoma in 3. 5. There were no perioperative or immediate postoperative deaths but one patient died about two months after the thymectomy due to respiratory failure. 6. During the follow-up period, 11 patients [78.6 %] showed clinical improvement. Among them, 4 cases [28.6 %] showed complete remission, 3 [21.4 %] showed marked improvement, and 4 [28.6 %] showed subjective improvement. 7. Among the 8 patients with thymic hyperplasia, clinical improvement was noticed in 7 patients 5 %]. Among the 6 patients with thymoma, 4 patients [66.7 %] showed improvement.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.161-165
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• 2006

Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.91-96
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• 2012

Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.298-305
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• 2016

Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

• Journal of Environmental Science International
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• v.26 no.9
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• pp.1013-1021
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• 2017

Exposure to Diesel Particulate Matter (DPM) potentially causes adverse health effects (e.g. respiratory symptoms, lung cancer). Due to a lack of data on Elemental Carbon (EC) exposure levels in underground copper ore mining (unlike other underground mining industries such as non-metallic and coal mining), this case study aims to provide individual miners' EC exposure levels, and information on their work practices including use of personal protective equipment. EC measurement was carried out during different work activities (i.e. drilling, driving a loader, plant fitting, plant operation, driving a Specialized Mining Vehicle (SMV)) as per NIOSH Method 5040. The copper miners were working 10 h/day and 5 days/week. This study found that the most significant exposures to EC were reported from driving a loader (range $0.02-0.42mg/m^3$). Even though there were control systems (i.e. water tanks and DPM filters) on the diesel vehicles, around 49.5% of the results were over the adjusted recommendable exposure limit ($0.078mg/m^3$). This was probably due to: (1) driver's frequently getting in and out of the diesel vehicles and opening the windows of the diesel vehicles, and (2) inappropriate maintenance of the diesel vehicles and the DPM control systems. The use of the P2 type respirator provided was less than 19.2%. However, there was no significant difference between the day shift results and the night shift results. In order to prevent or minimize exposure to EC in the copper ore mine, it is recommended that the miners are educated in the need to wear the appropriate respirator provided during their work shifts, and to maintain the diesel engine and emission control systems on a regular basis. Consideration should be given to a specific examination of the diesel vehicles' air-conditioning filters and the air ventilation system to control excessive airborne contaminants in the underground copper mine.

• Child Health Nursing Research
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• v.15 no.4
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• pp.359-366
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• 2009

Purpose: This study was done to identify perceived body image, intentional caloric restriction and physical manifestations of unbalanced nutrition according to the Body Mass Index (BMI) in elementary school students. Methods: The research design was a cross-sectional descriptive study. Data collection was done by using a structured questionnaire that consisted of 34 items. Participants were 151 students in 5th and 6th grades of elementary schools in Gangwon province. Frequency and percentage, one-way ANOVA, and $\chi^2$-test with SPSS WIN 12.0 were used to analyze the data. Results: In elementary school students, over-weight/obesity and normal weight groups reported that they would be satisfied with a thinner body image compared to the present image. The score for intentional caloric restriction was significantly higher in the over-weight/obesity group than in the under-weight group. In physical manifestations of unbalanced nutrition, students in the under-weight group frequently were pale and had dry skin, whereas the over-weight/obesity group reported frequent upper respiratory symptoms. Conclusion: The results suggest that elementary school students need to develop the perception of an adequate body image and to avoid inadequate caloric intake if promotion of the child's growth and development is to be without physical manifestations of unbalanced nutrition.