• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.342-346
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• 2011

Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.54-60
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• 2009

Purpose : Yellow fever, a mosquito-borne viral hemorrhagic fever, is one of the most lethal diseases. Recently there have been an increasing number of Korean children who have travelled to yellow fever endemic zones and were administered yellow fever vaccine (YFV). Therefore, we carried out this study to provide child travelers with safety information of YFV. Methods : This study was conducted at the International Clinic of National Medical Center in Seoul between April 2007 and June 2008 for the evaluation of adverse events of YFV. One hundred twenty-five children received YFV (17-DD) and were prospectively monitored for adverse events through telephone interviews on day 3, 6, 9, 16, 23 and 30 after vaccination. Results : Adverse events were observed in 31 (24.8%) of 125 child travelers who received the YFV. The mean age was 12.5${\pm}$5.0 years. Sixty-six of the child travelers (52.8%) were males. The common adverse events were pain in 11 (8.8%), swelling in 8 (6.4%) and redness in 7 children (5.6%) at the injection site. The systemic adverse events included mild fever in 5 (4.0%), headache in 5 (4.0%), cough in 4 (3.2%), abdominal pain in 3 (2.4%), and vomiting in 2 children (1.6%). Most of the adverse events were detected within 7 days of administration and there were no differences in adverse events by gender or age. All travelers who had complained of symptoms improved spontaneously or following symptomatic treatment. Conclusion : This study showed that YFV is well-tolerated and there were no reports of severe adverse events. Studies are ongoing to clarify the cause and risk factors for rare adverse events.

• Women's Health Nursing
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• v.6 no.1
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• pp.96-108
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• 2000

The purpose of this study was to provide the basic data for developing a program for effective education about GDM(Gestational Diabetes Mellitus) by investigating the knowledge and learning needs of pregnant women about GDM. The subjects were 192 pregnant women who visited obstetrical clinics for prenatal care. The data were collected from October, 1998 to December, 1999, using a 50-item questionnaire(knowledge ; 30 items, learning needs ; 20 items), and analyzed by SAS program for t-test, ANOVA, Ducan test, and Pearson correlation coefficients. The results were as follows. 1. The knowledge level about GDM 1) Pregnant women had very little knowledge(total means ; 15.1 of 30.0) about GDM. 2) Pregnant women more than 30 years old, pregnant women from Seoul, and pregnant women who had more than a bachelor's degree were more knowledgeable about GDM. 3) Pregnant women who didn't experience spontaneous abortions, pregnant women who had DM(Diabetes Mellitus) patients in their families, and pregnant women who received education about DM were more knowledgeable about GDM. 4) Pregnant women knew very well that GDM women have more maternal and fetal complications than normal pregnant women. Although they were knowledgeable about the importance and ways of controlling blood glucose level, they knew very little about the causes, symptoms, or management of hypoglycemia. 2. The learning needs about GDM 1) Pregnant women had high learning needs (total means ; 85.0 of 100.0) about GDM. 2) The learning needs of pregnant women who had more than a bachelor's degree and pregnant women who earned less than two million won in monthly income were higher than that of other groups. 3) Pregnant women had high learning needs about the health of their baby and themselves, but their learning needs related to weight control and exercise-things that play important roles in controlling blood glucose level-were relatively low. As a result of the above findings, a systemic and individualized program is required for pregnant women and GDM patients, In addition to that, further studies that investigate the effects of education and retention of learning obtained by education are required in the near future.

• Korean Journal of Veterinary Service
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• v.45 no.2
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• pp.79-86
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• 2022

Reproductive disorders in cows cause economic loss in livestock farms. This study was carried out to investigate the incidence of endometriosis in the uterine of Korean indigenous cow (Hanwoo). In the present study, the uterine of 25 cows was provided by the slaughterhouse. As a result on a visual examination of the uterus, 18 out of 25 were visually normal, and 7 uteruses (28%) appeared rather pale and showed purulent or mucosal symptoms in Uterine horn. However, the results of hematological analysis showed that both RBC and WBC were normal and showed no signs of systemic inflammation, indicating 7 cows showed asymptomatic endometriosis. The inflammatory uterus (28%) showed a wide range of pathological conditions that elicit an inflammatory response, such as serous exudate and bleeding. Histological and microscopic analysis in the inflammatory group demonstrated that there was swelling of the uterine glands, and neutrophil, basophil, and lymphocyte appeared in the uterine gland. Moreover, plasma cells and hemosiderin-laden macrophages were increased in the endometrial stroma, which lead to inhibit pregnancy by suppression of the synthesis of pregnancy hormones, and the appearance of hemosiderin-laden macrophages is an indicator of intracellular bleeding. In summary, hematologically, it is a normal diagnosis in Korean indigenous cows, however, when the uterus was extracted and investigated microscopically, the asymptomatic endometriosis were evident. In order to achieve the goal of healthy cow management and breeding within 2 weeks after birth, cows' uterus should be washed, disinfected, and through thorough the hygiene management, it aims to prevent asymptomatic endometriosis to produce healthy offspring and reduce the breeding interval.

• Korean Circulation Journal
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• v.53 no.7
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• pp.425-451
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• 2023

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA₂DS₂-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

• Journal of dental hygiene science
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• v.24 no.2
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• pp.115-123
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• 2024

Background: The population of Gangneung City in South Korea has shown a gradual increase in the proportion of individuals aged 65 years and older, and the most frequently reported diseases for several years have consistently been periodontal diseases, including gingivitis and periodontitis. The regional imbalance in the distribution of dental personnel and resources has emerged as a problem of inequality in the use of dental care. It has been advocated to identify areas with disadvantages in dental care and develop public dental policies based on that. This study aimed to develop a customized oral healthcare program for local seniors based on a Public-Private-Academic Partnership, and to evaluate the oral health status of older adults in Gangneung City. Methods: The participants were residents aged 60 years and above in Gangneung City. A questionnaire including general information, systemic health status, and oral health status was administered to the participants. In addition, oral healthcare and education tailored to each individual's health status were provided once or twice based on their oral health status. The collected data were analyzed using IBM SPSS Statistics 25 for descriptive statistical analysis. Results: Among the older adults in Gangneung City, 75% had at least one prosthesis and exhibited symptoms of gingivitis or periodontitis. Additionally, the modified sulcus bleeding index decreased among participants who underwent the program twice. Over 90% of the participants expressed satisfaction with the program. Conclusion: The program appeared to contribute positively to the oral health promotion among local seniors. Further oral healthcare programs should focus on seniors in rural and old urban areas to reduce disparities in oral health across regions.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.594-598
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• 2005

Purpose : Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. Methods : A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid(group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). Results : The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. Conclusion : Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.143-151
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• 2004

Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.156-168
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• 2010

Purpose : To compare immunogenicity and reactogenicity of a combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine (DTPa-IPV, $Infanrix^{TM}$ IPV, GlaxoSmithKline Biologicals) with co-administration of commercially available DTPa and IPV vaccines at separate injection sites (DTPa+IPV). Methods : A total of 458 infants aged 8-12 weeks were randomized to receive three-ose primary vaccination at 2, 4 and 6 months with DTPa-IPV or DTPa+IPV. Blood samples were collected pre and post vaccination for measurement of immune responses. Reactogenicity was assessed following each dose using diary cards. Results : One month post-dose 3, seroprotection rates for anti-diphtheria, anti-tetanus and anti-poliovirus types 1, 2 and 3 were ${\geq}99.5%$ and vaccine response rates to pertussis antigens were at least 98.6% in both DTPa-IPV and DTPa + IPV groups. Non-inferiority between the groups was demonstrated based on pre-defined statistical criteria. Incidences of both local and systemic symptoms were within the same range across both groups with grade 3 symptoms reported following no more than 4.3% of DTPa-IPV doses and 4.5% of DTPa + IPV doses. Two serious adverse events (both pyrexia) after DTPa-IPV administration were considered vaccine-related. Both infants recovered fully. Conclusion : Combined DTPa-IPV vaccine was immunogenic and well tolerated when used as a three-dose primary vaccination course in Korean infants. DTPa-IPV could be incorporated into the Korean vaccination schedule, reducing the number of injections required to complete primary immunization.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.277-284
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• 2008

Background: In principle, cervical tuberculous lymphadenitis (CTBL) is a medical disease that may require surgical treatment, particularly in young women who complain of psychosocial and cosmetic problems. We encountered 13 cases of aggravated CTBL treated surgically despite the appropriate course of antituberculous chemotherapy. We report the clinical characteristis of these cases. Methods: The clinical data of 13 patients with aggravated CTBL requiring surgical treatment from January 2000 to December 2006 at the Department of Chest Medicine, Internal Medicine and Plastic Surgery, National Medical Center was reviewed retrospectively. Results: Twelve of the 13 cases (92%) were female. The most common age was 21~30 years (69%). Multiple nodes were palpated in 11 cases (85%). The supraclavicular lymph nodes were sites the most commonly involved (54%). The other involved sites in the order of decreasing frequency were the jugular chain, posterior cervical, submandibular and infraauricular lymph nodes. A palpable mass was the most commonsymptom. Neck pain was reported in 3 cases (23%). General symptoms such as weight loss, fatigue, anorexia and night sweats were noted in 5 cases (38%). Respiratory symptoms such as cough, sputum, hemoptysis, dyspnea and chest pain were observed in 4 cases (31%). Pulmonary tuberculosis was noted in 11 cases (85%). Other extrapulmonary tuberculosis coexisted in 4 cases (31%). This suggests that surgical CTBLs may be manifestations of a systemic disease and might be difficult to treat. Most cases (92%) were stages 2 and 3 at the initial diagnostic period but all cases fell into stage 4 and 5 when reassesed before surgery. The average duration of anti-TB chemotherapy before and after surgery was 10.2 and 15.2 months, respectively. The 13 patients were followed up until June. 2008. Among them, 2 cases had newly developed CTBL and the other 11cases showed no recurrence. Conclusion: In principle, CTBL is the medical disease. However, despite the appropriate course of anti-TB chemotherapy, CTBL can progress to a more advanced stages and grow rapidly to a large-sized or fistulous mass with a persistent abscess. Surgical treatment may be inevitable for patients with psychosocial and cosmetic problems caused by these masses, particularly in young women.