• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.1-8
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• 2010

Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.827-832
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• 2004

Background: The significance of MIDCAB is emerging topics recently as OPCAB is going to be universalized, and long-term outcome of bypass graft surgery was proved to be more excellent than balloon dilation or stent insertion. We report our MIDCAB results in 73 patients in the last three years. Material and Method: Retrospective analysis of medical records was done from November 1, 2000 through November 31, 2003. There were 47 males and 26 females ranging in age from 31 years to 79 years (average $61.3\pm9.8$ years). Observation periods after operative procedures were 10 to 1238 days (average $763\pm319.8$ days). Left longitudinal parasternal incision as a standard procedure was done to approach the heart after dissection of the left internal thoracic artery by partial or total resection of 3rd to 5th ribs. Result: Of those patients, 46 patients were transferred to ICU after extubation at operation room and 58 patients were extubated within 3 hours after operation. Average ICU staying periods was $26.8\pm11.5$ hours. Follow-up angiography during admission was done in 36 patients and showed 100% patency. Only one patient died on the 10$^{th}$ post operative day because of sudden CVA. Complications included wound problems in 4 patients, and constructing pericardial window using thoracoscopy due to continuous pericardial effusion in 1. Permanent pacemaker was inserted in one patient owing to sick sinus syndrome. In one patient with recurrence of angina 8 months after operation, stenosis at anastomic site was found and improved with balloon dilatation. Conclusion: We were satisfied with our results of MIDCAB in single and multi-vessel coronary artery disease. These results have made the cardiologists tried to operate positively and we expect widening operative indications including hybrid revascularization.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.130-137
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• 2019

Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

• Neonatal Medicine
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• v.16 no.2
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• pp.205-212
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• 2009

Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.91-100
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• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.314-322
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• 2010

Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%). The peak month was May (10.0%), the peak day of the week was Sunday (24.7%), and the peak time of day was 20:00-0:59 (8.5%). There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog) or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD)-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding) (31.5%), and the most common symptom was fever (13.1%). Final outcomes were discharged (73.8%), admitted (25.7%), transferred (0.4%), and expired (0.1%). In adolescent patients aged 15-9 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%); the most common symptom was abdominal pain (9.6%). Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

• MISULJARYO - National Museum of Korea Art Journal
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• v.98
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• pp.130-153
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• 2020

Using stylistic analysis and historical documents, this paper examines the production details of images enshrined in Myeongbujeon (Hall of the Underworld) at Magoksa Temple in Gongju, focusing on the wooden seated Ksitigarbha Bodhisattva and the stone Ten Kings of Hell. Inside Myeongbujeon, the wooden seated Ksitigarbha Bodhisattva is placed at the center, flanked by standing images of Mudokgwiwang and Domyeong-jonja, with images of the Ten Kings and their attendants along the walls. All of these images were transferred to Magoksa Temple in the latter half of the 1930s. The wooden seated Ksitigarbha Bodhisattva came from Jeonghyesa Temple in Cheongyang, the other sculptures came from Sinheungsa Temple in Imsil, and a painting of the Ten Kings came from Jeongtosa Temple in Nonsan. The wooden seated Ksitigarbha Bodhisattva is known to have been produced in 1677, around the same time as the stone sculptures of the Ten Kings. A close analysis of the details of the bodhisattva sculpture-including the facial features, body proportions, and drapery characteristics-strongly suggests that it was produced in the 1620s or 1630s by the monk sculptor Suyeon (who was active in the early half of the seventeenth century) or his disciples. In particular, the rendering of the drapery on the lower half of the body closely resembles Buddhist sculptures produced by Suyeon that are now enshrined at Bongseosa Temple in Seocheon (produced in 1619) and at Sungnimsa Temple in Iksan (produced at Bocheonsa Temple in Okgu in 1634). According to the votive inscription, the stone sculptures of the Ten Kings and their attendants were produced in 1677 under the supervision of the monk sculptor Seongil. However, these are the only known Buddhist images produced under Seongil, and no details about other monks involved in the production have ever been found, making it difficult to speculate about their lineage. Historical records do suggest that Seongil worked on other projects to produce or repair sculptures with disciples of the monk sculptors Hyehi or Unhye, indicating amicable relations between the two groups. Unlike most such images in the Honam or Yeongseo regions, the Ten Kings at Magoksa Temple are made from stone, rather than wood or clay. Also, the overall form and the drapery conform to statues of the Ten Kings that were popularly produced in the Yeongnam region. Thus, the images are believed to be the work of monks who were primarily active in Yeongnam, rather than Honam. In the future, a systematic investigation of wooden seated Ksitigarbha Bodhisattva images and stone Ten Kings of Hell images produced in the Chungnam region could illuminate more details about the production of the images at Magoksa Temple, and perhaps shed light on the conditions that led to the production of stone Buddhist sculptures in the Honam area during the late seventeenth century.

• MISULJARYO - National Museum of Korea Art Journal
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• v.96
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• pp.209-223
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• 2019

The Iron Seated Buddha sculpture in the National Museum of Korea had long sat unregistered in storage at the museum. However, a new accession number "bon9976" has recently been assigned to it. This sculpture was excavated from the neighborhood of Heungnyongsa Temple in Baekun-ri, Yidong-myeon, Pocheon-gun, Gyeonggi-do Province together with another Iron Seated Buddha sculpture(bon9975) called "Iron Buddha from Pocheon." A comparison and examination of Gelatin Dry Plate and official documents from the Joseon Government-General Museum during the Japanese occupation period have revealed that these two Iron Buddha sculptures were transferred to the Museum of the Government-General of Korea on December 17, 1925. The Iron Seated Buddha sculpture(bon9976) has a height of 105 centimeters, width at the shoulders of 57 centimeters, and width at the knee of 77 centimeters. The Buddha is wearing a robe with rippling drapery folds and the right shoulder exposed. He is seated in the position called gilsangjwa(the seat of good fortune) in which the left foot is placed over the right thigh. The features of the Buddha's oval face are prominently sculpted. The voluminous cheeks, eye sockets in a large oval shape, slanted eyes, short nose, and plump lips can also be found in other ninth-century Iron Seated Buddha sculptures at Silsangsa Temple in Namwon, Jeollanam-do Province, Hancheonsa Temple in Yecheon, Gyeongsangbuk-do Province, and Samhwasa Temple in Donghae-si, Gangwon-do Province. Moreover, its crossed legs, robe exposing the right shoulder, and rippling drapery folds suggest that this sculpture might have been modeled after the main Buddha sculpture of the Seokguram Grotto from the eighth century. The identity of this Iron Seated Buddha can be determined using the Gelatin Dry Plate(M442-2, M442-7). In them, the Buddha has its right palm facing upwards and holds a medicine jar on its left palm. Until now, the Iron Seated Bhaiṣajyagura(Medicine) Buddha(bon1970) excavated from Wonju has been considered the sole example of an iron Medicine Buddha sculpture. However, this newly registered Iron Seated Buddha turns out to be a Medicine Buddha holding a medicine jar. Furthermore, it serves as valuable material since traces of gilding and lacquering clearly remain on its surface. This Iron Seated Buddha sculpture (bon9976) is presumed to have been produced around the ninth century under the influence of Esoteric Buddhism by the Monk Doseon(827~898), a disciple of the Monk Hyecheol, to protect the temple and help the country overcome geographical shortcomings. According to the records stored at Naewonsa Temple(later Heungnyongsa Temple), Doseon selected three significant sites, including Baegunsan Mountain, built "protector" temples, created the Bhaisajyagura Buddha triad, and enshrined them at the temples. Moreover, the inscription on the stele on the restoration of Seonamsa Temple states that Doseon constructed temples and produced iron Buddha sculptures to help the country surmount certain geographical shortcomings. Heungnyongsa Temple is located in Dopyeong-ri, Yidong-myeon, Pocheon-si, Gyeonggi-do Province. This region appears to have been related to rituals directed to the Medicine Buddha since Yaksa Temple(literally, "the temple of medicine") was built here during the Goryeo Dynasty, and the Yaksa Temple site with its three-story stone pagoda and Yaksadong Valley still exist in Dopyeong-ri.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.178-190
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• 2003

Background : The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. Materials and Methods : 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. Results : In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. Conclusion : Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.