• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.136-145
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• 2002

Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.46-52
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• 1997

Urinary tract infection (UTI) in children has been known to be a cause of renal damage, leading to scar formation, hypertension and renal failure. And vesico-ureteral reflex (VUR), frequently accompanying UTI in young children, has been incriminated as the main factor causing scar formation. This retrospective study has been undertaken to see the relationship among UTI, VUR and renal scar formation. Study population consisted of 291 children (boy 134, girl 42) with UTI, who have been admitted to the Pediatric Department of Kyungpook University Hospital during 6 1/2 year period from January 1990 to June 1996. VUR was diagnosed by VCUG and renal scar by ultrasonogram, DMSA scan (or DMSA SPECT) and IVP. The following result were obtained. Sexual difference showed male predominance (male to female, 134:42) below 1 year of age, and female predominance (male to female, 11:35) over 5 years of age were rioted. VUR has been found in 64 children (22%) and the degree of reflux, classfied by the method proposed by 'International Reflux Study in Children', were as follows ; Grade I : 4.0%, Grade II : 3.0%, Grade III : 2.7%, Grade IV : 5.8% and Grade V : 6.2%. There was no sexual difference E.coli was the most predominant infecting agent occurring in 167 children (57%), and end-stage renal failure was diagnosed at the time of first admission in 5 children with Grade V VUR. Renal scar has been noted in 49 out of 582 kidneys (8.4%), and the incidence of scar foramation according to the degree of VUR were as follow ; Grade 0 (No reflux) : 1.2%, Grade I : 6.7%, Grade II 27.3%, Grade III 29.4%, Grade IV : 57.1%, and Grade V : 100%. In summary, present study shows that renal scar formation in UTI has close correlation with the severity of VUR occurring more frequently in severe reflux, so that early diagnosis and proper treatment of UTI and VUR is of paramount importance in preventing renal damage in children with UTI.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.65-73
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• 2007

Purpose : Voiding cystourethrography(VCUG) is a commonly performed diagnostic procedure in children with urinary tract infections. Recently, with the widespread use of prenatal ultrasonography, VCUG is performed as part of the postnatal radiological evaluation of asymptomatic infants with prenatally detected hydronephrosis. The procedure is relatively simple but it involves discomfort and some complications. We studied post procedural symptoms and complications in children who underwent VCUG. Methods : This study reviewed 259 patients who underwent VCUG in our hospital between October 2005 and September 2006. We did a chart review and a telephone interview with the patients' parents about symptoms and complications associated with VCUG. Results : Among 269 children, 217 patients(80.7%) were under 2 years of age and 5 patients (1.9%) were over 8 years of age. Their mean age was $13.1{\pm}22.9$ months. After VCUG, dysuria was found in 49 patients presented with dysuria, and irritability in 36 patients with irritability. Other complications were hematuria, fever, frequency, bladder rupture and urinary tract infection. Mean symptoms duration was $1.4{\pm}0.7$ days. There was no significant relationship between prophylactic antibiotics use and complication rate associated with VCUG. Conclusion : Our study demonstrated that 32.7% of patients showed complications including bladder rupture and urinary tract infection after VCUG. We also found that prophylactic antibiotics use did not prevent urinary tract infection nor decrease the rate of complications associated with VCUG. Therefore, we suggest that the procedure must be done carefully and aseptically, and we should closely observe the children who undergo VCUG for development of possible complications.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.157-163
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• 2005

Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.129-136
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• 1987

To determine the hepatitis 8 virus infection rate of the medical school students and appropriate time for immunization with hepatitis B vaccine,355 students in the 1st, 2nd and 3rd grades of Medical School of Kyungpook National University who had not been vaccinated and volunteered to participate in this study were tested for HBsAg, anti-HBs and anti-HBc with radioimmunoassay method (Abbott Lab. kit). A questionnaire was administered to ask the history of transfusion, acupuncture and surgery. HBsAg positive students were retested 16 months after the initial test. Overall HBsAg positive rate was 6.8% and the age adjusted rate for male (7.2%) was higher than that for female (4.9%). Anti-HBs positive rate was 35.3% (36.1% for male, 37.9% for female) and anti-HBc positive rate was 45.5% (46.5% for male,44.7% for female). Overall hepatitis B virus (HBV) infection rate was 49.1% and the infection rate for male (50.3%) was slightly higher than that for female (46.5%). HBsAg positive rate and infection rate were increased as the grade increased but it was attributed to the age distribution of the students. HBaAg positive rate for 20 years old students was 1.7%; 21 years, 6.6%; 22 years, 6.1%; 23 years, 12.2%; and 24 years and older, 6.4%. HBV infection rate showed an increasing trend as age increased; 45.8% for 20 years,41.5% for 21 years, 49.5% for 22 years, 55.5% for 23 years and 59.6% for 24 years and older. The age differences in HBsAg positive rates and HBV infection rates did not reach the statistical significance level of 0.05. However, these findings and similar age differences in HBsAg positive rates and HBV infection rates observed in other study suggest that there is a significant age differences. Study of the same age group in other schools and different social classes is warranted to confirm the age difference. Clarification of the reason for such differences would provide a clue to identify the major route of HBV transmission in this age group. Among 26 HBsAg positive students in the initial test, only one student was active hepatitis patient. Out of 24 students who had follow-up test after 16 months 22 students were positive for HBaAg and two students became HBsAg negative and anti-HBs positive. It is obvious that nearly one-half of the medical school students were infected with HBV before 20 years of age and the HBV infection occurs in medical school. Thus, it is recommended to test all the students for HBV infection soon after the admission to the medical school and immunize all the susceptible students with hepatitis B vaccine and give booster as they start to practice at a hospital.

• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.352-361
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• 1987

During the period of May 10 to June 6, 1987, we have conducted the survey about the number of the food daily taken and the intake of nutrition of the 83 pregnant women who have registered at Sudong Myun and Mikum-myun, Yangchu-gun which are demonstration area of the public health and medicine of the College of Medicine, Ewha Women's University, and of the 100 pregnant women who have been to the University Hospital attached to the above School. The result of the survery is as follows: 1) Among the above pregnant women, primigravida constituted 91 women and multigravida 92 women. As for the month of pregnancy, those who have been pregnant for ten months numbered 43 women (23.5%), which was the highest number. As for age, those who were 25 to 29 years old constituted 63.9% , which was the highest in percentage. 2) As for the level of education, those who graduated from high school constituted 49.2%, which was the highest in percentage. As for occuptation, those who were entirely in charge of household affairs as housewives were 89.6% , which comprised most of the jobs held by the above women. 3) As for the composition of a family in environmental food and nutrition, one generation was 68.3%, and two member family was 42.6% which was the highest. As for those taking rare of cooking and serving meals, housewives constituted 95.1%. 4) As for the economic situation of dietary life, those who were in the highest level (A level), were 47.0% in an urban area and 41.0% in a rural area, which were the highest in percentage. 5) The food which the above people selected after being pregnant was fruit not only in an urban area, but also in a rural area. And in terms of the percentage of fruit, an urban area and a rural area showed 44.0% and 54.2% respectively. As for milk, and urban area and a rural area showed 28.0% and 8.4% respecitively, which disclosed that the rate of a rural area was much lower than that of an urban area. 6) As for the number of food intake, 10-14 was 54.0% in an urban area, which was the highest. And 5-9 was 73.5% in a rural area, which was the highest. 7) As for the composition of food taken according to the number of food taken, meat showed the lowest rate in 5-9 group. (p<0.05) As the number of food taken increased, the rate of food taken (points) increased (2.4). Milk and milk products showed a low rate in 5-9 group and 15-19 group (p<0.05). Fruit intake showed a similar rate in all groups. As for vegetables, the rate of intake was high, as the number of food taken increased. Cereals showed a similar rate in all groups. Ans the points of intake was high. As for fat, the rate of intake was high, as the number of food taken increased. 8) In 5-9 group in the number of food intake, energy was 79.9% of RDA, protein was 64.9%, fat was 90.0%, carbohydrate was 81.6%, iron was 83.0%, calcium was 71.1%, vitamin A was 94.3%, vitamin $B_1$ was 77.8%, vitamin $B_2$ was 79.2%, and vitamin C was 88.2%, so that it showed the lowest sufficiency rate RDA. 15-19 group maintained the balance in energy and all nutrients nealy. In 20-24 group, fat was 142.4%, vitamin $B_2$ was 105.6% and vitamin C was 102.2%, so that it exceeded RDA.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.175-186
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• 1997

Purpose : To evaluate the qualitative immunologic changes by ionizing radiation. we studied the altered capacities of the macrophages and lymphocytes to produce cytokines in conjunction with resistance to Listeria monocytegenes (LM) infection in mice Materials and Methods : BALB/c mice and Listeria monocytogenes were used. The mice were infected intraperitoneally with $10^5LM$ at 1 day after irradiation (300cGy) and sacrificed at 1, 3, 5 days after infection, and then the numbers of viable LM per spleen in the irradiated and control group were counted. Tumor necrosis factor-alpha ($TNF-\alpha$), interferon-gamma ($IFN-\gamma$). interleukin-2 (IL-2), and nitric oxide (NO) were assessed after irradiation. Results : Under gamma-ray irradiation with a dose range of 100-850cGy, the number of total splenocytes decreased markedly in a dose-dependent manner, while peritoneal macrophages did so slightly Cultured peritoneal macrophages produced more $TNF-\alpha$ in the presence of lipopolysaccharide (LPS) during the 24 hours after in vitro irradiation, but their capacity of $TNF-\alpha$ Production showed a decreased tendency at 5 days after in vivo total body irradiation. With 100cGy and 300cGy irradiation, cultured peritoneal macrophages produced more NO in the presence of LPS during the 24 hours after in vitro irradiation than without irradiation. Activated splenocytes from irradiated mice (300cGy) exhibited a decreased capacity to Produce IL-2 and $IFN-\gamma$ with Concavalin-A stimulation at 3 days after irradiation. When BALB/c mice were irradiated to the total body with a dose of 300cGy, they showed enhanced resistance during early innate phase, but a significant inhibition of resistance to LM was found in the late innate and acquired T-cell dependent phases. Conclusion : These results su99es1 that increased early innate and decreased late innate and acquired immunity to LM infection by ionizing radiation (300cGy) may be related to the biphasic altered capacity of the macrophages to produce $TNF-\alpha$ and the decreased capacities of the lymphocytes to produce IL-2 and $IFN-\gamma$ in addition to a marked decrease in the total number of cells.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.368-372
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• 1999

Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.462-469
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• 2006

Background: Pneumonectomy for inflammatory lung disease has been of major concern because of its associated morbidity and mortality, particularly with respect to pleuropneumonectomy. The purpose of this study is to evaluate the surgical outcomes, and identify the risk factors contributing to postoperative complications in patients undergoing pleuropneumonectomy. Material and Method: Ninety-eight patients underwent pneumonectomy for benign inflammatory lung disease were retrospectively analyzed. Pleuropneumonectomy (Group A) was done in 48 patients and standard pneumonectomy (Group B) was done in 50 patients. Clinical characteristics, postoperative complications were examined and compared between 2 groups. In pleuropneumonectomy group, postoperative risk factors affecting morbidity were evaluated. Result: There was one in-hospital death. Twenty-three major postoperative complications occurred in 21 patients (21.4%). The common complications were empyema and bronchopieural fistula (BPF) in 8 (8.4%), re-exploration due to bleeding in 8. At least one postoperative complication occurred in 14 of 48 patients from Group A (29.2%) and in 7 of 50 patients from Group B (14%). In Group A, empyema and BPF encountered in 6 and re-exploration for bleeding in 6 were the most common complication. In univariate analysis, right pneumonectomy, completion pneumonectomy, large amount of blood loss (>1,000 mL), and intrapleural spillage were risk factors contributing to postoperative complications in Group A. In multivariate analysis, intrapleural contamination during operation was a risk factor of postoperative complication. Conclusion: The morbidity and mortality rates of pneumonectomy for chronic inflammatory lung disease are acceptably. However, we confirm that pleuropneumonectomy is a real technical challenge and a high-risk procedure and technically demanding. Meticulous surgical techniques are very important in preventing serious and potentially lethal complications.