• 한국사회복지학회:학술대회논문집
• /
• 2003.05a
• /
• pp.282-309
• /
• 2003

This exploratory qualitative study investigates the effects of experiencing domestic violence on male adolescent offenders' masculinities. Empirical and theoretical literature suggests that negative male role models in violent families result in male adolescents' experiencing conflict in constructing gender identities, especially masculinities. Moreover. criminologists argue that masculinities are often connected with crimes as a way to prove masculine competence. This study compares male adolescent offenders who have experienced domestic violence with those who have not experienced domestic violence and explores how domestic violence experiences influence the construction of gender identities among male adolescent offenders. The study used a secondary qualitative data analysis method. The data consisted of ethnographic in-depth interview transcripts, observational field notes, and formal facility records collected at a juvenile correctional facility in Minnesota. The process of data analysis was a "constant comparative method" that sought to understand differences and similarities in the expressed gender narratives and identity patterns between the two groups of offenders. This process also examined differences within each group. The qualitative data analysis revealed that domestic violence experiences in childhood may be related to the construction of gender identities during adolescence. The findings of this study showed that male adolescent offenders who had experienced domestic violence tended to attach themselves to oppressed mothers more readily than those who had not experienced domestic violence. Next, their attachment to mothers related to the construction of more relational gender identities although most participants, regardless of domestic violence experiences, had much in common regarding gender expression. Finally, despite these relational gender identities, male adolescent offenders who had experienced domestic violence tended to depend upon violence and crimes to show masculine competence, as did male adolescent offenders who had not experienced domestic violence. The study findings suggest a need for research to understand the construction of gender identities in the context of particular experiences and the importance of building theories that advance a comprehensive understanding of the construction of masculinities and youth crime. This study also discusses the development of social work programs that protect young men from adherence to exaggerated masculinity, which is often associated with crimes.

• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.215-222
• /
• 2009

Purpose: Billroth II gastroenterostomy is a typical reconstruction method after distal gastrectomy for gastric carcinoma, but it has problems, especially frequent reflux esophagitis. Various methods have been tried to address this problem. Among them are Braun enteroenterostomy and Roux-en-Y gastroenterostomy, which are performed separately according to the size of the gastric remnant. The aim of our study was to determine whether these applications are compatible. Materials and Methods: Between September 2003 and April 2007, we performed Roux-en-Y gastroenterostomy operations (14 patients) when the size of the gastric remnant was <10%, Braun enteroenterostomy (17 patients) when the size was between 10 and 20%, and Billroth II gastroenterostomy (14 patients) when the size was between 20 and 40% after subtotal gastrectomy for gastric cancer by a single surgeon at our hospital. We analyzed the results of each treatment. We evaluated the symptoms and endoscopic findings using questionnaires and hospital records. To evaluate nutritional states, we reviewed albumin and hemoglobin levels and body weight changes. Results: All operations were performed safely mortality was 0% and postoperative complications were 8.9%. On endoscopy, reflux gastritis was observed to occur in 7.63%, 18.65% and 40.0%, respectively, of patients who had undergone Roux-en-Y, Braun and Billroth II operations (P=0.13). Reflux esophagitis was observed in 1 patient in the Roux-en-Y group and 1 patient in the Braun group. Endoscopic gastrostasis was observed in 2 patients in the Roux-en-Y group, one of which was thought to cause reflux esophagitis. Patients in the Roux-en-Y group and Braun groups ingested a lower volume of food than did those in the Billroth II group (respectively, 7.1%, 0.0% and 28.7%) and complained less of postprandial discomforts (respectively, 14.3%, 23.5% and 57.1%) and reflux symptoms (respectively 0.0%, 11.8% and 42.9%). Conclusion: The application of Braun enteroenterostomy and Roux-en-Y gastroenterostomy to the small gastric remnant may be effective for reducing reflux symptoms and abdominal discomfort after distal gastric resection. We recommend Roux-en-Y gastroenterostomy when the size of the gastric remnant is <10%, and Braun anastomosis in the others. It will need to be determined which reconstructive procedure is better for many different conditions.

• Journal of The Korean Association For Science Education
• /
• v.19 no.2
• /
• pp.239-247
• /
• 1999

This study is to make suggestion for developing textbook systematically by analyzing biological contents and organization in science textbooks which are important instructional media to accomplish objectives of the 6th middle school science curriculum. The inclusiveness degree of the 6th science educational objectives reflected in the textbooks was analyzed by Klopfer's and the Korean Educational Department's objectives taxonomy. And the biological contents and the organization of the science textbook were analyzed by learner, subject matter, and society dimensions which are selecting criteria for curriculum objectives suggested in Tyler's curriculum model. The analyzed results are as follows: 1. The inclusiveness degree of the educational objectives was very low. 2. Regarding the dimension of learner, the concepts of formal operational cognitive level were much increased as grade becomes higher. And the degree of learner's interests reflected on the learning topics and domains was very low. 3. Regarding the dimension of subject matter, the concept-centered learning was increased, in relation to inquiry learning as grade becomes higher. The analyzed results of inquiry subskills showed that observation, classification, and recording skills in 1st grade, observation and operation skills in 2nd grade, and interpreting data skills in 3rd grade were centered. As the problems and processes were presented, so most of inquiry activities had low openness scale. The learning contexts were organized into discipline-centered in relation to real life. 4. Regarding society dimension, the learning topics of environments and health were much presented. but those of biotechnology and career were presented scarcely. And most learning topics related society dimension were organized in textbooks of the 2nd and 3rd grade. These suggested that to accomplish curriculum objectives effectively. the inclusiveness degree of educational objectives is to increase and, the contents and organization of textbook were constructed harmoniously in aspects of learner, subject matter and society dimensions.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.3
• /
• pp.277-284
• /
• 2006

Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

• Clinical and Experimental Pediatrics
• /
• v.45 no.9
• /
• pp.1134-1140
• /
• 2002

Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

• Clinical and Experimental Pediatrics
• /
• v.50 no.5
• /
• pp.436-442
• /
• 2007

Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

• Neonatal Medicine
• /
• v.17 no.2
• /
• pp.201-206
• /
• 2010

Purpose: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. Methods: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. Results: The mean gestational age and birth weight (BW) of all infants were $27^{+6}{\pm}1^{+6}$ weeks and 951${\pm}$245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033${\pm}$285 g vs. 821${\pm}$126 g, P=0.048) and weight on operation day (1,195${\pm}$404 g vs. 893${\pm}$151 g, P=0.042), longer hospital days (105${\pm}$29 vs. 141${\pm}$39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative $FiO_2$ (0.29${\pm}$0.06 vs. 0.38${\pm}$0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. Conclusion: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high $FiO_2$ might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.

• Korean Journal of Ecology and Environment
• /
• v.36 no.1 s.102
• /
• pp.38-47
• /
• 2003

The water quality of the Pyeongtaek Reservoir and its main streams has been eval uated far water pollution state in March, June, September and December,2000. The following are the findings: $NH_4$ accounts for the majority of TN in the inflow streams. In the reservoir, TN and $NH_4$ are the more present in the winter season and less in the summer season, with $1.6{\sim}2.4$ times of $NO_3$ and $5.3{\sim}11.4$ times of $NO_2$ found in December and June compared with other seasons. The concentration of each component is different between streams: $NH_4$ among inorganic nitrogen has the highest concentration in the upstream, and $NO_3$ is more prevalent in the downstream. SRP accounts for $25{\sim}69%$ of TP in the stream. Unlike N component, P component in the reservoir rapidly decreases from upstream toward downstream, except in the summer. Average SRSi slightly increases in the fall, i.e., immediately after rainfall. In the streams, the average concentration of chlorophyll-a ranges from 9 to $33{\mu}g/l$, and is relatively high in the downstream. In contrast, in the reservoir, it is the highest in the upstream where $NH_4$ and SRP are frequently found. In particular, diatom and cryptomonad algae are bloomed in March, and blue-green algae in September; their maximum values are $108{\mu}g/l$ and $130{\mu}g/l$, respectively. Considering the concentration of N and P nutrients, pollution loads can affect the Pyeongtaek Reservoir in the downstream in this order: Ansong Stream

• Childhood Kidney Diseases
• /
• v.11 no.1
• /
• pp.51-58
• /
• 2007

Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children. Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded. Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups. Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.2
• /
• pp.213-221
• /
• 2005

Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.