• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.81-86
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• 2009

Purpose : Febrile convulsions are classified into simple or complex types, the latter being characterized by increased risk of recurrence and progression to epilepsy. This study aimed to delineate the clinical characteristics of complex febrile convulsions. Methods : Between January 2003 and December 2006, 550 children were diagnosed with febrile convulsions at the Department of Pediatrics, Ilsan Paik Hospital. Their medical records were retrospectively reviewed for comparison between simple and complex febrile convulsions, and clinical findings of complex febrile convulsions were clarified. Results : Our subjects comprised a male-to-female ratio of 1.64:1; the age range was from 8 months to 8 years. Simple febrile convulsions comprised 432 cases, i.e., 4 times as many as complex febrile convulsions (118 cases). The causes of febrile illness included acute pharyngotonsillitis (357 cases, 64.9%), pneumonia (55 cases, 10.0%), acute gastroenteritis (37 cases, 6.7%), and otitis media (20 cases, 3.6%). We did not find any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsions, and cause of febrile illness. Regarding subtypes of complex febrile convulsions, repeated convulsions were the most frequent (72.0%), followed by prolonged convulsions (16.9%) and focal convulsions (5.1%). Conclusion : We have reported here the clinical features of complex febrile convulsions. Although the results did not show any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsion, and cause of febrile illness, further studies are essential to delineate complex febrile convulsions.

• Women's Health Nursing
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• v.4 no.2
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• pp.217-230
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• 1998

The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.6.1-6
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• 1982

Papilloma is the common benign tumor of the larynx and the incidence of its malignant change was variable. The authors recently experienced 2 cases of squamous cell carcinoma of the larynx which were considered to be transformed from laryngeal papilloma. Case 1. A 58 year old male patient visited O.P.D. of Department of Otolaryngology of Busan National University Hospital, because of hoarseness for 3 years on May 13th, 1980. At that time, local finding of indirect laryngoscopy revealed whitish hypertrophic papillomatous mass on both vocal cords and anterior commissure, and dirty gray white pseudomembrane on left aryepiglottic fold, and the result of biopsy was squamous cell papilloma. So the laryngeal papilloma was removed under suspension laryngoscopy and then he had no specific treatment in spite of being recommended 5-FU topical spray. On March 5th, 1981, he visited O.P.D. again because of progressive exacerbation of hoarseness with mild dyspnea and histopathological finding was revealed squamous cell carcinoma of the larynx. Seven days later from that day, he visited emergency room due to severe dyspnea, and emergency tracheostomy was performed on sitting position. On April 7th 1981, total laryngectomy was performed successfully and postoperative irradiation therapy was recommended. Case 2. A 47 year old male patient visited our O.P.D. because of hoarseness for 5 years on Sep. 27, 1978. At that time, local finding of indirect laryngoscopy revealed papillomatous mass on left vocal cord and left ventricle and result of biopsy was squamous cell papilloma. So he had been treated with 11 times removal of papilloma, topical spray of 5-Fu and estrogen for 3 years, but the papilloma had been recurred. On Sep. 9th, 1981, he visited O.P.D. because of severe dyspnea and emergency tracheostomy and biopsy was performed. The result of biopsy was squamous cell carcinoma of larynx and total laryngectomy was performed successfully.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.41-50
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• 2007

Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

• Journal of Chest Surgery
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• v.32 no.4
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• pp.373-378
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• 1999

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.519-531
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• 1993

Background: Lymphangioleiomyomatosis(LAM) is a very rare disease occurring in women of reproductive age and leading to progressive respiratory failure despite therapy. But the natural history of this disease is uncertain and although anti-estrogenic agents have been used for more than twenty years, it's efficacy is still in debate. This study was performed to enhance understanding of this fatal disease in Korea by examining clinical, radiological, and pathologic findings of all the previously reported cases of LAM on Korea along with four new cases of LAM whom we report in this paper. Method: Out of twlve cases of LAM previously unpublished and published in domestic papers, two cases whose diagnoses were considered doubtful after review of clinical, radiological, and pathologic findings at "Asian Congress on Lymphangioleiomyomatosis" at Kyoto, Japan in feburary of 1993 were excluded from this study. Six cases which were reported previously and four new cases of LAM whom we report in this paper were analysed for the clinical, radiological, and pathologic characteristics. Results: All ten patients were women with mean age of $33{\pm}7$. The most common symptom was exertional dyspnea and most patients had history of pneumothoraces. Pulmonary function tests showed decreased diffusing capacity. on high resolution computed tomography(HRCT), all the cases had characteristic cysts. Most of the patients did not respond to hormonal therapy. Conclusion: In women of reproductive age, presenting with dyspnea who has a history of pneumothorax, LAM should always be considered as one of the diagnostic possibilities. If suspected, HRCT should be done to look for characteristic cysts and if needed, open lung biopsy should be done to confirm the diagnosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.254-262
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• 2003

Dental caries has a multifactorial aetiology in which there is an interplay of three principal factors: the host(saliva and teeth), the microflora(dental plaque) and the substrate(diet), and a fourth factor time. There is no single test that takes into consideration all these factors and can accurately predict an individual's susceptibility to dental caries. The risk of dental caries can be evaluated by analysing and integrating several causative factors. The objective of the study was to clarify the relationship between caries activity and the status of caries of primary teeth and the relationship between the quantity of S. mutans in the dental plaque and the status of dental caries. Forty nine children ages 5 were examined with caries indices, Dentocult-SM and quantity of S. mutans. The results were as follows: All the survey results were similar with national means of 5-6 years Korean preschool children. The deft index of subjects was 5.46 and defs index was 9.81. There was 8.6% of negative, 10.9% of mild, 28.1% of moderate and 52.3% of active results at screening strip test. 8.6% was negative, 17.2% was mild, 33.6% was moderate and 40.6% was active in site strip test. The Spearman correlation coefficient was 0.775, and overall kappa index was 0.496 between screening strip test and site strip test. There also was a high correlation between caries incidence, Dentocult-SM test, and quantity of S. mutans. Dentocult-SM test as a caries activity test is a reliable method for measuring the status of dental caries in primary teeth.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.295-302
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• 2009

Purpose : To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. Methods : Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed. Results : The mean gestational age ($27^{+6}2^{+3}$ vs. $28^{+5}{\pm}$2^{+6}$) and birth weight (979${\pm}$241 g vs. 1,071${\pm}$271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period. Conclusion : GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.

• The korean journal of orthodontics
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• v.26 no.3
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• pp.255-265
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• 1996

The purpose of this study was to investigate if there were a significant difference between cephalometric measurements of mandibular position derived from a centric occlusion tracing compared to those of a converted centric relation tracing in the Class III malocclusion. The sample consisted of 25 Class III malocclusion and 25 normal occlusion persons who had no orthodontic treatment. The records included an lateral cephalometrics in centric occlusion, centric relation and centric occlusion bite registration and diagnostic casts mounted on the SAM II articulator in CR. The amount of CR-CO discrepancy of condyle was recorded using a MPI(Mandibular Position Indicator, MPI $200^{(R)}$, Great Lakes Orthodontics, USA). The conversion of the CO cephalogram to CR using the MPI readings was performed on the Conversion work sheet. Measures of mandibular position were chosen for the purpose of this study. The comparison of the difference between CO and CR cephalometric measurements in the normal occlusion and Class III malocclusion group were studied. The results were as follows: 1. In the features of CR-CO discrepancy of the condyle, the condyle was displaced posterior and inferior when the teeth were in centric occlusion. The horizontal component(${\Delta}X$) in Class HI malocclusion group was greater than the vertical component(${\Delta}Z$) and also greater than the horizontal component(${\Delta}X$) in normal occlusion group. There was no statistically significant correlation between MPI measurements and the groups of normal occlusion and Class III malocclusion group. 2. In the comparison of the cephalometric measurements in each group, Normal occlusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity and ODI. Class HI malocclusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity, ODI, SNB, APDI, L1-FP and it had more significance than the normal occlusion group. 3. The Value of cephalometric measurements was significantly different between CO and CR but there were no differences between the groups of normal occlusion and Class III malocclusion. The results of this study suggest that if the discrepancies are greater than the amount of normal displacement from clinically captured centric relation, centric relation should be considered as the starting point for proper diagnosis and treatment planning.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1008-1012
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• 2003

Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. Results : The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. Conclusion : The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.