• Title/Summary/Keyword: 4구분법

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Predictable risk factors and clinical courses for prolonged transient tachypnea of the newborn (지속성 신생아 일과성 빈호흡을 예측하게 하는 위험인자와 임상경과)

  • Chang, Ji Young;Kim, Chang Ryul;Kim, Ellen A;Kim, Ki Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.349-357
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    • 2010
  • Purpose : Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN). Methods : The medical records of 107 newborns, >$35^{+0}$ weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ${\geq}72$ hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors. Results : Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, $FiO_2$ >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and $FiO_2$ >0.4 within 6 hours of life. Conclusion : When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of $FiO_2$ within 6 hours of life, the infant is at high risk of having persistent tachypnea ${\geq}72$ hours. We need further study to find the way to reduce PTTN.

A Study on the Status of Recognition and Practical Application of Oral Hygiene Devices : with outpatient as the central figure (치과병·의원 내원환자의 구강위생용품에 대한 인지도 및 사용실태에 관한 연구)

  • Kim, Soo-Kyung
    • Journal of dental hygiene science
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    • v.2 no.2
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    • pp.95-103
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    • 2002
  • This study was carried out to investigate recognition level and practical application status of oral hygiene devices through making a survey of Seoul inhabitants. And survey was implemented in order to propose oral hygiene device for household health care activities. The following results were obtained by analyzing personal interviews of 347 commuting patients at two university hospitals and seven dental clinics. 1) The average length of toothbrush head was estimated as 22.3 mm and average changing cycle was 2.3 months. The user ratio of flat-headed brush was estimated as 51.9% and 46.7% were using fluoridated toothpaste. 2) Generally the ratio of toothpick users was higher than other device users. But the user ratio of dental floss was higher than toothpick in case of patients under orthodontic treatment. 3) The patients under orthodontic treatment were not familiar with handling orthodontic toothbrush. Though 45.8% among orthodontic patients recognized this type of toothbrush, only 25.4% of them knew how exactly to use it. 4) It was shown very low user ratio of oral hygiene devices that the patients who had periodontal problem, hypersensitive trouble, halitosis, implant or denture 5) The patients who had halitosis showed the highest user ratio of toothpick. The patients who had separation of teeth showed the highest user ratio of dental floss. The patients who're under orthodontic treatment showed the highest user ratio of interproximal brush and motorized brush. 6) In response to the most interesting dental disease, it's surveyed as follows; 60.3% of dental caries, 24.0% of periodontal disease, 14.8% of false occlusion and 0.9% of oral cancer. 7) Regarding the motivation of using those oral hygiene devices, 45% responded that it was because of recommendation by dental clinics. Among the negative answers, 38.6% responded that it was because of no selection guidance. 31.3% answered that they didn't use hygiene device because it's inconvenient. 12.0% answered that it's difficult to buy and expensive. 7.8% responded that they didn't feel significant improvement. 4.8% answered that dental hospitals and clinics didn't even introduce those hygiene devices. Therefore efficient campaign for those hygiene devices over all Korea nation should be developed and education program must be prepared for each case of patients in every dental hospitals and clinics.

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The Clinical Aspects of Acute Septic Arthritis and Acute Osteomyelitis in Children (소아기 급성 화농성 관절염과 급성 골수염의 임상적 고찰)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.149-156
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    • 2005
  • Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

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Estimation of the Moisture Maximizing Rate based on the Moisture Inflow Direction : A Case Study of Typhoon Rusa in Gangneung Region (수분유입방향을 고려한 강릉지역 태풍 루사의 수분최대화비 산정)

  • Kim, Moon-Hyun;Jung, Il-Won;Im, Eun-Soon;Kwon, Won-Tae
    • Journal of Korea Water Resources Association
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    • v.40 no.9
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    • pp.697-707
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    • 2007
  • In this study, we estimated the PMP(Probable Maximum Precipitation) and its transition in case of the typhoon Rusa which happened the biggest damage of all typhoons in the Korea. Specially, we analysed the moisture maximizing rate under the consideration of meteorological condition based on the orographic property when it hits in Gangneung region. The PMP is calculated by the rate of the maximum persisting 12 hours 1000 hPa dew points and representative persisting 12 hours 1000 hPa dew point. The former is influenced by the moisture inflow regions. These regions are determined by the surface wind direction, 850 hPa moisture flux and streamline, which are the critically different aspects compared to that of previous study. The latter is calculated using statistics program (FARD2002) provided by NIDP(National Institute for Disaster Prevention). In this program, the dew point is calculated by reappearance period 50-year frequency analysis from 5% of the level of significant when probability distribution type is applied extreme type I (Gumbel distribution) and parameter estimation method is used the Moment method. So this study indicated for small basin$(3.76km^2)$ the difference the PMP through new method and through existing result of established storm transposition and DAD(Depth-Area-Duration). Consequently, the moisture maximizing rate is calculated in the moisture inflow regions determined by meteorological fields is higher $0.20{\sim}0.40$ range than that of previous study. And the precipitation is increased $16{\sim}31%$ when this rate is applied for calculation.

Risk Factors for Atrophic Renal Scar (위축성 신반흔의 위험인자)

  • Lee, Jung-Won;Kim, Hyun-Jin;Lee, Seoung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.193-200
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    • 2005
  • Purpose : An atrophic renal scar(RS) is one of the underlying causes for childhood hyper tension and chronic renal failure. The risk factors for atrophic renal scar were evaluated. Methods : 41 children, who presented with first febrile urinary tract Infection at the Ewha Womans University Hospital between 1995 and 2003 and had generalized atrophic RS on $^{99m}Tc-DMSA$ renal scan, were retrospectively studied. Atrophic RS was divided into severe atrophic RS(n=14) if relative uptake on renal scan was below 10$\%$, or mild atrophic RS(n=27) if relative uptake on renal scan was between 10-35$\%$. RS was defined as congenital if the scar was detected on the first renal scan, and as acquired if the scar developed on the follow-up renal scan from acute pyelonephritis of the first renal scan. The control group was consisted of randomly selected 41 children with segmental RS. The risk factors for atrophic RS such as the generation time, VUR, gender and ACE gene polymorphism were evaluated. Results : The age distribution of atrophic RS and segmental RS did not differ significantly (P>0.05). The rate of congenital RS in atrophic RS was 61.0$\%$(25/41), which was significantly higher than 9.8$\%$(4/41) of segmental RS(P<0.01). Atrophic RS developed mote frequently in male children(M:F 68.3$\%$ 31.7$\%$) than segmental RS(M:F 41.4$\%$ .58.5$\%$)(P<0.05). Vesicoureteral reflux(VUR) was found in 92.7$\%$(38/41) of 4he atrophic RS, which was significantly higher than 53.7$\%$(22/41) of segmental RS(P<0.05). In children without VUR, the male to female ratio did not differ between atrophic RS and segmental RS(P>0.05) But in children with VUR, there was a higher proportion of males with severe atrophic RS than segmental RS($85.7\%:45.5\%$) ACE gene polymorphism did not differ between the atrophic and segmental RS groups, irrespective of the presence of VUR(P>0.05). Conclusion : Most atrophic RSs were congenital which could not be preventable postnatally and the major risk factors were VUR and the male gender. ACE gene polymorphism was not the significant risk factor for an atrophic RS. (J Korean Soc Pedialr Nephrol 2005;9:193-200)

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The Clinicopathologic Characteristics of Patients with Gastric Carcinoid Tumor (위 유암종의 임상병리학적 특징에 대한 후향적 연구)

  • Jang, Jeong-Moon;Kong, Seong-Ho;Yoon, Hong-Man;Ahn, Hye-Seong;Lee, Hyuk-Joon;Yoon, Won-Jae;Kim, Sang-Kyoon;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.262-268
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    • 2009
  • Purpose: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). Materials and Methods: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. Results: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1:1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, ${\pm}6.52$). Conclusion: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.

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Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.358-363
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    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

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Carbon Budget Evaluated in Two Urban Parks of Seoul (서울의 두 도시 근린공원에서 평가된 탄소수지)

  • Kim, Gyung Soon;Pi, Jung Hun;An, Ji Hong;Lim, Chi Hong;Jung, Song Hie;Joo, Seung Jin;Lee, Chang Seok
    • Korean Journal of Ecology and Environment
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    • v.49 no.1
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    • pp.51-61
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    • 2016
  • This study was carried out to assess the carbon budget of two urban parks and one natural park and to prepare the plan for improving the ecological functions of the park including carbon sink. Net Ecosystem Production (NEP) of those study sites was calculated from the relationship between Net Primary Production (NPP) and soil respiration of each study site. To understand carbon budget of the whole area designated as the park, carbon budget of the urban park was analyzed by classifying the vegetated and the non-vegetated zones. NEP of the Nohae and the Sanggye parks calculated by reflecting areal size that the non-vegetated zones occupy were shown in -1.0 and $0.6\;ton\;C\;ha^{-1}yr^{-1}$, respectively. On the other hand, NEP of Mt. Bulam natural park as a reference site was in $2.3\;ton\;C\;ha^{-1}yr^{-1}$. Based on the result, the Nohae park was assessed as carbon source rather than carbon sink. On the other hand, the Sanggye park was classified as carbon sink but the role was poor compared with natural park. The result is, first of all, due to lower NPP of the vegetation introduced for the parks compared with natural vegetation. The other reason is due to wide arrangement of non-vegetated zone. To solve those problems and thereby to create the urban park with high ecological quality, selection of plant species suitable for the ecological characteristic of the park, their arrangement imitated natural vegetation, and ecological zoning were recommended.

Studies on Dry Matter Yield s, Chmical Composition And Net Energy Accumlation in Three Leading Temperate Grass Species III. Seasonal changes of chemical components under dfferent cutting managements (주요북방형 목초의 건물수량 , 화학성분 및 Net Energy 축적에 관한 연구 III. 예취관리에 화학성분의 계절적 변화)

  • 김정갑;양종성;한흥전
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.6 no.3
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    • pp.157-163
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    • 1986
  • Synthesis and accumulation pattern of Weender components in orchardgrass (Dactylis glomerata L.) cv. Potomac and Baraula, perennial ryegrass (Lolium perenne L.) cv. Reveille and Semperweide and meadow fescue (Festuca pratensis Huds.) cv. Cosmos 11 and N.F.G. were studied under different growth environments and cutting managements. The field experiments were conducted as a split plot design with three cutting regimes of 6-7 cuts at grazing stage, 4-5 cuts at silage and 3 cuts at hay stage from 1975 to 1979 in Korea and West Germany. The results obtained are summarized as follows: 1. Air temperature, rainfalls and solar radiation were found to be an important meteorological factors influenced to synthesis and accumulation of Weender components. Under high temperature and strong solar radiation during summer season in Korea, accumulation of crude fiber and cell-wall constituents (NDF) in the plants, as average of all grass species and cutting regimes, were increased to about 30.1% and 48.7% from 27,9% and 42.9% in spring, respectively, while total nonstructural carbohydrates (TNC) were decreased to 1.52% in summer from 4.01% in spring. In West Germany, the concentration of Weeder components showed little seasonal variation. 2. Crude fiber and neutral detergent fiber (NDF) were shown higher concentration in orchardgrass than those of perennial ryegrass and meadow fescue, but N-free extractions and TNC as well as net energy value were less accumulated in orchardgrass. Orchardgrass contained lower net energy contents with 534 StE. 431 StE and 575 StE/kg for Suweon, Cheju and Freising, respectively, as compared with 624 StE (Suweon), 491 StE (Cheju) and 657 StE/kg (Freising) in meadow fescue.

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The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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