• Journal of Korean Academy of Nursing
• /
• v.3 no.3
• /
• pp.97-110
• /
• 1973

The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.5
• /
• pp.583-594
• /
• 2000

Dislodgement of a crown or extension bridge and the loosening of a retainer of a bridge is a serious clinical problem in fixed restoration. Generally these problems are considered to be associated with deformation of the restoration. During biting, the restoration is subjected to complex forces and deforms considerably within the limit of its elasticity. Deformation of the restoration under the occlusal force induces excessive stress in the cement film, which then leads to the cement fracture. Such a fracture may eventually cause loss of the restoration. Because most of the past retention tests for full veneer crown were done without fatigue loading, they were not exactly simulating intraoral environment. And the purpose of this study was to evaluate the effect of cyclic cantilever loading on the retentive strength of full veneer crowns depending on different type of cements and taper of prepared abutment. Steel dies with $8^{\circ}\;or\;16^{\circ}$ convergence angle were fabricated through milling and crowns with the same method. These dies and crowns were divided into 8 groups. Group 1 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 2 : $16^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 3 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, without loading Group 4 : $8^{\circ}$ taper die, cementation with zinc phosphate cement, with loading Group 5 : $16^{\circ}$ taper die, cementation with Panavia 21, without loading Group 6 : $16^{\circ}$ taper die, cementation with Panavia 21, with loading Group 7 : $8^{\circ}$ taper die, cementation with Panavia 21 without loading Group 8 : $8^{\circ}$ taper die, cementation with Panavia 21, with loading After checking the fit of die and crown, the luting surface of dies and inner surface of crowns were air-abraded for 10 seconds. The crowns were cemented to the dies, with cements mixed according to the manufacturer's recommendations. A static load of 5kg was then applied for 10 minutes with static loading device. Twenty-four hours later, group 1, 3, 5, 7 were only thermocycled, group 2, 4, 6, 8 were subjected to cyclic loading after thermocycling. Retentive tests were performed on the Instron machine. From the finding of this study, the following conclusions were obtained 1. Panavia 21 showed significantly higher retentive strength than zinc phosphate cement for all groups (p<0.05). 2. There was a significant difference in the retentive strength between $8^{\circ}\;and\;16^{\circ}$ taper for zinc phosphate cement(p<0.05), but no significant difference for Panavia 21 (p>0.05). 3. Cyclic loading significantly decreased the retentive strength for all groups(p<0.05). 4. For zinc phosphate cement, there was 35% reduction of the retentive strength after loading in the $16^{\circ}$ taper die, 25% in the $8^{\circ}$ taper die, and for Panavia 21, 21% in the $16^{\circ}$ taper die, 18% in the $8^{\circ}$ taper die.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.38 no.10
• /
• pp.1324-1330
• /
• 2009

Lindera obtusiloba Blume (LO), which is widely distributed in Korea, Japan and China, has traditionally been used as a popular folk medicine for the treatment of fever, abdominal pain, bruise and extravation. The purpose of this study was to examine the toxicities of the single and 14-day repeated doses in Sprague-Dawley rats orally administrated with LO at doses of 0, 500, 1000, 2000 (14-day repeated toxicity test) and 5000 (single toxicity test) mg (dry weight)/kg of body weight/day. The results showed that there was no difference in body weight change, food intake, water consumption, or organ weight among different dose groups. Also we observed no death and abnormal clinical signs during the experimental period. Between the groups orally administered LO and the control group, there was no statistical significance in hematological test or serum biochemical values. There were no evidences of histopathological alteration as well as abnormal gross finding mediated by single and 14 days treatments with LO. These results suggest that no observed adverse effect level (NOAEL) of the oral application of LO was considered to be more than 2000 mg/kg in rats under the conditions employed in this study.

• The Korean Journal of Health Service Management
• /
• v.2 no.1
• /
• pp.105-124
• /
• 2008

The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

• Clinical and Experimental Pediatrics
• /
• v.49 no.6
• /
• pp.653-658
• /
• 2006

Purpose : Because voiding cystourethrography(VCUG) is an invasive method, we studied whether VCUG could be postponed through evaluation of alternative non-invasive tests including renal ultrasonography and $^{99m}Tc$-DMSA renal scan. Methods : We reviewed the medical records of 175 patients initially diagnosed with febrile urinary tract infection during the one year period of 1999, and compared 3-tests : renal ultrasongraphy, $^{99m}Tc$-DMSA renal scan, and VCUG. Results : Renal ultrasonography didn't contribute to the prognostication of pyelonephritis(photopenic areas) or vesicoureteral reflux(VUR). Presentation of photopenic areas in $^{99m}Tc$-DMSA renal scan was related to VUR. If both findings of renal ultrasonography and $^{99m}Tc$-DMSA renal scans were normal, this condition was closely related to normal results in VCUG. And if both examinations were abnormal, the condition was closely related to VUR. But this state could not always guarantee the normal result from VCUG because of low sensitivity in finding VUR. Conclusion : In cases in which acute phyelonephritis is demonstrated by $^{99m}Tc$-DMSA renal scan, VCUG is required. In addition to this, if the conditions of hydronephrosis, vesicoureteral dilatation, increases of renal volume, and changes of echogenesity are shown by renal ultrasonography, VCUG should be performed. If a patient has difficulty undergoing VCUG, temporary postponement of VCUG can be taken into consideration, but only in cases where both examinations of renal ultrasonography and $^{99m}Tc$-DMSA renal scan are normal. Nevertheless, close observation is be advised even in this case.

• Clinical and Experimental Pediatrics
• /
• v.48 no.11
• /
• pp.1225-1231
• /
• 2005

Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.

• Clinical and Experimental Pediatrics
• /
• v.46 no.7
• /
• pp.702-709
• /
• 2003

Purpose : $IFN{\gamma}$ sentitizes many tumor cells to $TNF{\alpha}$ and FASL-mediated apoptosis by enhancing the expression of TNF or FAS/CD95 receptor and modulating the activation of caspase and Bcl-2 family. It has been reported that $IFN{\gamma}$ and $TNF{\alpha}$ synergistically caused differentiation and growth inhibition of neuroblastoma cells. Even though some neuroblastoma cell express FASR/FASL on the cell surface, they could not induce apoptosis by ligation of the FAS/CD95 receptor. But the treatment of $IFN{\gamma}$ is reported to induce apoptosis in some neuroblastoma cell lines through the CD95/CD95L autocrine circuit. In this study, we examined whether $IFN{\gamma}$ could affect $TNF{\alpha}$ and agonistic FAS/CD95 antibody(CH-11)-induced apoptosis against neuroblastoma cell lines that had shown diverse drug sensitivity and resistance. Methods : CHLA-15, CHLA-90 and LA-N-2 neuroblastoma cells were cultured in IMDM and treated with recombinant $IFN{\gamma}$, $TNF{\alpha}$ and CH-11 antibody. Cell viability was measured by DIMSCAN with a fluorescent calcein-AM. Apoptosis was analyzed through flow cytometry using Annexin V-PE and 7-ADD staining and confirmed by pancaspase and caspase-8 blocking experiments. The expression of TNF RI and FAS/CD95 receptor was evaluated by flow cytometry using the corresponding antibody and PE-conjugated secondary antibody. Results : $IFN{\gamma}$ or $TNF{\alpha}$ alone had no demonstrable cytotoxic effects, whereas both cytokines in combination induced apoptosis synergistically in CHLA-15 and CHLA-90 cells. Although there was no cytotoxicity with the ligation of CH-11 alone in CHLA-90 cells, pretreatment of $IFN{\gamma}$ increased the sensitivity of CH-11-mediated apoptosis. The expression of TNFRI and FAS/CD95R were non-specifically enhanced after treatment of $IFN{\gamma}$ without relation to sensitivity to $TNF{\alpha}$ and CH-11. This finding suggest up-regulation of both receptors may contribute to sensitization of $TNF{\alpha}$ and CH-11-mediated apoptosis by $IFN{\gamma}$ in only sensitive cell lines. Conclusion : $IFN{\gamma}$ induced sensitization of $TNF{\alpha}$ and agonistic FAS/CD95 antibody-mediated apoptosis on some neuroblastoma cells through up-regulation of TNFRI and FAS/CD95 receptor.

• Childhood Kidney Diseases
• /
• v.6 no.1
• /
• pp.48-55
• /
• 2002

Purpose: Thin glomerular basement membrane nephropathy (TGBMN) is recognized as the leading cause of microscopic hematuria in both children and adults. However thinning of glomerular basement membrane (TCBM) has been found in healthy adult and also is known to be associated with various renal diseases such as Alport syndronh, IgA nephropathy and mesangial proliferative glomerulonephritis. The association of TGBM with minimal change nephrotic syndrome (MCNS) has been very rare so that the present study was undertaken to determine the relationship between TGBM and MCNS. Methods: The study population consisted of 49 children with biopsy- proven MCNS who have been admitted to the pediatric department of Kyungpook University Hospital during the past 5 years from 1997 to 2001. Group I consisted of 8 children associated with TGBM and Group II 41 children without TCBM. Various parameters such as age of illness, duration from discovery of illness to the time of biopsy, family history of hematuria and other laboratory tests were compared between these two groups and the following results were obtained. Results: Age distribution showed slightly older age in Group I ($7.1{\pm}3.5$ years) compared to Group II ($4.8{\pm}2.9$ years). However this was not statistically different (P=0.056). Family history of hematuria was noted in 2 cases in Group II. Though statistically not significant, hematuria was seen in 2 out of 8 cases ($25\%$) in MCNS children with TGBM, compared to 7 out of 41 cases ($17\%$) with MCNS children without TGBM. Other parameters such as BUN, creatinine, 24 hours urine protein excretion, serum protein, albumin, cholesterol, and T4/T8 ratio, showed no difference. Also renal biopsy finding showed no significant difference and the thickness of glomerular basement membrane in Croup I was $188{\pm}30nm$. Conclusion: TGBM was found in 8 out of 49 children with MCNS ($16.3\%$). And this high frequency of occurrence indicates that these association is not an incidental findings. Typical clinical findings of TCBMN was not noted in all of the 8 children with MCNS associated with TGBM, suggesting that thinning of glomerular basement membrane (TCBN) is secondary to rather than the cause of MCNS. (J Korean Soc Pediatr Nephrol 2002;6: 48-55)

• Childhood Kidney Diseases
• /
• v.15 no.1
• /
• pp.66-75
• /
• 2011

Purpose: Early diagnosis and treatment of febrile urinary tract infection (UTI) in children is important to prevent kidney damage. This study aims to evaluate the relationship between the presence of pyuria, the severity, and underlying genitourinary anomalies in patients with UTI. Methods: We retrospectively reviewed 293 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from June, 2007 until January, 2010. We divided the patients into two groups, one with the finding of pyuria at admission, and the other without, and compared the fever duration, white blood cell counts (WBC) and C-reactive protein (CRP) in peripheral bloods, hydronephrosis, cortical defects, vesicoureteral reflux and admission period. Results: Among the 293 patients with febrile UTI, 189 patients showed findings of pyuria whereas 104 patients did not. Patients with pyuria showed an increment of WBC ($14,694{\pm}485.2$ vs. $11,374{\pm}451.2/uL$, P <0.05) and CRP ($46.9{\pm}3.9$ vs $17.1{\pm}3.6$ mg/L, P <0.05) in peripheral blood sample. The presence of cortical defects (21.7 Vs 5.8%, P <0.05) and vesicoureteral reflux (15.9 Vs 6.7%, P <0.05) was also increased in patients with pyuria compared to patients without pyuria. There were no specific differences in fever duration, admission period, and hydronephrosis. Within the group with pyuria, CRP in peripheral blood sample increased proportionally with the increment of pyuria (P <0.05). Conclusion: In patients with febrile UTI, the increment of WBC in the urine sample can be a helpful predictor for increased CRP in peripheral blood and acute pyelonephritis.

• Journal of Chest Surgery
• /
• v.31 no.8
• /
• pp.749-755
• /
• 1998

Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.