• Clinical and Experimental Pediatrics
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• 제46권8호
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• pp.769-776
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• 2003

목 적 : 한 나라의 건강 지표로 중요한 의의를 갖는 영아 사망의 2/3는 신생아기에 일어나며 주로 저출생 체중아에 의한 것이다. 최근 신생아 집중치료의 발달로 1,500 gm 미만의 극소 저출생 체중아의 생존율이 향상되는 추이여서, 본 연구는 1996년 부터 2001년까지 6년간 전남대학교병원에서 극소 저출생 체중아의 발생 빈도와 생존율 및 이환율 변화를 알아보고자 하였다. 방 법 : 본 연구는 1996년 1월부터 2001년 12월까지 전남대학교병원 신생아 집중 치료실에 입원했던 1,500 gm 미만의 극소 저출생 체중아 565명을 대상으로 하였다. 1996년부터 1998년까지를 전반기, 1999년부터 2001년까지를 후반기로 나누어 기간별 VLBWI의 생존율, 이환율 및 입원 기간의 차이를 비교하였고, 이를 또한 출생 체중과 재태 연령별로도 비교하였다. 생존 환아에서의 이환율은 '단기 질환'과 '장기 질환'으로 질환을 구분하여 비교하였고, 원내 출생아에서의 VLBWI 발생 빈도 및 기간별 변화, 기간별 주산기 인자와 생존율과의 상관관계, 사망 원인에 대해서도 조사하였다. 결 과 : 원내 출생 VLBWI의 발생 빈도는 총 8.3%이었으며 전반기 6.0%, 후반기 11.0%로 후반기에 그 빈도가 증가하였다. VLBWI 총 생존율은 76.8%이었으며, 전반기(71.8%)에 비해 후반기(80.1%)에 향상되었고, 특히 출생 체중 1,000-1,249 gm과 재태 연령 28-30주에서 개선되었다. 주산기 인자 중 후반기에 제왕 절개 분만이 증가하였고, 다태아에 비해 단태아일 경우, 질식 분만에 비해 제왕 절개 분만일 경우에 생존율이 증가하였다. 사망의 빈도는 생후 7일 이전 사망이 전체 사망의 58.8%로 가장 빈번하였다. 사망 원인으로는 신생아 호흡 곤란 증후군이 주요한 원인이었고, 패혈증, 폐출혈 빈도순이었다. 이환율은 전반기(82.5%)에 비해 후반기(92.3%)에 유의하게 증가하였다. 생존한 환아에서 전반기에 비해 후반기에 총 이환율과 단기 이환율은 증가하였으나 장기 이환율은 통계학적으로 유의한 차이가 없었으며, 출생 체중 1,000-1,499 gm과 제태 연령 28-33주에서는 단기 이환율이 유의하게 후반기에 증가한 반면 오히려 장기 이환율은 감소하였다. 생존 환아에서 평균 입원 기간은 전반기에 비해 후반기에 유의하게 연장되지는 않았다. 결 론 : VLBWI의 빈도가 증가하고 생존율이 향상된 반면 이환율은 증가되었다. 그러나, 출생 체중 1,000-1,249 gm과 재태 연령 28-30주에서 현격한 생존율 증가와 함께 '단기 이환율'은 증가되었으나 오히려 '장기 이환율'은 감소하였다.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.443-447
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• 2005

저자들은 지속되는 발열, 빈혈, 혈소판 감소증, 흉수, 복수 및 간비종대 등의 비특이적인 전신증상을 주소로 내원한 13세 남아를 경부 림프절 조직 검사에서 혼합형의 Castleman병으로 진단한 후 스테로이드와 면역글로불린을 투여하여 호전된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.116-121
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• 2008

Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.

• Neonatal Medicine
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• 제25권2호
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• pp.66-71
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• 2018

Purpose: Respiratory morbidity is the most common problem among neonates admitted to neonatal intensive care units. Therefore, the aim of this study was to make a differential diagnosis between transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and pneumonia through comparison of clinical features and test results. Methods: This retrospective study was conducted in 86 infants with TTN, RDS, or pneumonia. These were infants who had respiratory distress, were born after ${\geq}34$ weeks of gestation, and transferred to the neonatal intensive care unit of Kosin University Gospel Hospital between June 1, 2011 and June 30, 2016. Results: The numbers (percentage) of infants with TTN, RDS, and pneumonia were 51 (59.3%), 20 (23.3%), and 15 (17.4%), respectively. Late-preterm and early-term newborns accounted for 65.1% of the infants. Tachypnea was observed in 74.4% of the neonates. The median age at admission was 4 hours (0 to 116) after birth. The infants with RDS had significantly lower birth weights, pH levels, base excess and oxygen saturation levels at admission, longer duration of total ventilator therapy, and hospital stay than those in the other two groups. The infants with pneumonia showed significantly high initial high-sensitivity C-reactive protein levels and significant chest radiographic findings. Conclusion: Early differential diagnosis for TTN, RDS, and pneumonia is challenging because they show similar respiratory symptoms at an early stage. Clinical features and test results can be used to determine the etiology of respiratory distress and early antibiotic treatment.

• 생명과학회지
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• 제5권3호
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• pp.145-150
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• 1995

Alcoholic liver disease is defined by the development of three types of liver damage following chronic heavy alcohol consumption, namely, alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, The clinical features and laboratory tests often do not distinguish among these types of liver injuries. In addition, a considerable number of the patients who have clinical and laboratory features compatible with alcoholic liver disease are diagnosed on liver biopsy to have chronic viral hepatitis or other lesion. Because of these factors, liver biopsy is frequently needed to arrive a definite diagnosis of the disease, its activity, and its chronicity. Fatty liver is usually a benign and reverible condition that disappears on abstinence from alcohol. However, alcoholic hepatitis is usually regarded as a precursor of cirrhosis. The principle factors in the development of alcoholic hepatitis and cirrhosis are the quantity and length of ingestion of alcohol. women are much more susceptible than men to hepatic injuries. Since only 10 - 20% of alcoholics develop cirrhosis, however, it is conceivable that other factors, either genetic, environmental, or nutritional may contribute in the genesis of liver injuries. The most important factor in the treatment of alcoholic liver disease is prolonzed abstinence from alcohol, since abstinence by itself improves clinical status and survival, Nutritional support in patients with nutritional deficiency, and specific drug therapies such as corticosteroid or anabolic steroids for hospitaliged patients with severe alcoholic hepatitis also play an important role in devreasing morbidity and improving survival. Liver transplantation is a newer treatment modality in the patients with advanced cirrhosis, not responsible to medical treatment.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.7-11
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• 2011

Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

• 대한한방소아과학회지
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• 제24권2호
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• pp.88-98
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• 2010

Objectives The purpose of this study is to evaluate the clinical effectiveness and prophylactic treatment effectiveness of Gagam-Bopyeyangyeongjeon(GGBYJ) on the Lung Weakness Children(肺系虛弱兒) who catch cold easily. Methods The study has been carried out from 27 children, who were treated with GGBYJ in Department of Pediatrics, $\bigcirc\bigcirc$ Oriental Medical Hospital from August to December in 2009. The study was completed through patient chart review and telephone survey. Results 1. Immediately after the treatment, there was significantly decreasing(p=0.005) on respiratory symptoms in the Lung Weakness Children(肺系虛弱兒) who catch cold easily. 2. After the treatment, when season changes (three months later), there were preventive and continuous effects on reducing morbidity and on decreasing degree of symptoms against new respiratory infections compared to the previous year before taking medicine. 3. GGBYJ improved the respiratory symptoms, and also anorexia, constipation, heights, skin and fatigue. Conclusions In conclusion, there were significant clinical and preventive effectiveness of GGBYJ for the Lung Weakness Children(肺系虛弱兒) who caught a cold easily. Further studies are needed with more clinical cases.

• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.101-106
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• 2013

Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.13-19
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• 2011

The emergence of antibiotic-resistant pathogens is a Serious clinical problem in the treatment of infectious diseases that increase mortality, morbidity, hospitalization length, and the cost of healthcare. In particular, $Streptococcus$ $pneumoniae$ is a major etiologic pathogen of pneumonia, sinusitis, otitis media, and meningitis. As the definition of penicillin resistance to $S.$ $pneumoniae$ was recently changed, macrolide-resistant $S.$ $pneumoniae$ is a major resistant pathogen in the community. Infections caused by antibiotic-resistant strains are associated with incorrect use of antibiotics and critical clinical outcomes. For the appropriate use of antibiotics to treat infections, physicians always should have up-to-date information on the current epidemiologic status of antibiotic resistance for common pathogens and their susceptibility to antimicrobials. Appropriate selection of antimicrobials, strict control of infection, vaccination, and development of a feasible national policy of infection control are important strategies for the control of antimicrobial resistance. This review article focuses on the current status of antibiotic-resistant $S.$ $pneumoniae$ in community-acquired pneumonia in Korea.