• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.427-436
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• 2001

Objective : To estimate the prevalence of congenital heart disease from the 1990 student heart disease screening program. Methods : The heart disease screening program for elementary students was conducted in Kyonggi-do, in 1998. The subjects of the present study comprised the 40,402 students who attended the schools in the catchment area of a collaborative university hospital and who participated in the primary examination. The congenital heart disease (CHD) patients were initially identified through a questionnaire about prior medical history, and further through diagnostic tests & medical examinations in the secondary & the tertiary examinations. Certain assumptions were used in the estimation of the number of CHD cases among non-participants of the secondary & tertiary examinations. The overall prevalence of CHD was estimated by adding the CHD detection rates of the participants and the estimated prevalence of the non-participants. Results : Among the 40,402 primary participants, 1,655 were referred further, of whom 79.1% (1,309) participated in the secondary examination. Of these, 121 were referred to the tertiary examination, with a participation rate at this last stage of 80.2%. The positive predictive value (PPV) of the screening tools was the highest when the results of both EKG and the questionnaire were positive. Because 85.9% of the detected cases had a past history of CHD, PPV was higher when the selection criteria in the questionnaire included past CHD history than when it didnt. The CHD defection rate among the participants was 1.76 cases/1,000 and the presumed number of cases among the non-participants was 31; giving an estimated final CHD prevalence of 2.52 cases/1,000 (95% CI : 2.06-3.06). Among the identified cases of CHD, VSD (52.8%) was the most common, followed by PDA (9.7%), TOF (9.7%) & PS (9.7%). Conclusion : Because the characteristics of the non-participants differed from those of the participants, the estimation of prevalence was influenced by the participation rate. Of the detected cases, 85.9% had a past history of diagnosis or operation for CMD. These findings suggested that the prevalence estimated in this study may be an underestimation of the actual condition. Therefore, a birth cohort study is required in order to more accurately estimate the prevalence and the effects of the program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.570-577
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• 2017

The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.154-161
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• 1997

Background : Although the long term adverse effects of cigarette smoking on health are well known, the acute possible detrimental effects of smoking on pulmonary or cardiovascular function, especially when these systems are stressed by the metabolic demands of exercise, have not been well studied The purpose of this study is to determine the acute action of cigarette smoking on cardiopulmonary function under stress. Method : Twenty -one healthy smoking subjects were studied. Before exrecise testing, history taking, physical examination and baseline studies, including CBC, chest PA, PFT and EKG, were done. The subjects performed an incremental bicycle exercise test to exhaustion on two occasions, one without smoking and the other after smoking 5 cigarettes/h for 2 hours. All indices of P.F.T. and bicycle ergometry were compared between before and after smoking. Results : 1. $VO_2$max and $O_2$ pulse showed significant decrease in smoking day. 2. Although there were no significant differences, anaerobic threshold showed a tendency of decrease and HRmax showed that of increase in smoking day. 3. P.F.T. and respiratory indices showed no significant change io smoking day. Conclusion : Cigarette smoking has immediate adverse effect, especially on the cardiovascular system rather than the respiratory system. These results would be due to the effect of elevated HbCO and/or impaired blood flow in response to the exercise stimulus.

• Korean Journal of Veterinary Research
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• v.41 no.3
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• pp.437-445
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• 2001

This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis and to evaluate the embolized kidney using B-mode ultrasonography and selective angiography. Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. Ultrasonographic findings revealed that size of the kidney was significantly increased at 9 days and 17 days and the length of renal cortex was significantly decreased at 17 days after ligation of the unilateral ureter and it was in accordance with dilation of ipsilateral renal pelvis. No significant change of BUN, creatinine, ALT, calcium, and phosphorus was found immediately after unilateral experimental hydronephrosis. Therefore, it was concluded that unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and respiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. Average ethanol dose for renal artery embolization was $1.94{\pm}1.24ml/kg$. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. Ultrasonographically, the mean longitudinal length of the embolized kidney decreased significantly at 2 and 3 months after TAE-RA compared to that of contralateral normal kidney. In summary, marked shrinkage of the embolized kidney was observed in dogs with unilateral experimental hydronephrosis treated by TAE-RA with iohexol-ethanol and no adverse effects were observed throughout the observation period. It is concluded that TAE-RA with iohexol-ethanol solution is a viable alternative to nephrectomy in dogs with unilateral hydronephrosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.21-27
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• 2008

Purpose: The aim of this survey was to analyze the choice of sedative drugs and their side effects during pediatric endoscopic sedation in Korea. We also evaluated doctors, caretakers and patient satisfaction with the procedures. Methods: Between June 2006 and July 2006, a 16-item survey regarding current sedation practices, during one month, was mailed to 28 hospitals in Korea. The results of the survey responses were then analyzed. Results: Endoscopy performed under conscious sedation was reported in 89.0% of the responders and endoscopy under general anesthesia in 0.9% of 465 endoscopic procedures. Endoscopy under conscious sedation was performed in 89.1% for upper gastrointestinal endoscopy (GFS) and 88.1% for lower GFS. Midazolam was used for conscious sedation during the endoscopy in 84.5% of cases and propofol was used in two cases (0.5%). In addition, a bezodiazepine/opioid combination was used iin 84.6% (44 cases) for lower GFS. Patients were monitored with pulse oxymetry, EKG (91.4%) as well as automatic BP (5.1%). Transient hypoxia was the only side effect noted and was treated with supplemental oxygen (4.6%). Flumazenil was used in 2.71% of cases. The choice of sedation was made by the endoscopist (84%). The satisfaction rate for endoscopists was 68%, and for the patients and caretakers was 84% (as reported by the endoscopists). Conclusion: Midazolam was used only for the upper GFS and benzodiazepine/opioid combination was used for the lower GFS in Korea. The rate of satisfaction was relatively high and there were no significant side effects noted during the endoscopy under conscious sedation.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.386-392
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• 1996

Preoperative and postoperative evaluation was done in 60 adult patients above 20 years of age among 152 patients, who had operation for the congenital atrial septal defect from January 1984 to June 1993 in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Anatomically, the secundum type defect was present In 58 cases and the other two were ostium primum type defect. The defect were closed directly in 45 cases and with patches in 15 cases. Preopera ive EKG findings revealed regular sinus rhythm in 81%, arrhythmia 19%, RVH 32%, RAD 30%, Postoperative findings were regular sinus rhythm in 76%, arrhythmia 24%, RVH 25%. RAD 25%. In hemodynamic data, the mean SPAP in patients over 40 years old was 41.91 $\pm$ 14.33mmHg compared to 31.46 $\pm$ 13.77 mmHg in patients under 40 years old, and the difference between the two groups was stastistically significant. And then the patients were classified into two groups (group A sinus group, and group B : arrhythmia group) according to their preoperative rhythm. The patients in group B were older, had greater value of mean SPAP and Rp/Rs. Mean Qp/qs was higher in group A. But the difference between two groups about the mean Qp/qs and Rp/Rs was not significant. Postoperative complications such as arrhythmia, pneumothorax or hemothorax occurred in 7 cases, but there was no operative mortality. The functional improvement were remarkable in half of the patients who underwent surgery.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.381-387
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• 2006

Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

• The Korean Journal of Emergency Medical Services
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• v.15 no.1
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• pp.47-63
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• 2011

Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.232-241
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• 1998

음주습관과 심혈관계 질환 위험요인사이의 관련성을 파악하기 위하여, 1996년 한국 경북에 있는 도시지역 한 철강회사에서 40-50대(40-59세) 남자 근로자 3444명으로부터 공복시 혈액을 10m1 채취하여 혈청지질, 혈당, Uric acid를 측정하고 신장, 체중, 혈압(10-20분 휴식후 측정)과 EKG를 측정하였다. 과거병력, 현재 건강상태, 음주량과 기간 및 음주종류를 포함한 생활습관, 흡연량/일, 운동시간/주 등의 설문지를 작성하였다. 알콜 소비량은 양-빈도의 Index에 의해 측정되었다. 한국 중년 남자에 대한 음주량, 음주기간, 알콜종류등에 따른 심혈관계 질환의 위험요인 유무 정도를 알아보기 위해, 비음주자를 기준으로하여 비교대상군은 금주자와 음주량(2군) 등에 의해 3군으로 분류하였으며, 음주기간에 따른 심혈관계 질환의 위험요인 유무정도를 알아보기 위해 비음주자을 기준으로하여 비교 대상군은 금주자와 음주기간(4군)에 따라 5군으로 분류하였다. 알콜종류에 따른 심혈관계 질환의 위험요인 유무정도를 알아보기 위해 비음주자을 기준으로하여 비교 대상군은 금주자와 음주알콜종류(3군)에 따라 4군으로 분류하였다. 심혈관계 질환 위험요인은 기준되는 범주를 2개(Table 1)로 분류하여 2*2표를 이용하여 odds ratio(dummy variable로 처리), ${\beta}$-coefficient와 표준오차를 이용해서 신뢰구간(95% C.I.)을 구하여 유의성 검정을 하였다. 금주자의 정의는 과거 3달 이상 술을 마시지 않는 사람을 말한다. 연구 집단의 평균 연령은 $44.4{\pm}3.9$세 이며, 비음주자는 649명으로 18.9%, 금주자는 70명(2.0%)이며 음주자는 2725명(79.1%)이다. 음주자중 에타놀 섭취를 평균 100.5g/주(median) 미만인 군은 1239명으로 연구집단 3444명중 35.7%이며, 평균 100.5g/주(median) 이상 음주군은 1276명으로 44.5%이었다. 3444명중 1532명(44.5%) 이 맥주와 소주를 섞어서 마시는 사람이었다. 음주 양에서, 연령, 흡연 양, 흡연 기간, 운동, 음주기간, 알콜종류 등을 통제하여 logistic regression한 결과, 비음주자에 비해 중정도 음주자(${\ge}$100.5gm/week ethanol)의 확장기 혈압의 Odds ratio는 1.33배로 유의하게 높았다(P<0.05). 다른 요인들은 통계적으로 유의한 차이를 보이지 않았다. 알콜종류에서도 연령, 흡연 양, 흡연 기간, 운동, 음주양, 음주기간, 등을 통제한, 비음주자에 비해 맥주와 소주를 섞어 마시는 음주자의 확장기 혈압의 Odds ratio는 1.38배로 유의하게 높았다(P<0.01). 다른 요인들은 통계적으로 유의한 차이를 보이지 않았다. 반면에 음주 습관 중 음주기간에서는 연령, 흡연양, 흡연 기간, 운동, 음주양, 알콜종류 등을 통제한 logistic regression 분석 결과 유의한 차이를 보인 것은 없었다. 그러나 음주기간과 심혈관계 질환 위험요인중 수축기와 확장기 혈압과의 관계는 J 모양을 나타내었다 . 수축기 혈압의 금주자군은 비차비가 1.0보다 약간 낮고(Odds ratio=0.88) 음주기간이 2-10년인 군의 Odds ratio=1.14, 음주기간이 11-20 년인군의 Odds ratio =1.18, 21년 이상인 군의 Odds ratio=1.20로 비음주자의 odds ratio=1에 비해 점차적으로 위험이 높아졌다. 확장기 혈압의 금주자군은 비차비가 1.0보다 약간 낮고(Odds ratio=0.91), 음주기간이 1년 이하인 군의 Odds ratio=1.18, 음주기간이 2-10 년인 군의 Odds ratio=1.23, 음주기간이 11-20 년인 군의 Odds ratio=1.27, 21년 이상인 군의 Odds ratio=1.27로 비음주자의 odds ratio=1에 비해 점차적으로 위험이 높아졌다.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.49-54
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• 2000

Background: Echocardiography is rapidly establishing itself as the primary diagnostic technique for investigation of children with heart diseases, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analyzed data on the patients referred to the pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. Methods: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. Results: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(67 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6% (26R cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral ed to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia01.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia. 13 cases(3.0%); normal heart. 144 cases(33.6%). Conclusion: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patients were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Therefore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.