• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.498-510
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• 2012

Objectives : This study was designed to find out whether there is a correlation between qi-stagnation score and pressure pain threshold (PPT) on acupuncture point $CV_{17}$ in burning mouth syndrome (BMS) patients. Methods : Thirty BMS patients who newly visited Oral Disease Clinic at the Kyung Hee University Korean Medicine Hospital were surveyed. The subjects were evaluated on age, illness duration, sex, self-assessed severity of BMS, qi-stagnation score, and PPT on 3 acupuncture points ($CV_{17}$, Rt. $SP_9$, Lt. $SP_9$). Results : There was significant correlation between age and PPT on $CV_{17}$ (p=0.005). Therefore, partial correlation analysis with age as control variable was done, and the result showed significant correlation between qi-stagnation score and PPT on $CV_{17}$ (p=0.001). Qi-stagnation diagnostic point by PPT on $CV_{17}$ was suggested as 3.8056 $kg/cm^2$ based on the fact that diagnostic score is 28.50 in the qi-stagnation questionnaire. Furthermore, considering that PPT is effected by age, we could attain qi-stagnation diagnostic equation of PPT on $CV_{17}$, that is suggested as $0.047{\times}(age)+0.848kg/cm^2$. PPT of 3 acupuncture points ($CV_{17}$, Rt. $SP_9$, Lt. $SP_9$) was compared, and the result showed that PPT was significantly lower on $CV_{17}$ (w/Rt $SP_9$: p=0.022, w/Lt. $SP_9$: p=0.012). Also, significance and correlation coefficient with qi-stagnation were higher on $CV_{17}$ (p<0.001, r=-0.620) than Rt. $SP_9$ (p=0.023, r=-0.413) or Lt. $SP_9$ (p=0.014, r=-0.444). Conclusions : The result of this study suggested that PPT on $CV_{17}$, measured quantitatively by algometer, had a strong correlation with qi-stagnation score in BMS patients. Therefore, the study showed that $CV_{17}$ can be a useful acupuncture point in diagnosing qi-stagnation by measuring PPT in BMS patients.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.185-192
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• 2017

Objectives : The aims of present study was to investigate clinical characteristics of male patients with eating disorders. Methods : The present study included 32 male patients with eating disorders and 75 female patients with eating disorders, recruited from an eating disorders specialized clinic in a university hospital, Seoul, Korea. We compared clinical characteristics of eating disorders and comorbid conditions of depression and anxiety between men and women with eating disorders. Correlations between eating disorders psychopathology in men with eating disorders and their weight suppression(WS) were investigated. Results : There was no difference in age at presentation, age of onset, illness duration, and body mass index at presentation between genders. Male patients with eating disorders had higher rates of premorbid overweight or obesity than female patients with eating disorders had. WS in the male patients was associated with the severity of their eating disorders. Conclusions : The present study provides grounds for improved understanding for clinical features of eating disorders in males.

• Child Health Nursing Research
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• v.4 no.2
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• pp.274-285
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• 1998

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.81-92
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• 2017

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

• Tuberculosis and Respiratory Diseases
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• v.68 no.3
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• pp.162-167
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• 2010

Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). Methods: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. Results: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median $PaO_2/FiO_2$ ratio of 230.0 (145.0~347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3~158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. Conclusion: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, $PaO_2/FiO_2$ ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.247-255
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• 2018

Background: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. Methods: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to ${\beta}$ coefficient values. Results: Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ${\geq}65$ years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ${\geq}3$, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores. Conclusion: The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.

• Korean Journal of Clinical Pharmacy
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• v.15 no.2
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• pp.75-81
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• 2005

Community acquired pneumonia (CAP) remains a prevalent and potentially life threatening illness. American Thoracic Society and Infectious Disease Society America recommend combination therapies with ${\beta}-lactam$ plus a macrolide or a fluoroquinolone monotherapy for the empirical treatment of CAP. The aim of this study was to compare moxifloxacin monotherapy with cephalosporin plus azithromycin combination therapies. From January 2004 to March 2005, 18 patients in the moxifloxacin group(MG) and 21 patients in the cefuroxime or ceftriaxone plus azithromycin group(CAG) with CAP were retrospectively reviewed with regard to clinical, laboratory and microbiological data. Each patient was stratified into mild (risk class I-II), moderate (risk class III) and severe (risk class VI, V) group according to and PSI (Pneumonia Severity Index) score. Each group was compared for microbiological eradication, clinical assessment, the length of hospital stay. As results, Total 39 patients with CAP were reviewed. The appropriateness of admission was 83.3% in MC vs. 76.2% in CAC. The mean length of the hospital day was for 8.31 days vs. 7.39 days, days switching parenteral to oral antibiotics in 5.19 days vs. 5.28 days, clinical improvement in 2.43 days vs. 2.61 days in MG vs. CAC. Radiological improvement required 3.75 days vs 3.63 days in MG vs. CAG and bacteriological eradication rate at discharge was the same in the both groups. Mortality rate was 11.1% (2 of 18) vs 14.3% (3 of 21) in MG vs. CAG (p=0.77). Drug cost of the mean 5 hospital days requiring parenteral antibiotics was the most inexpensive in moxifloxacin group for the 147,045 won, and ceftriaxone 1g-azithromycin group for the 170,285 won, cefuroxime bid-azithromycin group for the 207,800 won, ceftriaxone 2g-azithromycin group far the 220,570 won, cefuroxime tid-azithromycin group for the 251,700 won. There was no significant statistical difference in clinical, bacterial, radiological cure and hospital days, and switch to oral days. In conclusion, that i.v. moxifloxacin monotherapy was as effective as azithromycin plus cefuroxime or ceftriaxone combination therapies fur the treatment of CAP. In drug cost analysis, moxifloxacin is less expensive than CAG.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.4
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• pp.273-278
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• 2015

Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.

• Child Health Nursing Research
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• v.7 no.3
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• pp.280-297
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• 2001

The purpose of the study was to develop and test the model for the quality of life in mothers of children with nephrotic syndrome. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around ten constructs. Exogenous variables included in this model were mother's health, father's health, marital intimacy, mother's attitude on children, economic state, side effect of steroid, severity of illness and social support. Endogenous variables were mother's burden and quality of life. Empirical data for testing the hypothetical model were collected by using a self-report questionnaire from 152 mothers of children with nephrotic syndrom at the outpatient clinics and in the hospital. The data was collected from May, 1999 to August, 1999.Reliability of the seven instruments was tested with Cronbach's alpha which ranged from 0.71 - 0.92.For the data analysis, SPSS 8.0 WIN program and LISREL 8.20 WIN program were used for descriptive statistics and covariance structural analysis. The results of covariance structural analysis were as follow :1. The hypothetical model showed a good fit with the empirical data. [x2 = .56, df = 3, p = .90(p>.05 ), GFI = .99, AGFI = .99, RMSR = .005.] 2. For the parsimony of model, a modified model was constructed by deleting 1 variable and excluding 2 paths according to the criteria of statistical significance and meaning.3. The modified model also showed a good fit with the data[x2 = 2.83, df = 7, p = .90( p>.05 ), GFI = 1.00, AGFI = .97, RMSR = .011].The result of the testing of the hypothesis were as follows : 1. Mother's health(γ21 = .26, t = 4.16), father's health(γ22 = .19, t = 2.92), marital intimacy(γ23 = .26, t = 4.13) and social support(γ28 = .12, t = 2.03) had a significant direct effect on the quality of life.2. Mother's burden(β21 = -.20, t = -3.10) had a significant negative direct effect on the quality of life.3. Mother's attitude on children(γ14 = -.34, t = .-4.57), mother's health(γ11 = -.22, t = -2.96) and side effect of steroid (γ16 = -.23, t = .-2.69) had a significant direct negative effect on the burden. The result of this study showed that mother's health, marital intimacy, mother's burden, father's health, and social support had a significant direct effect on the quality of life. Mother's attitude on children, mother's health, and side effect of steroid had a significant direct effect on mother's burden. These six variables, mother's health, marital intimacy, father's health, social support, mother's attitude on children and side effect of steroid were identified as relatively important variables. The results of this study suggest, it needed to determine the nursing intervention will alleviate mother's burden and promote a greater quality of life in mothers of children with nephrotic syndrom.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.89-95
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• 2010

Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.