• Neonatal Medicine
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• v.25 no.4
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• pp.196-201
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• 2018

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.4
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• pp.232-236
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• 2022

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.3
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• pp.192-196
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• 2024

Objectives: Borderline intelligence has been excluded from formal diagnostic systems and not included in disability diagnoses, leaving gaps in treatment, education, and social welfare despite various functional impairments. Therefore, we aimed to shed light on ways to enhance the intelligence and functioning of individuals with borderline intelligence by reviewing research on its progression, education, and treatment. Methods: Ten studies that met the inclusion and exclusion criteria were included in the final literature review and analyzed according to detailed topics (participant characteristics, design, and results). Results: Borderline intelligence is associated with various comorbid conditions, such as anxiety, depression, attention deficit/hyperactivity disorder, and addictive disorders, which negatively impact its course and prognosis. Individuals with borderline intelligence often face challenges in academics, employment, interpersonal relationships, and health owing to lifelong cognitive impairments. The treatment of borderline intelligence necessitates addressing environmental factors, such as neglect and abuse, as well as treating comorbid mental disorders, which are crucial for prognosis. Tailoring treatment programs for cognitive profile characteristics have been proposed, and studies have reported the effectiveness of pharmacotherapy, working memory training, and intensive rehabilitation training. Therefore, early intervention during childhood brain development is necessary. Risk factors, such as lack of parental education, and their impact on treatment outcomes have also been reported. Conclusion: Extensive research is needed on education, treatment, and prognosis related to borderline intelligence. Active intervention for children with borderline intelligence is essential to improve their functioning and quality of life.

• Journal of The Korean Association For Science Education
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• v.34 no.3
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• pp.321-330
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• 2014

Changes are expected in the future, and the future society will expect changes in education. Science curriculum needs to reflect such demands for changes in the future of education. Hence, this study explored ways to reflect the changes demanded by the future society in science education. In this study, we investigated the major issues and directions for improvements based on the findings from questionnaires given to 447 primary and secondary school science teachers as well as in-depth interviews with 12 experts. We explored the problems of the 2009 revised national science curriculum including organization of science elective courses, fusion 'science' as an elective course, intensive course-taking of science, career-focused science curriculum, variation of completion units in science elective courses, and fairness of science elective course selection in college entrance. In addition, we proposed ways to organize science curriculum around core competencies and STEAM education suggested by science teachers. According to the results, we need to add such key competencies as basic learning abilities, self-identity, and moral competencies to science curriculum in addition to existing key competencies including problem solving and communication. Regarding the fusion science, experts contended that convergence of science courses should come before that of science and other subjects, and that STEAM with science as the axis was the desired form of convergence. We also need to establish a curriculum development center that exclusively focuses on science curriculum research and development.

• Korea journal of population studies
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• v.34 no.1
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• pp.53-72
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• 2011

This study analyzes the effects of life course events and labor market conditions on the duration of career interruption among Korean women. The data were drawn from 'A Survey on the Women's Employment Interruption in Korea' conducted by the Korean Ministry of Gender Equality in 2009(currently the Korean Ministry of Gender Equality and Family). This study categorizes the duration of career interruption into three categories: (1) short term interruption(less than 12months), (2) short-medium term interruptio(12-35 months), (3) intermediate term interruption(36-59 months), (4) long term interruption(longer than 36 months), and then analyzes how demographic factors, labor market condition, and life events shape the timing of re-entry into the labor market among women. According to the findings, the jobs that are conducive to combining market work and mother's role expedite women's return to the labor market. Further, the younger, higher the level of human capital, and higher monthly wages that women earned before leaving the labor market, women are likely to experience short-term interruption(less than 12 months) rather than long-term interruption(longer than 60 months). Women who left from the labor market to care for kids are also likely to return to the labor market. However, women who have preschoolers are likely to experience long-term career interruption. These findings highlight the role of family supportive culture at the workplace in order for women to continue their employment while intensive family formation period. Furthermore, the finding that the discriminatory practices against women, in particular mother workers at the workplace lead women to exit from the market work calls for attention to establish family friendly workplace.

• Journal of Korea Port Economic Association
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• v.39 no.3
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• pp.33-46
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• 2023

The Autonomous ships are equipped with a function to judge and navigate the sea conditions on their own, so the job of the ship officer who operates it changes. The educational curriculum to nurture ship officer with the ability to operate and manage autonomous ships must also be changed. This study aimed to develop the curriculum for training autonomous ship officer by using the Delphi survey method suitable for predicting the uncertain future. Among the current 61 subjects for training ship officer identified in the Delphi survey, 32 subjects with high importance should be maintained in the training for autonomous ship officer, and subjects with low importance should be abolished or integrated into other subjects. These subjects were collectively referred to as 'general courses'. The expert panel of the Delphi survey suggested 42 items as new subjects, with 18 items of 'high', 14 items of 'middle', and 10 items of 'low'. Through in-depth analysis of these items by experts, 27 subjects were adjusted and three courses were proposed : 1)'Basic course(10 courses)' for developing basic capabilities such as basic theories for understanding advanced technology and information applied to autonomous ships, 2)'Job course(10 courses)' for practical competency directly related to autonomous ship operation, 3)'Intensive course(7 subjects)' for fostering land remote operators of autonomous ships. Since the introduction and spread of autonomous ships will progress rapidly, research to develop and supplement autonomous ship pilot training courses should be continued by reflecting the level of autonomous navigation of autonomous ships.

• Korean Circulation Journal
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• v.53 no.3
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• pp.170-184
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• 2023

Background and Objectives: Several cases involving severe right ventricular (RV) failure in advanced cancer patients have been found to be pulmonary tumor thrombotic microangiopathies (PTTMs). This study aimed to discover the nature of rapid RV failure syndrome with a suspected diagnosis of PTTM for better diagnosis, treatment, and prognosis prediction in clinical practice. Methods: From 2011 to 2021, all patients with clinically suspected PTTM were derived from the one tertiary cancer hospital with more than 2000 in-hospital bed. Results: A total of 28 cases of clinically suspected PTTM with one biopsy confirmed case were included. The most common cancer types were breast (9/28, 32%) and the most common tissue type was adenocarcinoma (22/26, 85%). The time interval from dyspnea New York Heart Association (NYHA) Grade 2, 3, 4 to death, thrombocytopenia to death, desaturation to death, admission to death, RV failure to death, cardiogenic shock to death were 33.5 days, 14.5 days, 7.4 days, 6.4 days, 6.1 days, 6.0 days, 3.8 days and 1.2 days, respectively. The NYHA Grade 4 to death time was 7 days longer in those who received chemotherapy (7.1 days vs. 13.8 days, p value=0.030). However, anticoagulation, vasopressors or intensive care could not change clinical course. Conclusions: Rapid RV failure syndrome with a suspected diagnosis of PTTM showed a rapid progressive course from symptom onset to death. Although chemotherapy was effective, increased life survival was negligible, and treatments other than chemotherapy did not help to improve the patient's prognosis.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1000-1006
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• 2002

Purpose : In the course of treatment, patients with hematological or oncological disorders often develop pulmonary complication. The patients who develop a severe pulmonary complication have a poor outlook. The causes of pulmonary complication are either infectious or non-infectious in origin. We have analyzed the etiology and outcome of these patients admitted to the pediatric intensive care unit of Asan Medical Center. Methods : Medical records of 95 patients on Pediatric oncology service who were admitted to pediatric intensive care unit(PICU) of Asan Medical Center from Jan 1997 to May 2000 were retrospectively reviewed. Results : The mean age of the patients was 8.5 years(2 months-18 years). The underlying malignancies of these 95 patients were as following; acute lymphoblastic leukemia(31 cases), lymphoma (11 cases), acute myeloid leukemia(nine cases), brain tumor(eight cases) and other solid tumors(25 cases). Pulmonary complications included pneumonia, acute respiratory failure, pneumothorax and pleural effusion. The most common cause of pulmonary complication was infection(88%) in etiology. The overall mortality rate was 56.8%. Pulmonary complications in these patients carried high rates of mortality regardless of whether they were immune compromised(76%) or not(69%). Even without pulmonary complications, the hematological or oncological patients admitted to PICU had high mortality rates of 43%. Conclusion : Pulmonary complications are frequent finding in the hematological or oncological patients admitted to Intensive Care Unit. The main etiology of these pulmonary complications was infection, which carried a high mortality rate regardless of their immune status at the time when they were admitted to PICU.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.329-335
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• 2004

Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.39-45
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• 2009

Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M：F=27：21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.