• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.127-137
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• 1998

The authors surveyed extrafamilial sexual abuse in the children under 15years old by the physician's reports. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as followings. 1) The number of respondents who have had the experience of treating victims of extraf/amilial child sexual abuse were 641(53.2% of total respondents). 2) 338(52.7%) of the perpetrators were known persons and 277(43.2%) were strangers, the most common age bracket were 20s, 30s and 10s, and almost all(99.8%) of the perpetrators were male. 3) The mean age of victims was $9.7{\pm}3.5$ years old, and almost all(98.6%) of the victims were female. 4) The ways by which extrafamilial child sexual abuses were found were victim’s own reports：273(62.6%), pain complaint, 156(24.3%) and abnormal behavior 96(15.0%), other person’s report 72(11.2%), detection during examination 19(3.0%), and pregnancy 4(0.6%). 5) Time lags between extrafamilial child sexual abuses and hospital visits were within 24 hours 332 (51.8%) and from 1 day to 1 week 232(36.2%), victims were rather quickly 6) Physical complications were perineal wound 571(89.1%), hymen rupture 349(54.4%), wound of other part of body 124(19.3%), pregnancy 37(5.8%), and sexually transmitted disease 18(2.8%), and other serious complications such as vaginal-rectal lacerations 8, intastinal bleeding 7, death 2, hypotensive shock 1. These results suggest considerable numbers of physicians have had the experience of treating victims of extrafamilial child sexual abuses, and extrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.3
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• pp.182-191
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• 2011

Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.105-123
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• 1981

This study was carried out during the month of September 1976 to analyse and compare the health complaints of two groups of the university women, those who lived at home and those who lived in the university dormitory. The purpose of the study was to provide basic data required by the university health program for planning related to the health need of women students. The study sample consisted of 434 students living in the dormitory and 381 students living at home enrolled for the fall semester 1976 in a womens university in Seoul. The instrument used for the collection of data was an abridged version of a modified Cornell Medical Index. The questionarre included 35 items related to physical health complaint and 22 items related to mental health complaints. The data was treated by a computer (SPSS) using one way analysis, the Fishers' ratio and Chi-Square test at the 5％ level were used for the test for statistical significance. The interpretation of this study is limited due to the sample which was restricted to one university and not randomly selected. To guide the direction of the study, it was hypothesized that the rate of expressed health problems of students living in the dormitory would be Venter than that of students living at home. The hypothesis was tested and rejected. The following is a summary of the findings; 1. Total health (physical and mental) complaints a. There was no statistically significant difference between the home and dormitory groups with regard to total health complaints expressed. b. The rate of total complaints expressed by the home group significantly higher than dormitory group only among third year students. c. There was no statistically significant between the home and dormitory groups in their satisfaction with their economic situation. d. The home group showed a significantly higher rate of complaints related to the Nervous System compared to that of the dormitory group. 2. Physical health complaints a. Students living at home showed a significantly higher rate of physical complaints than the dormitory group. b. When the year variable was controlled, the third year was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the physical complaints those data were further analysed to see whether the specific system areas were operating as variables in each year. The results were as follow: Among the home group, First year students showed a higher rate in Family History of Disease, while the third year students more Nervous System and Cardiovascular System complaints. Among the dormitory group, only fourth year students showed a higher rate in the Skeletal-Muscular System. This was the only area the dormitory group though only for the fourth year students supported the hypothesis. d. When the economic satisfaction variable was controlled, the satisfied group was the only group which showed a different rate between home and dormitory groups; the home group presented higher rate. e. Since the economic satisfaction variable seemed to affect the physical complaints those data were further analyzed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistically significant difference between home and dormitory groups. 3. Mental health complaints a. There was no significantly difference between home and dormitory groups with regard to mental health complaints expressed. b. When the year variable was controlled the third year group was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the mental complaints, those data were further analyzed to see whether the specific system areas were operatings variables in each economic satisfaction level. The result were as follows: Among the home group, the third year students showed higher rates in Inadequacy and Anxiety. d. When the economic satisfaction variable was controlled, the very satisfied group was the only group which showed a different rate between home and dormitory groups: the home group presented a higher rate. Since the economic satisfaction variable seemed to affect the mental complaints, those data were further analysed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistical significant difference between the home and dormitory groups. Although the social environment of dormitory life differs from family life, there was no difference in the rate of total health problem complaints between the home and dormitory groups but the home group showed a higher rate of physical health complaints than the dormitory group. Possible positive factors influencing dormitory life and negative factors influencing family life affecting health complaints must be explored in order to relate to the health needs of the university health program. This study could not define the causes for the fewer physical complaints of dormitory students living at home. Further study of such causal factors recommended in order to provide the data needed to contribute to a more effective health program.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.62-66
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• 2006

Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.18-26
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• 2013

Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.591-596
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• 2004

Recently, thoracic sympathicotomy for craniofacial hyperhidrosis (FH) is increasingly avoided contrast to palmar hyperhidrosis. We recently demonstrated that selective T2 sympathicotomy for FH in woman might be recommended because of differences of the postoperative satisfaction between man and woman. Therefore, this study was designed to analyze the postoperative long term results, evaluate the effectiveness of T2 sympathicotomy and establish the new strategy in treatment of FH in woman. Material and Method: From May 1998 to July 2001, 27 cases of FH in woman that were performed T2 sympathicotomy and minimum 2 years have passed since then at the follow up period. Among them, 20 cases were evaluated by telephone review and medical record. Bilateral sympathetic trunks were severed on the 2nd rib with 2mm thoracoscopic instruments. 7 patients combined with gustatory sweating (GS). Ages ranged from 25 to 62 (mean age, 46.4 years). Result: All patients were relieved of symptom immediately after operation. At postoperative 1 week, all patients were satisfied: 15 patients, “very satisfaction” and 5 patients, “relatively satisfaction”. However, during long term follow up period (from 25 to 63 months postoperatively), 9 patients (45%) were relatively satisfied, 8 patients (40%) complained that there was no difference of postoperative satisfaction and 3 patients (15%) complained of non satisfactory results (regret for surgery). 16 patients (80%) had complaint of uncomfortable feeling because of postoperative GS. Some degree of compensatory sweating (CS) had occurred in all patients: severe 10 patients (50%), severe but acceptable 6 patients (30%), and just conventional 4 patients (20%). The sites of CS were trunk, back, axilla and extremities. Conclusion: Thoracoscopic T2 sympathicotomy is relatively considerable method for FH in woman and the postoperative satisfaction depends on GS and the degree of individual adaptation for CS. Therefore, it is required that the prediction of preoperative risk factors for GS and CS and then careful selection of patients to increase the postoperative satisfaction, and the development of acceptable new treatment modalities.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.512-517
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• 2008

Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.341-351
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• 2009

There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.