• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.537-542
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• 1997

Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. The normal onset time of oral Chloral hydrate is 30-45 minute with some variations. We are often frustrated see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried additional administration of Midazolam intranasally to 22 patients of those who failed to respond properly to the initial dose(50-75mg/kg) of oral Chloral hydrate. The average age and weight of the patients was 34.2 months(22-61 mos.) and 15.2 kg(10-17 kg) respectively. Half of the regular dose of Midazolam(0.1mg/kg) was administered intranasally. using needless syringe in 42 cases without notable resistance of the patient. The onset was very rapid in most cases and colud proceed the treatment under the constant monitoring by Pulse oximeter. All the planned procedures could be completed in 93.2 % (69.4% of 'Good' plus 23.8% of 'Fair' rating)with only 6.8 %('Poor' rating) of failure rate. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.53-63
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• 2005

The purpose of this study was to identify menstrual discomforts and coping m adult women. The subjects were 577 adult women. aged 20 years old and over. selected by convenient sampling. Data were collected through a questionnaire survey from December 2. 2004 to December 31. 2004. Two instruments were modified and used in this study. the Menstrual Discomfort Questionnaire by Park(1988) and the Menstrual Coping Questionnaire by Billings & Moos(198l). The data were analyzed by descriptive statistics. t-test. and ANOVA with SPSS 10.0 program. The results of this study were as follows. 1. The prevalence rate of dysmenorrhea was $85.6\%$. 2. The total mean score for menstrual discomforts was 2.82 of a possible total of 5. The mean score for each category was 3.10 for water retention. 2.93 for negative affect. 2.89 for pain. 2.74 for autonomic reactions. 2.73 for behavioral change. and 2.59 for concentration. 3. Statistical differences were found for menarche age(F=9.351. p<.00l), feeling to menstruation(F=12.376. p<.001). dysmenorrhea(t=7.3l7. p<.001). onset of dysmenorrhea (F= 12.766. p<.001). taking medication(t=6.289. p<.001). and degree of taking medication (F=12.924. p<.00l). 4. The coping modes with the highest scores were 'rest and go to the bed '$(83.3\%)$. 'regard menstruation as a physiological and temporary phenomenon' $(68.6\%)$, and 'take a warm shower' $(64.5\%)$. We conclude that there were many women with dysmenorrhea. that the first day was the onset of menstrual discomfort. and that it differed by menarche age. feeling to menstruation. dysmenorrhea. onset of dysmenorrhea. taking medication. and degree of taking medication. Nursing intervention has to be considered in programs to reduce menstrual discomfort.

• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.36-41
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• 2019

Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There were significant differences in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.128-135
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• 2017

Purpose: Extended-spectrum ${\beta}$-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum ${\beta}$-lactamase -urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. Methods: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum ${\beta}$-lactamase-positive and extended-spectrum ${\beta}$-lactamasenegative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). Results: Extended-spectrum ${\beta}$-lactamase urinary tract infection occurred in 11 % patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extended-spectrum ${\beta}$-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum ${\beta}$-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. Conclusion: Extended-spectrum ${\beta}$-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum ${\beta}$-lactamase urinary tract infection.

• Journal of Acupuncture Research
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• v.21 no.5
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• pp.27-44
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• 2004

Objective : To evaluate the pain improvement of the lumbago patients taken the electro-acupuncture therapy using Visual Analogue Scale. Methods : The 25 patients of 46 lumbago patients visited department of Acupuncture & Moxibustion in National Medical Center from 1st March to 20th August had taken the electro-acupucture therapy more than 5 times. We checked on their age, sex, onset, radiating pain, back pain past history and Straight Leg Raising test. And we evaluated their improvement of back pain using Visual Analog Scale(VAS) at each visit. Then we analyzed the pain improvement by their age, sex, onset, radiating pain, back pain past history, Straight Leg Raising test, visiting frequency and Visual Analog Scale on 1st visit(VAS1) Results : VAS of 24 patients has improved and VAS of one patient has not been changed. There's no patient getting worse. The women and the positive group at SLR Test had better result of pain improvement. Conclusion : The lumbago patients taken electro-acupuncture more than 5 times showed significantly different pattern of pain improvement according to the sex and the SLR test.

• Journal of Nutrition and Health
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• v.27 no.3
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• pp.272-280
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• 1994

The weaning practice of infants from 5 to 12 months of age in the area of Chunchon, Kangwon-do was studied. Subjects were divided into 2 groups depending on residential area, monthly family income and mother's educational level. Parents of group 1 (n=90) received higher education and more monthly family income than those of group 2(n=32). The family income was significantly higher in group 1 than in group 2. Mother's educational level has been markedly improved over 10 years, which affected the feeding methods before weaning in both groups(P<0.05). Group 1 appeared to be bottle-fed. Bottle-and mixed-feeding were mainly due to lack of breast milk. 95.6% of group 1 and 71.9% of group 2 started weaning before the age of 6 months and only 16.4% were completely finished regardless of the groups. Commercially prepared foods were used more than home-made for first given-supplementary food. 82.2% of group 1 received fruits and 84.4% of group 2 cookies/crackers as their main supplementary foods. As the motivation of onset of weaning, 'for baby's health and nutritional status' was the most common. These results demonstrate that there are distinct differences between these 2 groups in 1) the feeding methods prior to weaning, 2) time of onset of weaning, and 3) main supplementary foods, influenced by mother's educational level, economic purchasing power, or subjects birth order.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.5
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• pp.1075-1078
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• 2002

Objective: The management for the stroke should ,given as soon as possible to be effect. But Patients with stroke symptoms commonly delay many hours before seeking medical attention. We evaluated the factors which are related to the time of hospital arrival after acute stroke. Method: Data were obtained from 317 patients admitted to our hospital within 72 hours of stroke onset. We assessed demographic variables, stoke subtype. referral routes. history of previous stroke, level of consciousness, distance from the place where stroke occurred to hospital, and the time interval between onset of stroke and arrival at the hospital. Results: Mean patient age was 65.99±9.57 years. The mean time interval between onset of stroke and hospital arrival was 17.26±18.69 hours and 128 (40.38%) patients arrived within 6 hours. The patients whoes stoke subtype was infarction, who arrived our hospital by way of other hospital, who had no suffered from previous stroke and who showed no impairement of consciousness was arrived at the hospital late(p<0.05). Conclusion: The majority of patients arrive at the hospital after prolonged delays for multiple reasons, and patients with milder symptoms, for whom treatment might be more effective, were less likely to arrive in time for therapy. Our study suggest that effective education about stroke to the patients and public would be highly necessary.

• Clinical and Experimental Pediatrics
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• v.53 no.11
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• pp.921-930
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• 2010

Juvenile rheumatoid arthritis (JRA) is the most common rheumatic childhood disease; its onset is before 16 years of age and it persists for at least 6 weeks. JRA encompasses a heterogeneous group of diseases that is classified according to 3 major presentations: oligoarthritis, polyarthritis, and systemic onset diseases. These presentations may originate from the same or different causes that involve interaction with specific immunogenetic predispositions, and result in heterogeneous clinical manifestations. An arthritic joint exhibits cardinal signs of joint inflammation, such as swelling, pain, heat, and loss of function; any joint can be arthritic, but large joints are more frequently affected. Extra-articular manifestations include high fever, skin rash, serositis, and uveitis. The first 2 types of JRA are regarded as T helper 1 (Th1) cell-mediated inflammatory disorders, mainly based on the abundance of activated Th1 cells in the inflamed synovium and the pathogenetic role of proinflammatory cytokines that are mainly produced by Th1 cell-stimulated monocytes. In contrast, the pathogenesis of systemic onset disease differs from that of other types of JRA in several respects, including the lack of association with human leukocyte antigen type and the absence of autoantibodies or autoreactive T cells. Although the precise mechanism that leads to JRA remains unclear, proinflammatory cytokines are thought to be responsible for at least part of the clinical symptoms in all JRA types. The effectiveness of biologic therapy in blocking the action of these cytokines in JRA patients provides strong evidence that they play a fundamental role in JRA inflammation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.411-422
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• 2020

With the increasing number of children with inflammatory bowel disease (IBD), very early-onset IBD (VEO-IBD), defined as IBD that is diagnosed or that develops before 6 years of age, has become a field of innovation among pediatric gastroenterologists. Advances in genetic testing have enabled the diagnosis of IBD caused by gene mutations, also known as monogenic or Mendelian disorder-associated IBD (MD-IBD), with approximately 60 causative genes reported to date. The diagnosis of VEO-IBD requires endoscopic and histological evaluations. However, satisfactory small bowel imaging studies may not be feasible in this small population. Both genetic and immunological approaches are necessary for the diagnosis of MD-IBD, which can differ among countries according to the available resources. As a result of the use of targeted gene panels covered by the national health insurance and the nationwide research project investigating inborn errors of immunity, an efficient approach for the diagnosis of MD-IBD has been developed in Japan. Proper management of VEO-IBD by pediatric gastroenterologists constitutes a challenge. Some MD-IBDs can be curable by allogenic hematopoietic stem cell transplantation. With an understanding of the affected gene functions, targeted therapies are being developed. Social and psychological support systems for both children and their families should also be provided to improve their quality of life. Multidisciplinary team care would contribute to early diagnosis, proper therapeutic interventions, and improved quality of life in patients and their families.

• Journal of Genetic Medicine
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• v.10 no.2
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• pp.88-93
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• 2013

Alexander disease (ALXD) is a rare demyelinating disease of the white matter of the brain that is caused by a mutation in the glial fibrillary acidic protein (GFAP) gene. The overexpression of GFAP in astrocytes induces a failure in the developmental growth of the myelin sheath. The neurodegenerative destruction of the myelin sheath of the white matter is accompanied by an accumulation of abnormal deposits of Rosenthal fibers in astrocytes, which is the hallmark of ALXD. The disease can be divided into four groups based on the onset age of the patients: neonatal, infantile, juvenile, or adult. Early-onset disease is more severe, progresses rapidly, and results in a shorter life span than late-onset cases. Magnetic resonance imaging and genetic tests are mostly used for diagnostic purposes. Pathological tests of brain tissue for Rosenthal fibers are definitive diagnostic methods. Therapeutic strategies are being investigated. Ceftriaxone, which is an enhancer of glial glutamate transporter (GLT-1) expression, is currently in clinical trials for the treatment of patients with ALXD. To date, there are no clinically available treatments. The cause, pathology, pathophysiology, inheritance, clinical features, diagnosis, and treatment of ALXD will be reviewed comprehensively.