• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.81-89
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• 2004

Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

• Journal of Acupuncture Research
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• v.17 no.1
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• pp.55-66
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• 2000

The following results have been obtaind after examing 72patients with facial paralysis who were hospitalzed and treated through the time period of December 1st, 1996 to November 30th, 1999 at the Department of Acupuncture and Moxibustion of Seoul Oriental Medicine, Kyungwon University. During the examination, those 72 patients were divided into two groups, and One group was treated by oriental-western treatment, the other group was treated by oriental treatment. Oriental treatments were acupuncture and moxibustion, herb medicine, physical treatment and hygienic treatment. The one of main western treatments is steroid therapy. The results were obtained as follows : 1. In regard to signs at the first medical examination, lacrimation was showed highest number and facial paralysis, dysgeusia, hyperacusis were showed in numerical order. 2. In regard to prescription of oriental herb medicine, Kamissangbotang(加味雙補湯) was prescribed in greatest numbers and Boyangwhanotang(補陽還五湯), Kamiboiktang(加味補益湯), Ligigepungtang(理氣祛風湯) were prescribed in numerical order. 3. In regard to treatment number, 10~19 times for treatment was showed highest number and 1~9 times, 20~29 times, 40~49 times were showed in numerical order . 4. In regard to mean treatment times about injury region and main sign, the effect of oriental-western treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 15.1, 27, 13.2 and 21.4 times, repectively. The effect of oriental treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 34.8, 22.1, 33.8 and 16.3 times, respectively. 5. In regard ta the effect of treatment about injury region and main sign, oriental-western treatment was showed as follows: cases of lacrimal gland disorder were showed 1 of excellent case, 1 of fair case, 5 of good cases. In hyperacusis patients, there was showed 1 of fair case. In dysgeusia patients, there was showed 1 of excellent case, 3 of fair cases, 1 of good case. In facial paralysis, there were showed 5 of fair cases. Oriental treatment was showed as follows: In lacrimal gland disorder, the excellent were 4 cases, the fair were 10 cases, the good were 3 cases and the poor were 4 cases, In hyperacusis, the fair were 5 cases, the poor 2 cases. In dysgeusia, the excellent were 4 cases, the fair were 1 case, the good were 1 case and the poor was 1 case, In facial paralysis, the excellent were 9 cases, the fair were 4 cases, the good 3 cases and the poor were 3 cases. 6. The effect of total treatment was as follows: 30 cases were showed fair effect, 19 cases were showed excellent effect, 13 cases were showed good effect and 10 cases were showed poor effect. 7. In regard to attack factor, overlabour was showed highest number and wind-cold, mental stress, trauma, ear disease, common cold, dental diseae, reason unknwon were showed in numerical order. 8. In regard to premonitory symptoms, non significant symptoms were in 38 cases, the pain of peri-stylomastoid region were in 38 cases and headache, dysaesthesia of periorbit, dysgeusia, stomatitis, eyelid tic were showed in numerical order. 9. In regard to sex, male were 33 cases and female were 39 cases. The distribution of age was disclosed that thirty, forty, fifty, seventy, sixty, twenty and below twenty years were revealed in turn. Sex and paralytic side were showed as follows: male-left were 15 cases, male-right were 18 cases, female-left were 19 cases and female-right were 19 cases. In regard to attack frequence in month, March was showed highest number and January, April, May, August, October, etc were showed in numerical order. In regard to attack frequence in season, spring was showed highest number and winter, summer, fall were showed in numerical order, but attack frequence between four seasons wasn't showed significant difference.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.239-244
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• 1999

Purpose : In 1998, there was an outbreak of mumps in Taejon, Korea. We analyzed the monthly incidence, clinical manifestations, and complications during the outbreak and the annual incidence of the recent ten years. Methods : We reviewed the clinical records of 35 mumps patients who had been admitted to Taejon St. Mary's Hospital from January to December, 1998. Results : Mumps was prevalent in summer(from June to August) with 20 cases(57%). Thirthy-three patients(94.3%) received MMR at 15 months of age and no patients received a booster mumps vaccine. The mean age of the mumps patients was 10.5 years-old and the majority of mumps(71%) occurred between 5 and 12 year of age. The male female ratio was 2.2 : 1. The clinical manifestations were swelling of parotid gland(100%), fever (91%), vomiting(77%), abdominal pain(74%) and headache(66%) in order of frequency. Meningitis occurred in 20 cases(57%) and the mean WBC count of CSF was $464{\pm}263/mm^3$. In serology, the mean serum amylase level was $483{\pm}294IU/dL$ and anti-mumps IgM and IgG were positive in 11 and 15 out of 18 cases, respectively. From 1989 to 1997, the mean number of inpatients with mumps was 3.4 per year. Conclusion : We experienced an outbreak of mumps in 1998. It is suggested that there was a primary mumps vaccine failure in Korea and that further studies for vaccine faiure and method of booster mumps vaccine are necessary.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.97-105
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• 1997

Purpose : Aseptic meningitis mainly caused by enterovirus is common in pediatric population especially during summer & fall. Most of pediatric patients restore their health without any complications with proper management. Between May to August of 1996, Masan and surrounding areas of the Kyoungsangnamdo were epidemic areas for the aseptic meningitis. The purpose of this study was to determine causative virus and describe correlation between disease and clinical symptoms in aseptic meningitis patients and those with fever and characteristic rashes without apparent meningitis symptoms. Methods : Between May to August, 1996, 57 patients with high fever and characteristic feature of rashes were reviewed. From 22 cerebrospinal fluid & 57 stool obtained specimens, viral culture and detection of enterovirus RNA were conducted. Collected specimens were kept in $-30^{\circ}C$ environment until sending of specimens to labortory. The virus identified through indirect immunofluorescence. RT-PCR method was used to identify enterovirus RNA in cerebralspinal fluid. Results : 1) One hundred fifty five pediatric patients with viral infection required hospitalization. Disease occurred higher rate in male than female with ratio of 1.94:1. Examined patients' age ranged from 15days old to 15years old. But most of patients(74.8%) were under age of 5years old. The time of occurrence was between May to August of 1996. 2) All patients had high fever and physical symptoms in those patients include headache, vomiting, abdominal pain, diarrhea, and rashes. The rashes observed mainly in patients under age of 4 years and were predominantly commom patients under age of 18 months olds)<0.001). 3) Between sampled patients and non-sampled patients, clinical course was similar. Echovirus type 9 was cultivated in 41 out of 57 cases of collected stool specimens. RT-PCR that used on CSF showed positive results in 10 out of 22 cases. Three cases of positive cultivated of positive results in RT-PCR were echovirus type 9. Conclusions : Echovirus type 9 was thought to be the causative agent of aseptic meningitis that was prevalent throughout mid areas of Kyoungsangnamdo from May to August, 1996. Additionally causative agent that responsible for high fever with rashes without meningitis symptoms also thought to be the same echovirus type 9.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.114-123
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• 2005

Purpose : A wide, epidemic outbreak of M. pneumoniae pneumonia occurred throughout Korea in late 2003. Compared with previous years, the 2003 outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. We compared the clinical characteristics for M. pneumoniae pneumonia of 2003 to those of the past years. Methods : One hundred six children diagnosed with M. pneumoniae pneumonia by serologic tests at Bundang Cha General Hospital between Aug 2003 to April 2004 were enrolled. Medical records were reviewed retrospectively, for clinical, laboratory and radiological aspect as well as complications. The pleural effusions of 3 patients who underwent thoracentesis were also analyzed. Results : The duration of fever, cough, rhinorrhea, and sore throat was $8.2{\pm}4.7$, $22.1{\pm}4.8$, $8.4{\pm}2.1$, $4.3{\pm}1.2$ days, respectively. The incidence (percentage) and duration of abdominal pain, vomiting, diarrhea, headache, skin rash, arthralgia was $5.1{\pm}2.5$ (21.9%), $3.4{\pm}2.1$ (17.1%), $4.3{\pm}1.8$ (16.2%), $3.5{\pm}2.1$ (14.4%), $5.5{\pm}0.7$ (5.9%) and $4.6{\pm}1.3$ days (4.9%), respectively. The mean duration of admission and treatment were $7.4{\pm}4.3$ days and $21.6{\pm}11.1$ days. Higher values of CRP and ESR on admission were positively correlated with the duration of fever and length of admission. The findings of pleural effusion were similar to those seen in TB pleurisy. Complications, including myocarditis (2 cases), arthritis (3 cases), vasculitis (5 cases), asthma (3 cases), ARDS (1 case), and DIC (2 cases) were observed in 14.1% of patients. Conclusion : We found a number of characteristics of M. pneumoniae pneumonia among cases from late 2003 that were different from those of previous years. This outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. A multicenter study is needed to verify the changes in clinical characteristics observed during the 2003 outbreak from previous ones.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.30-36
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• 2005

Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.24-28
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• 2006

Purpose : The purpose of this study was to investigate the health status and nutritional condition of children living in a low-income community through anthropometric, laboratory evaluation. Methods : A community-based survey identified children below 15 years living in a low-income community. Their weight, height, visual acuity, hearing level and dental status were measured. Blood sample were obtained on June and July, 2004. Hemoglobin, serum cholesterol, Hepatitis B antigen/antibody, AST and ALT were measured. Results : A total of 285 students(M : F=141 : 144) aged 6 to 14 years were included in this study. The heights and weights in some grades were smaller than controls. The prevalence of obesity was 10.6 percent in males and 10.7 percent in females. The prevalence of abnormal visual acuity, hearing impairments and dental carries were 20.5 percent, 0.3 percent and 69.4 percent. The prevalence of anemia was 10.1 percent. Serum total cholesterol was over 200 mg/dL in 7 percent. They complained of abdominal pain(22.1 percent) and headache(17.1 percent). Hyperthyroidism, cataract, neurofibromatosis, severe atopic dermatitis, ventricular septal defect, strabismus and inguinal hernia were newly diagnosed. Conclusion : Mean heights and weights of children in the low-income community were smaller than controls. The prevalence of abnormal visual acuity, hearing impairment and dental carries were higher than in the 2003 national health survey. Additional research is needed to evaluate the health status of the low-income community.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1107-1115
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• 2005

Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.240-259
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• 2000

1. Background and Purpose I intented to be helpful to understand the consitutional symptoms of soar throat and the application of the prescription through a clinical study of Soeumin Doksamkwankaeijungtang. 2. Methods I studied 16 patients(1 man and 15 women) treated by Doksamkwankaeijungtang in Chewon Oriental Clinic. And then I investigated the characteristics of patients treated by Doksamkwankaeijungtang, remedial values and side effects. 3. Results Doksamkwankaeijungtang was used in the age groups between twenties and sixties. There were 28 kinds of chief complaints including soar throat, tonsilitis, allergic rheum, bitter taste, dry throat, dry cough, stomatitis, lower abdominal pains, climacteric syndrome, etc. The distributions of remedial values were completely recovered (56.25%), much improved (18.75%), slightly improved(6.25%), no improved(12.5%), aggravated(6.25%), side effects(18.75%). There was one aggravated patient. Using the prescription, I prescribed it without any changing and addition according to the symptoms of soar throat. The remedial value of Doksamkwankaeijungtang was effective and not influenced by the dosage of Ginseng. The onset of action was very quick by the changes of dosage without the relation of age. Side effects were upward tendency of blood presser, headache, chest pain, etc. 4. Conclusion Doksamkwankaeijungtang was specifically effective in soar throat of Soeumin.

• Journal of the Korea Convergence Society
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• v.1 no.1
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• pp.41-47
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• 2010

This study was conducted to investigate determinent factors of the internet addiction that have influenced on middle school students. We randomly selected each one middle school in urban and rural areas, and conducted survey in 862 students of 2nd and 3rd grade from September 1 to 15, 2005. By using a statistical program called SPSS10.0, the data collected thereby were analyzed through a series of statistical methods including $x^2$-test, logistic regression analysis. The result of logistic regression analysis showed that the significant variables in urban area were resting time and using time a day. In rural area, sex, economic level, resting time and using time a day were significant variables. Higher status of internet addiction showed significant relationship with physical problems, anxiety, maladjustment to school, insufficient sleep time, fatigue in eyes, headache, pain in neck or shoulder, chronic fatigue, reduced vision, weight reduction, indigestion, xeroderma and adjustment to school. Especially, resting time and using time a day have dominant influence on internet addiction. And in case that the groups who showed high addiction tendency, there were negative health problem by physical, mental and social problem. To prevent internet addiction health education programs of right internet use and time, importance of rest, and health problems must be considered in internet addiction prevention policy.