• Clinical and Experimental Pediatrics
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• v.56 no.3
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• pp.125-129
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• 2013

Purpose: The use of implantable cardioverter defibrillators (ICDs) to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was $14.5{\pm}5.4$ years (range, 2 to 22 years). The follow-up duration was $28.9{\pm}20.4$ months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1), cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years). Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia. During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.301-311
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• 2011

This study was performed to determine the self-perceived fatigue and its association with job stress contents and psychosocial factors among white collar male workers. The self-administered questionnaires were given to 872 workers employed in 42 work places during the period from February 1st to April 30th, 2009. As a results, in terms of levels of self-perceived fatigue according to the job stress contents and psychosocial factors, under significantly higher level of self-perceived fatigue were those with higher level of job demand, lower job autonomy, lower supervisor support and higher locus of control than their respective counterparts. Multiple stepwise analysis revealed that the factors of influence on self-perceived fatigue included age, subjective status of health, job career, experience of sick absence, sense of satisfaction in work, regular exercise, sleeping hours, visiting out-patient department, job demand, supervisor support and self-esteem. The study results indicated that the level of self-perceived fatigue is so complicatedly influenced by variable factors as well as socio-demographic characteristics, job-related characteristics and health-related behaviors, to a greater extent, by JCQ and psychosocial factors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1149-1154
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• 2014

Background: In Malaysia, data from the Malaysian Health Ministry showed colorectal cancer (CRC) to be the second most common type of cancer in 2007-2009, after breast cancer. The same was apparent after looking at males and females cases separately. In the present study, the Geographic Information System (GIS) was employed to describe the distribution of CRC cases in Kuala Lumpur (KL), Malaysia, according to socio-demographic factors (age, gender, ethnicity and district). Materials and Methods: This retrospective review concerned data for patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah Persekutuan Health Office, taken from the cancer notification form (NCR-2), and patient medical records from the Surgical Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed. All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0. Results: Patients aged 60 to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%), Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rd and 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petaling and Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearest neighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation (Moran's I) showed clustering significant with p<0.01, Z score 3.14 and Moran's Index of 0.007. When mapping clusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on the northeast side of KL. Conclusions: This study demonstrated significant spatial patterns of cancer incidence in KL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning of screening of CRC in the targeted population and improvement of healthcare facilities to provide better treatment for CRC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.226-232
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• 1999

Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.512-518
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• 2002

Purpose : Cerebral palsies are the most common and severe motor disabilities in childhood. There is currently increased interest in their occurrence and patterns of likely cause for a variety of reasons. Therefore, a retrospective study was carried out to understand the clinical features of cerebral palsy. Methods : A retrospective chart review was conducted of all children with cerebral palsy who were diagnosed at St. Benedict Hospital between March 1999 and March 2001. Results : Cerebral palsy patients were classified into 6 major groups. Of six groups, spastic diplegia is the most common type of cerebral palsy(55.3%). The risk factors of cerebral palsy were placenta previa(1 case), placenta abruption(1 case), cytomegalovirus infection(1 case), prematurity (53 cases), neonatal asphyxia(12 cases), dystocia(2 cases), breech delivery(1 case), multiple birth(5 cases), head trauma(3 cases), meningitis(2 cases) and unknown(26 cases). Among the 59 in the preterm group, 37 patients showed MR or CT images of periventricular leukomalacia. Among the 44 in the term group, 15 patients showed MR or CT images of atrophy. Among 103 patients, 29 patients(28.2%) had a seizure disorder. Conclusion : It is very importent to understand the clinical features and risk factors of cerebral palsy for physicians to diagnose and manage cerebral palsy patient.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.893-897
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• 2003

Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.202-209
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• 2017

South Korea is becoming an aging society, increasing the population with dementia. This study analyzed the characteristics of the trend of dementia patients by utilizing 12 years' worth of data from five V hospitals within metropolitan cities. The results show that there has been an 11.3 times increase in the total number of new dementia patients in these five hospitals from 410 in 2003 to 5,048 in 2014; and among them, the rate of increase was highest in P hospital with a 30.3 times increase. Conversely, there has been a 6-times increase in D hospital, illustrating a noticeable gap between these hospitals. Overall, these hospitals have shown an enormous increasing ratio. In an analysis according to age, it's been shown that those aged between 75 and 84 showed the highest prevalence, and most patients, approximately 93.5%, were 65 years or older, while 20.2% were 85 years or older, showing a high ratio of elderly among dementia patients. In an analysis by type of dementia, it's been shown that Alzheimer's was the most prevalent with 44.4%, followed by unspecified dementia with 33.3%, and vascular dementia with 20.4%. As evident by the outcome of the study, there's been a drastic increase in the number of dementia patients in the past 12 years; since the prevalence of dementia was shown to be higher with older age, it is expected that the number of dementia patients will rise further in these five hospitals, where there's a high ratio of elderly patients. More elaborate and continuous plans are necessary for the management of dementia patients following the growing number of dementia patients.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.754-762
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• 2000

Objectives : The surgical results of 80 patients with growth hormone(GH)-producing pituitary adenoma were analyzed retrospectively to evaluate the clinical manifestations and to determine which preoperative factors significantly influenced the surgical outcome. Patients and Methods : The patients consisted of 39 men and 41 women and the age of patients at the time of initial operation ranged from 17 to 67 years(mean age, 40.5 years) Between January 1990 and June 1996, 77 patients underwent transsphenoidal surgery and 3 patients underwent craniotomy for GH-producing pituitary adenoma at our institution. Preoperative administration of octreotide was performed in 18 patients. Surgical control was defined as a postoperative serum basal level of GH less than 5ng/ml. A logistic regression model was used for univariate and multivariate analysis. Probability value of less than 0.05 was considered as statistically significant. Results : The most common presenting symptom was acromegaly, followed by headache, visual disturbance, and fatigability. Visual symptoms were present in 39% of the patients. Diabetes mellitus was associated in 24 patients and hypertension in 12. Preoperative mean basal level of GH was 93.2ng/ml(range 72-500ng/ml) which was closely related with tumor size(p<0.05). Grade II by Hardy's classification was the most common radiological type. Preoperative octreotide treatment significantly reduced the level of GH(p<0.05), but not enough to induce endocrinological remission. One patient died of cerebral infarction after craniotomy. The most common surgical complication was transient diabetes insipidus. The symptom of the earliest improvement after surgery was paresthesia and tightness of the hand and foot, followed by headache and easy fatigability. The preoperative visual symptom was improved in all patients. The patients who had hypertension or DM experienced alleviated symptoms in 67% and 92%, respectively. The overall rate of endocrinological remission was 44%. By multivariate logistic regression analysis, the size of tumor, extrasellar extension, and extent of removal were significant prognostic factors for endocrinologial remission. Conclusion : Early detection of a small tumor without extrasellar extension followed by a complete resection is highly recommended in order to achieve endocrinological cure of GH-producing pituitary adenomas.

• The Journal of the Korea Contents Association
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• v.18 no.5
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• pp.432-445
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• 2018

For health care professionals(HCPs) who have relatively higher possibility of exposing tuberculosis(Tb), it is important for them to equip with proper levels of knowledge and prevention activities. In terms of establishment of Tb education model for junior HCPs, therefore, literature review was done alongside 129 junior HCPs and 14 HCPs were asked to answer questionnaires and telephone survey. The results are follows.; Firstly, six educational themes such as epidermiology of Tb, Tb transmission and patho-physiology, test and diagnosis, latent Tb, Tb treatment, and Tb prevention were identified, based on the literature review. Secondly, the junior HCPs showed lower levels of knowledge regarding epidermiology, transmission and patho-physiology and latent Tb, compared to the other themes. When education courses are planned, longer period of time should be given to the lower level of knowledge areas. Thirdly, the HCPs emphasized that definition and type of Tb should be well integrated into the education in particular epidermiology education. They also responded that hospital infection and infection cycle of Tb need to be addressed during educational session about transmission and patho-physiology. in addition, they said that specific and detailed contents about diagnosis and group examination should be carefully delivered during the education, along with diagnosis, test and application of personal protective devices during education of latent Tb. They also answered that patient education and adverse effect of Tb medication should be taught during Tb treatment session, as well as self activities of health promotion for junior HCPs and systematic TB education as key way of Tb prevention. As the findings were from limited numbers of respondents and contained the sampling bias, the result has to be carefully interpretated prior to generalization. Therefore, further survey with larger study population is required in terms of development of Tb education model.