• Neonatal Medicine
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• v.17 no.1
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• pp.53-63
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• 2010

Purpose : Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR. Methods : The study subjects consisted of very low birth weight (VLBW) infants with a gestational age $\leq$32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge. Results : The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group. Conclusion : EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.198-206
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• 2019

Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

• Korea journal of population studies
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• v.20 no.2
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• pp.161-180
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• 1997

There are about 400, 000 Korean ethnics living in Central Asia. Most of Koreans in Central Asia are leading a stable middle class life mostly engaged in farm work. With increase of educational attainment of their children, a number of Koreans are launching into political and academic circles as well as in the cultural world or the press. In recent years, however, the countries in this area(Uzbekistan and Kazakstan) for this study advocate an ethnic united policy to stabilize the politics and society and to carry out efficient transformation from the former socialistic economy to a market oriented economy. In addition, they are trying to recover the culture and the language of each nation which has been forgotten in the assimilation of Russia policy. Koreans have difficulty in adaption to this kind of change. In fact, a number of Koreans lost traditional culture and could not speak their mother language - Korean. Although they more or less maintain national consciousness, they recognize Uzbekistan or Kazakstan as their nation politically. They associated with North Korea unilaterally before the launching of the Perestroika policy. But after the Seoul Olympics held in 1998, there was movement to know and understand South Korea. There has been increased in the investment by Korean companies in Central Asia. Now, what is an alternative idea for Korean community consciousness\ulcorner It can be summarized as follows: 1) The increase of aid to Korean education institute : Considering the last few decades of Russia's strong racial assimilation policy, which leads most Koreans to lost their language and national culture, the priority should go to Koreans education. 2) Local Korean press support : Though Korean newspaper are published and Korean broadcasting is on the air currently in Uzbekistan and Kazakstan, they are suffering from qualified staff and poor financial status. Therefore, positive support should be established for these Korean mass communication media outlets to recover their own function and expand their dissemination powers quickly. 3) Research on the actual condition for Korean Community : It is essential to directly examine the local Korean community's regional distribution, population structure, Korean group's formation and operation, social and cultural understanding, racial consciousness, hope for their mother land and much more. 4) Increase of mother land and education opportunity : To stir up national culture and national consciousness within the Korean community, it is necessary to expand continuous opportunities for mother land visits and education training for local Koreans, especially for second and third generations.

• Korea journal of population studies
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• v.10 no.1
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• pp.50-69
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• 1987

There are about 400, 000 Korean ethnics living in Central Asia. Most of Koreans in Central Asia are leading a stable middle class life mostly engaged in farm work. With increase of educational attainment of their children, a number of Koreans are launching into political and academic circles as well as in the cultural world or the press. In recent years, however, the countries in this area(Uzbekistan and Kazakstan) for this study advocate an ethnic united policy to stabilize the politics and society and to carry out efficient transformation from the former socialistic economy to a market oriented economy. In addition, they are trying to recover the culture and the language of each nation which has been forgotten in the assimilation of Russia policy. Koreans have difficulty in adaption to this kind of change. In fact, a number of Koreans lost traditional culture and could not speak their mother language - Korean. Although they more or less maintain national consciousness, they recognize Uzbekistan or Kazakstan as their nation politically. They associated with North Korea unilaterally before the launching of the Perestroika policy. But after the Seoul Olympics held in 1998, there was movement to know and understand South Korea. There has been increased in the investment by Korean companies in Central Asia. Now, what is an alternative idea for Korean community consciousness\ulcorner It can be summarized as follows: 1) The increase of aid to Korean education institute : Considering the last few decades of Russia's strong racial assimilation policy, which leads most Koreans to lost their language and national culture, the priority should go to Koreans education. 2) Local Korean press support : Though Korean newspaper are published and Korean broadcasting is on the air currently in Uzbekistan and Kazakstan, they are suffering from qualified staff and poor financial status. Therefore, positive support should be established for these Korean mass communication media outlets to recover their own function and expand their dissemination powers quickly. 3) Research on the actual condition for Korean Community : It is essential to directly examine the local Korean community's regional distribution, population structure, Korean group's formation and operation, social and cultural understanding, racial consciousness, hope for their mother land and much more. 4) Increase of mother land and education opportunity : To stir up national culture and national consciousness within the Korean community, it is necessary to expand continuous opportunities for mother land visits and education training for local Koreans, especially for second and third generations.

• Journal of the Korean Society of School Health
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• v.2 no.1
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• pp.58-90
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• 1989

This study was attempted to contribute to the development of school health by providing the basic data about the distribution basis and distribution aspect of teachers holding additional school health that are in charge of school health business in parimary schools, middle schools and high schools without any nurse-teacher. This study analyzed literatures about the history, related laws, organization and professional manpower of school health. The emphasis was set on the distribution basis of theachers holding additional school health. The results of this study are as following: 1. The school health of the world dates to the late 18th century in Europe where was free supplying with food for poor children. The school health of Korea orginated from smallpox vaccination which was executed with appearance of modern schools in the late 19th century. 2. The related laws of school health began as a part of Education Law with was constituted in 1949. By the School Health Law constituted in 1967 and the enforcement ordinance of School Health made firm the legal basis of school health. 3. The administrative organs of school health are the Ministry of Education in center and each Board of Education in cities and provinces. For the first time in 1979, the department of school health was established in the organization of the Ministry of Education. And at about the same time of establishment of the department of school health, health section was established in the department of social physical-training in locality. 4. In the manpower of school health which was presented in the related statute of school health, there are the ward chief of education, the superintendent of educational affair, of cities and districts, the mayors, the governors of provinces, the school managers, the principals, the school doctors, the school pharmacists, and the nurse-teachers, including teachers holding additional school health as the practical manpower of school health. 5. In order to get some information on distribution aspect of teachers additional school health, this study made up a questionnaire from August 3 to August 11, 1988. The subjects of this study were 212 leachers who took part in the yearly training for teachers holding additional school health from Kyunggi province, Chungbuk province and Jeonbuk province. The results of the questionnaire are as following: 1. The distribution percentages of teachers holding additional school health according to each Board of Education wich schools are subject to, are as following:70.1% (Kyunggi), 76.5% (Chungbuk), and 81.4% (Jeonbuk). There was a significant difference. The distribution percentages of teachers holding additional school health according to the school levels of 3 provinces are as following: 74.1% (Primary schools), 77.8% (Middle schools), 76.7% (High schools). There were little significant differences. 2. The distribution according to the general characteristics of the subject schools: There were 64.2 percent of primary schools and 35.8 percent of middle schools among 212 schools. 91. 5 percent of schools were located in districts. Public schools formed 55.7% and then national schools were higher in percentage than private schools. 58.5 percent of schools had 1-9 classes, 64.6 percent of schools had 101-500 students, and 90 percents of schools had 1-20 teachers. In considering student sex, the coed school showed the high distribution percentage (Primary schools : 100%, Middle schools: 81.6%). 3. The distribution according to the characteristics of teachers holding additional school health: 93.3 percent of teachers were female, and more than 60 percent of teachers were 20-29 years old. As the age got higher, the percentage became lower. There were little significant differences by marital status. In considering their educational status, 86.8 percent of teachers in primary schools were from teacher's colleges, and 64.5 percent of teachers in middle schools were from education colleges. In considering teaching career, 46.7 percent of teachers had teaching career of less than 2 years. 73.6 percent of teachers had held additional school health for less than one year. More than 80 percent of teachers had participated in the training one time or twice. More than 70 percent of teachers had 1-2 additional jobs except for the school health business. The motivation to hold additional school health is most caused by mandatory order, which accounts for more than 80.0 percent. In considering interesting degree concerning school health, lukewarm answer is the highest of 62.7 percent, followed by affirmative answer of 23.6 percent. In considering their contentment degree respecting additional school health job, "discontent or very discontent"is the highest of 47.6 percent. As a descontent reason of additional school health job, overwork is the highest factor of 37.9 percent. Among addiitional school health job, the most difficult affair is nursing service to be 34.0 percent, followed by health education of 31.6 percent. It testify the need of professional. The source of knowledge about school health has been acquired from masscommunication or private health experience, which account for as much as 56.1 percent. It shows seriousness of lack of professionalism. With regard to neccessity of school health experts, 95.8 percent represents absolute need. With above consideration of study results, I propose as follows : 1. I propose that the authorities concerned unify and improve statute respecting current school health which has not been steadfastly supporting school health business by ambiguity of expression and dualization. 2. I propose that the authorities concerned give the school manager, school staffs and parents of students educational chance with which they can acknowledge the importance of school health and in which they can participate as well as set up alternative policy plan to be albe to vitalize school health committee. 3. I propose that administrative organization practicable to taking totally charge of school health business is established within the Ministry of Education. 4. I propose that the authorities concerned back up and cooperate in an attempt by make school health better and desirable toward development by way of appointing qualitied health teachers on the basis of legally regular teacher staffs.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.832-838
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• 2005

Purpose : Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has been reported rarely in Korea. Methods : A clinical study was performed on 556 patients of M. pneumoniae pneumonia diagnosed serologically at Gil hospital from January 2001 to December 2004. We reviewed 65 cases among these patients, who had elevated level of serum AST and ALT greater than 50 IU/L respectively without evidence of hepatitis A, B, C, Cytomegalovirus and Ebstein-Barr virus infections. Results : Hepatitis occurred in 11.7% of Mycoplasma pneumoniae pneumonia, especially in fall and winter times. Male to female ratio was 1.2 : 1 and the mean age was 4 years and 3 months. Besides hepatitis, cough(95.4%), sputum(52.3%) and dyspnea(12.3%) were common as pulmonary manifestations. And among gastrointestinal manifestations, nausea/vomiting(26.2%) was the most common symptom, followed by poor oral intake(12.3%), diarrhea(12.3%) and abdominal pain(6.2%). In addition to hepatomegaly(4.6%) and splenomegaly(4.6%), coarse breathing sound was the most common physical manifestation, followed by rale(63.1%), pharyngeal injection(26.2%), and rash(10.8%). Anemia was noted in 20.0%, neutrophilia in 10.8%, eosinphilia in 38.5% and thrombocytosis in 6.2%, respectively. Mean level of ESR and CRP was 32.02 mm/hr and 6.69 mg/dL, respectively. Mean level of AST and ALT was 293.80 IU/L and 181.48 IU/L, respectively. Hyperbilirubinemia was noted in 7.7% and hypoalbuminemia was noted in 58.5%. Lobar or lobular pneumonia(78.5%) was the most common finding in chest X-ray and left lower lobe(39.2%) was most commonly affected. Pleural effusion was noted in 26.2%. Mean duration of hospitalization was 9.91 days. Serum AST/ALT level was normalized within 9.94 days and pulmonary consolidation resolved within 14.29 days. Conclusion : The prognosis of M. pneumoniae hepatitis is good. However, liver function should be considerately checked in M. pneumoniae infection because its incidence is not so low.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.557-566
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• 2009

Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.