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Orbital and Periorbital Cellulitis in Children: A Recent 7-Year Clinical Review (소아에서 안와와 안와주위 봉와직염에 관한 최근 7년간의 임상적 고찰)

  • Choi, Jeong Ho;Hon, Sun Yeong;Park, Sung Sin;Cha, Sung Ho;Kim, Eun Jin;Lee, Jin;Chang, Jin Keun
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.36-44
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    • 2008
  • Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

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Results of Stereotactic Radiosurgerv with Linear Accelerator for Intracranial Arteriovenous Malformation (두개강내 동정맥기형에서 선형가속기를 이용한 방사선수술의 결과)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Lee Yong Ha
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.215-224
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    • 1997
  • Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

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On Investigation of Status of Sex Education and Sex Education Needs of High School Students by Their Sexual Experience (일부지역 고등학생의 성교육 실태와 성경험에 따른 성교육 요구도 조사)

  • Lee, Seon-Suk;Cho, Soon-Ja;Sin, Yeon-Soon;Choi, In-Sook;Lee, Deok-Weon
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.85-105
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    • 2004
  • The purpose of this study is to provide basic data for practical and concrete program development, which can give students satisfaction in sex education. To achieve this purpose, an actual status of sex education for high school student and their sexual experience were investigated. And then tried to find out if there is difference of satisfaction in sex education and contents that they want to learn based on having sexual experience or not. For this study, a questionnaire of sexual awareness was conducted on 562 students among first graders and second graders of high school located in Kongju city, from on October 4th, 2004 to on October 15th. But only 550 answer sheets among 562 were analyzed, for 12 answer sheets were not proper enough to apply to this study. The collected data was computerized using SPSS WIN in frequency and percentage for actual condition of sex education and sexual experience and for satisfaction at the result of sex education based on having sexual experience or not. And then the $x^2$-test was verify the difference. The requirement for sex education, based on having sexual experience or not, was analyzed using t-test by computerizing the average and standard deviation. The conclusion of this study are as followings; 1. 93.8% students have ever been taught for sex education by teachers, but nursing teacher among them was the higher percentage than any other teachers. They took courses for sex education in discretion class, and the teaching method was a kind of lecture. 2. After taking sex education, 37.6% students said that it was boring, for they had already known the contents of the courses, and 43.8% students said that they acquired sex knowledge through the Internet and mass media. 3. It was highest percentage that 36.9% students had no agony about sex. The most serious worry was a sexual impulse and the sexual psychology of the opposite sex. To solve these worries, 61.6% students said that they consulted with their friends. 4. It showed that 89.9% male students and 71.6% female students had experiences various lascivious materials, 81.4% male students, 7.2 female students experienced masturbation, 52.7% female student and 44.8% male students experienced kissing or hugging, and 13.7% male students and 9.9% female students experienced sexual intercourse. 5. The satisfaction for sex education based on having sexual experience or not was different. In short, it showed that the students who experienced sexual experiences such as accessing to lascivious materials, kissing, hugging, and sexual intercourse except masturbation thought that sex education was important than the students who didn't experience sexual experiences. On the other hand, the students who didn't experience sexual experiences were more satisfied with the contents and level of sex education than the students who experienced sexual experiences. 6. The requirement for sex education based on having sexual experience or not was also different. The students who experienced sexual experiences wanted to learn an acquaintance with the other sex than the others. On the other hand, the students who didn't experience sexual experience wanted to learn friendship and love. The students who experienced sexual experience except masturbation was more desirable for taking sex education than the other students. In conclusion, it is fully required that sex education should be regular subject in school and teachers who are charge of sex education should be experts in this field, for only expert can teach systematic and adequate sex knowledge to students. In addition, it is also essential to understand contents of sex education which can be satisfactory for students' requirement. So we should develop concrete and practical programs for sex education.

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The Relationship Between Health Behavior and Family Environment in Middle School Students (중학생(中學生)의 건강행위(健康行爲)와 가족환경(家族環境)과의 관계(關係))

  • Kim, Eun Hee;Park, Jae Yong;Cha, Byung Jun;Kam, Sin
    • Journal of the Korean Society of School Health
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    • v.10 no.1
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    • pp.87-97
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    • 1997
  • The purpose of this study is to examine the importance of family environment for middle school student's health behavior. In order to do this we collected data through the questioning of 543 male students and 512 female students in 4 Pusan middle schools. The results of this study are summarized as follows. The score on their family cohesion and adaptability was 57.8, 43.5 on the average for male students and 59.8, 44.8 in female students. The score on their family adaptability and cohesion was higher in fema1e students than male students. The score of their Breslow health behavior was 4.20 from a total of 7.00, the total score of health behavior was 131.4 from a total of 176.0 scores. The students had a 43.9 out of 60.0 in personal hygiene and daily habits, 32.8 out of 40.0 for infectious disease preventive behavior, 30.2 out of 40.0 in accident prevention, 24.5 out of 36.0 in mental health. In the cases of males, the score for Breslow health behavior was higher the lower the school grade, the younger the parents, the higher the educational level of parents, the more comfortable the family, and the higher the economic state. There was a statistically significant difference with regard to family cohesion and adaptability. In the cases of females, The total score for health behavior was higher. However, the difference was not significant in other fields. With the multiple regression analysis, the health behavior of middle school student was associated significantly with sex (female students), grade, family cohesion, and adaptability. In Breslow health behavior, scale sex (male students), father's age, family cohesion and the harmony of parents were significant variables. From the results of this study, a good family environment fur middle school students is very important.

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Incidence of Immunoglobulin G Subclass Deficiencies in Patients with Bronchiectasis and the Clinical Characteristics of Patients with Immunoglobulin G Subclass Deficiency and Bronchiectasis (기관지확장증 환자에서 면역글로불린 G 아강 결핍증의 빈도 및 특성)

  • Kim, Chang Hwan;Kim, Dong-Gyu;Park, Sung Hoon;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Sin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol-Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.295-299
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    • 2009
  • Background: There are various etiologies causing bronchiectasis, but the cases without definite causes account for a quite high proportion. It is also uncertain that immunoglobulin G subclass deficiency (IgGSD) is associated with bronchiectasis. Therefore, we tried to measure the frequency of IgGSD in patients with bronchiectasis of unclear etiology, and to observe the clinical features of those patients with bronchiectasis and IgGSD. Methods: For the outpatients of a university hospital who were diagnosed as bronchiectasis by chest CT, we produced comprehensive history taking and physical examinations, and finally selected 31 patients with bronchiectasis of unclear etiology. Results: Two patients had total immunoglobulin G deficiency. The frequency of IgGSD was comparatively high (n=14). When we compared IgGSD group to normal immunoglobulin G subclass group, there were no significant differences in sex, age, and the frequency of sinusitis, bronchial asthma, and the abnormal lung function. Conclusion: In cases of bronchiectasis without definite causes, it can be considered to measure the level of immunoglobulin G subclass. It is also probably worthwhile to further evaluate the relationship between IgGSD and bronchiectasis.

Dental Care Utilization Patterns and Its Related Factors of the Rural Residents (경상북도 일부 농촌지역 주민의 치과의료이용양상 및 관련요인)

  • Chang, Bun-Ja;Kim, Ji-Young;Song, Keun-Bae;Kam, Sin;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.171-182
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    • 2003
  • Objectives: This study was conducted to analyze the dental care utilization patterns and related factors of the rural residents. Methods: The data collected by interview and self-administered questionnaire survey of 524 peoples of Seongju county in Gyeongsanbuk-do. The summarized results are as follows. Results: The rate of persons who experienced the oral disease was 52.5% during 1 year and it was at most in the age group of 40-49. The rate of persons who had experienced the oral disease were investigated according to general characteristics, perception of oral health, being of regular treatment facility. Therefore the rate of persons who had experienced the oral disease was significantly higher the younger peoples, worse oral health status and being of the regular treatment source than the other groups. During 1 year period, 64.0% of the cases had treated the perceived oral disease, 36.0% did no action at all during last year. Among respondents, 49.4% had treated their oral disease at dental clinics, 8.0% had treated at community health center or subcenter and remains did not treated at all. The results of logistic regression analysis suggested that statistically significant factors in dental health care utilization were educational level, degree of pain, oral health status and regular treatment facility. Therefore the dental health care utilization rate was higher at groups with the high educational level, serious pain, better oral health status and being of the regular treatment source than other groups. 45.5% of the rural residents did not treat their oral disease immediately due to the no identified need, limitation of time(19.2%), economic limitation(19.2%), and geographical limitation(9.0%). Conclusions: In consideration of above findings, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically.

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Attitude and Participation Status on District Health Planning in Officials of Health Centers (보건소 공무원의 지역보건의료계획 수립 참여실태 및 태도)

  • Jeong, Han-Ho;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.135-154
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    • 2003
  • Objectives: This study was performed to investigate attitude and participation status on district health planning of officials in Health Centers. Methods: The data collected by self-administered questionnaire survey of 674 officials of Health Centers and the data on district health planning of 28 Health Centers in Gyeongsangbuk-do and Daegu metropolitan city were analyzed. Results: Only 13.6% of officials of Health Centers responded that they had read 'the second district health planning paper' thoroughly and 12.5% of officials of Health Centers replied that they had known contents of 'the second district health planning paper' fully. 56.9% of officials of Health Centers didn't have 'the second district health planning paper'. Thirty five point four percent(35.4%) of health center officials replied that the mayor's or county executive's concern about the district health planning was high, 22.4% in councilors, 77.8% in Health Center chiefs, 44.9% in Health Center officials, 43.9% in him or her. Among respondents, 58.6% of Health Center officials replied that district health planning was necessary and 38.0% of subjects replied that the degree of utilization of district health planning was high. About thirty seven percent(36.9%) of respondents participated in making out 'the second district health planning paper' and 49.6% in 'the third district health planning paper'. Health Center officials replied that the most serious problem of district health planning was 'lack of budget and personnels'(39.8%), 'lack of concern for district health planning'(21.4%) and the most important thing to improve district health planning was 'establishing department for health planning', 'adjustment of establishment time for district health planning'. Conclusions: In order to establish effective district health planning, it would be necessary to secure budget and personnels, to promote the county executive's concern and Health Center officials' concern about the district health planning, to establish department for health planning, and to adjust establishment time for district health planning.

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Health Care Utilization Pattern and Its Related Factors of Low-income Population with Abnormal Results through Health Examination (저소득층 건강검진 유소견자의 의료이용 양상 및 관련요인)

  • Kwon, Bog-Soon;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.87-105
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    • 2003
  • Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.

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Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

Educational Needs of Elderly Hypertensive or Diabetes Patients and Educators for Education Program Development of Cardiocerebrovascular High-risk Group (심뇌혈관질환 고위험군 교육프로그램개발을 위한 노인 고혈압·당뇨병환자와 교육자의 교육요구도 및 지식수준에 대한 비교분석)

  • Lee, Hye-Jin;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.35 no.2
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    • pp.177-192
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    • 2010
  • Objectives: This study was conducted to examine the educational needs of elderly hypertensive or diabetes patients and educators for the education program development of cardiocerebrovascular high-risk group in community. Methods: This study was conducted with 60 hypertensive or diabetes patients aged 65 years or above (cardiocerebrovascular high-risk group) who had registered KHyDDI(Korea Hypertension Diabetes Daegu Initiative) Project and attended Hypertension Diabetes Intervention Center Program, and with 44 educators in the center between June and August, 2009. Data were collected using questionnaires including general characteristics, educational objectives, curriculum, contents, and methods. Results: The major findings of this study were as follows: In education methods, cardiocerebrovascular high-risk group and educators both preferred small-grouped(5-9 persons) or individual education, 30min-1 hour, 50%-50% of theory-practice ratio, 3 months of education. In education contents, both groups needed all the suggested contents. Five categories would be suggested for the development of education program. The first category was that there was no significant difference between cardiocerebrovascular high-risk group's needs and knowledge. The second was category of low knowledge level in cardiocerebrovascular high-risk group's knowledge. The repeated education would be necessary for this category. The third was category with large standard deviation in cardiocerebrovascular high-risk group's knowledge. Individual education would be necessary for this category. The fourth category was that there was significant difference between cardiocerebrovascular high-risk group's knowledge and knowledge assessed by educators. The improvement of educator's education skill would be necessary for this category. The fifth category was that there was significant difference between cardiocerebrovascular high-risk group and educator's needs. Conclusions: Small group or individualized and staged education reflecting above cardiocerebrovascular high risk group and educators' needs should be developed for more effective education to prevent and manage the cardiocerebrovascular disease.