• Childhood Kidney Diseases
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• v.25 no.2
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• pp.122-127
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• 2021

C1q nephropathy is a rare glomerulopathy that typically presents with nephrotic syndrome in children. Treatment with immunosuppressive agents renders patients vulnerable to infection and its complications. Gastroenteritis is common in children, and rotavirus is a leading cause. Extraintestinal manifestations of rotavirus have recently been reported; however, there is a paucity of cases exploring the involvement of a rotavirus on the respiratory system. Acute respiratory distress syndrome (ARDS) is a rapid onset respiratory failure characterized by noncardiogenic pulmonary edema and hypoxemia. Causes of ARDS include sepsis, pneumonia, pancreatitis, aspiration, and trauma. In this paper, we report a case of ARDS after rotavirus infection in a child with C1q nephropathy who had been treated with immunosuppressive agents.

• Journal of Oriental Medical Thermology
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• v.1 no.1
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• pp.28-37
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• 2002

Stable Compression Fractures(SCF hereafter) are most often caused by trauma such as traffic accidents. These SCFs usually occur in the thoracic and lumbar regions of the spinal cord. Human life spans have increased as a result of medical advances, which in turn has led to an increase in the elderly population. SCFs are divided into the categories of stable and unstable. The categories are determined through X-rays and P/Ex tests. The D.I.T.I. is then used to diagnose the severity and prognosis of the fracture injuries, and it allows an objective evaluation of the symptoms. This author researched 40 patients who were treated at Wonkwang University Oriental Medical Center from October 1995 to December 1996. The patients were diagnosed by X-ray as having SCFs and treated primarily with acupuncture. Both the changes in D.I.T.I. and patients' self-diagnoses of their conditions before and after treatment yielded the meaningful results which have been presented here. 1. 75% of those who suffer from Stable Compression Fractures are 60 years of older. Of those, the ratio of male to female is 1 to 4. This is due in part to the fact that many elderly women seek Oriental medicine treatment for conditions associated with advanced age. 2. 53.3% of these injuries occurred between T11 and L2. 3. 65% of patients were hospitalized for 10 to 29 days, and then able to be treated on an outpatiens basis. 4. The D.I.T.I. results showed 50% below $0.2^{\circ}C$, 30% between 0.3 and $0.5^{\circ}C$, 10% between 0.5 and $0.7^{\circ}C$, 10% between 0.7 and $0.9^{\circ}C$, and 0% over $0.9^{\circ}C$. 5. The results of treatment using Modified Evaluation System in Thoracolumbar Vertebral Fractures Method showed that 55% of patients achieved excellent recovery and 40% achived good recovery. After comparing the D.I.T.I. results before and after treatment, we found 50% of patients showed excellent recovery $({\Delta}T{\leq}0.2)$ and 40% showed good recovery$(0.2<{\Delta}T{\leq}0.5)$.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.51-56
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• 2009

Purpose: The purpose of this study was to investigate environmental factors contributing to childhood home slip-down injuries. Methods: Among a total of 2,812 injured children in our Customer Injury Surveillance System (CISS), we performed a prospective study on 262 children with home slip-down injuries who visited the pediatric emergency department of Asan Medical Center between March 2008 and February 2009. We made a frequency analysis on parameters such as activities just before the accident, the presence of any obstacles or lubricant materials, specific home place in the home where the injuries occurred, flooring materials on which the slip-down happened, additional objects hit after slip down, the site and kind of injury, the duration of therapy, and the disposition. Results: Walking was the most common activity just before the injury. Because rooms and bathrooms were most common places in the home for slip down injuries, laminated papers/ vinyl floor coverings and tiles were the most common flooring materials used in the places where the injuries occured. Most commonly, no obstacles caused the children to slip down, but the furniture, stairs, doorsills, wetness, or soapy fluid followed after that. Over half of the children who slipped (58%) also collided with other than the floor itself after the slip-down, most common objects hit were the edges of the furniture, and doorsills, followed by stairways. The head and neck were the most commonly injured sites, and a laceration was the most common kind of injury. Most children needed less than 1 week of therapy, only 4 children (1.53%) admitted. There were no mortalities. Conclusion: The environmental factors contributing to slip-down injuries were the bathroom, laminated papers/vinyl floors, the furniture, stairs, doorsills, and wetness or soapy fluid. Especially, the furniture, stairs, and doorsills can be both primary obstacles and secondary collision objects. For the safety of our children, we must consider these factors on housing, when decorating or remodeling our house.

• Korean Journal of Acupuncture
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• v.33 no.3
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• pp.102-113
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• 2016

Objectives : This study is aimed at developing and discussing the prediction model of blood stasis pattern of traditional Korean medicine(TKM) using machine learning algorithms: multiple logistic regression and decision tree model. Methods : First, we reviewed the blood stasis(BS) questionnaires of Korean, Chinese, and Japanese version to make a integrated BS questionnaire of patient-reported outcomes. Through a human subject research, patients-reported BS symptoms data were acquired. Next, experts decisions of 5 Korean medicine doctor were also acquired, and supervised learning models were developed using multiple logistic regression and decision tree. Results : Integrated BS questionnaire with 24 items was developed. Multiple logistic regression models with accuracy of 0.92(male) and 0.95(female) validated by 10-folds cross-validation were constructed. By decision tree modeling methods, male model with 8 decision node and female model with 6 decision node were made. In the both models, symptoms of 'recent physical trauma', 'chest pain', 'numbness', and 'menstrual disorder(female only)' were considered as important factors. Conclusions : Because machine learning, especially supervised learning, can reveal and suggest important or essential factors among the very various symptoms making up a pattern identification, it can be a very useful tool in researching diagnostics of TKM. With a proper patient-reported outcomes or well-structured database, it can also be applied to a pre-screening solutions of healthcare system in Mibyoung stage.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.91-99
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• 2008

Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was $3.7{\pm}2.1$, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.61-69
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• 1979

In Korea, the regional differences of medical facilities and man-powers are very serious recently. in order to solve rural medical problem, the comprehensive health care service is required earnestly in rural area. The present study was performed to provide the material for rural medical policy by analyzing the diseases occurring frequently in rural area and assuming the paramedical workers' abilities of medical treatment. The frequently by occurring diseases were classified by investigating. The chief complaints of 4559 subjects through home visiting for last weeks occurred in 1978. The paramedical workers' abilities of medical treatment were investigated by analyzing the clinical charts of patients treated by paramedical workers by systemic health care delivery system from, September 1977 to December 1977. The results obtained are summarized as fellows; 1. The rate of disease suffering recently for 2 weeks was 22.5% in Rural area. 2. The rate of respiratory disease was 36.%, gastrointestinal disease 18%, trauma 8% and neuromuscular disease 7.5%, respectively. 3. The coverage of treatment by health workers was 97.6% in general practitioner, 70% in community health practitioner and 42.1% in community health aid, respectively.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.208-211
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• 1998

Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.

• Clinics in Shoulder and Elbow
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• v.21 no.2
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• pp.82-86
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• 2018

Background: Although a common shoulder disease, there are no accepted classification criteria for frozen shoulder (FS). This study therefore aimed to evaluate the accuracy of the conventionally used FS classification system. Methods: Primary FS patients (n=168) who visited our clinic from January 2010 to July 2015 were included in the study. After confirming restrictions of the glenohumeral joint motion and absence of history of systemic disease, trauma, shoulder surgery, shoulder muscle weakness, or specific x-ray abnormalities, the Zuckerman and Rokito's classification was employed for diagnosing primary FS. Following clinical diagnosis, each patient underwent a shoulder magnetic resonance imaging (MRI) and blood tests (lipid profile, glucose, hemoglobin A1c, and thyroid function). Based on the results of the blood tests and MRIs, the patients were reclassified, using the criteria proposed by Zuckerman and Rokito. Results: New diagnoses were ascertained including blood test results (16 patients with diabetes, 43 with thyroid abnormalities, and 149 with dyslipidemia), and MRI revealed intra-articular lesions in 81 patients (48.2%). After re-categorization based on the above findings, only 5 patients (3.0%) were classified having primary FS. The remaining 163 patients (97.0%) had either undiagnosed systemic or intrinsic abnormalities (89 patients), whereas 74 patients had both. Conclusions: These findings demonstrate that most patients clinically diagnosed with primary FS had undiagnosed systemic abnormalities and/or intra-articular pathologies. Therefore, a modification of the Zuckerman and Rokito's classification system for FS may be required to include the frequent combinations, rather than having a separate representation of systemic abnormalities and intrinsic causes.

• Journal of agricultural medicine and community health
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• v.16 no.1
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• pp.40-47
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• 1991

Musculoskeletal disorders are a major cause of occupational disabilities. Approximately thirty percent state that the major reason for an inability to work is a musculoskeletal problem. A farm work is associated with increased stress and trauma to joints. Chronic overuse injuries are a result of stresses that exceed the body's adaptive or healing capabilities. They can occur in bone, tendons and muscle-tendon-bone junctions. The aim of the investigation was to the study the frequency of pain, ache, and discomfort in the musculoskeletal system among farmers, to find possible correlations between these symptoms and various working positions and different working actions. A questionnaire was answered by 138 farmers. Of those who answered the questionnaire 82% had pain and discomfort from back, shoulders, arms in orders, The result showed that musculoskeletal pain predominate in the farming seasons, and of those who had pain and discomfort 89% thought that farm works had a correlation with the pain and discomfort of musculoskeletal system. But only 17% of quationnaire were put to periodic medical examinations, and 50% of those who had pain and discomfort consulted a doctor. Education in effective pain treatment should therefore be intensifide to ascertain that farmers in rural areas have satisfactory knowledge of the musculoskeletal pain as a chronic overuse syndrome.