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Aortopulmonary Window (대동맥폐동맥창)

  • Kim Dong-Jin;Min Sun-Kyung;Kim Woong-Han;Lee Jeong-Sang;Kim Yong-Jin;Lee Jeong-Ryul
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.275-280
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    • 2006
  • Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

A Inquiry of the Perception of Death in School Age (학령기 아동의 죽음인식에 관한 탐색적 연구)

  • Joun, Young-Ran
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.13-28
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    • 2008
  • Purpose: This paper aims to examine the subjective structures and types of school age children's perception of death through an investigative study on their perception of death in order to provide a basic material for them to understand death, and develop and carry out an effective death education program. Methods: The study method used the Q Methodology which can investigate the subjective structures and types of school age children's perception of death. For Q-population, 20 school age children were used as subjects for neutral interviews and open surveys, and through documentary research, a total of 132 statements were collected, For Q-samples, 23 statements (Q-samples) were derived through a non-structural method. P-samples were 31 school age children (8-13 year olds), Q-sorting was carried out using Q-cards, and the collected data was analyzed using the PC QUANL program. Results: As a result of the study, children's perception of death was divided into five types. The first type was functional type, characterized by prominent subjective perception regarding the elements of death, such as non-reversibility, universality, non-functionality, and causality. The second was after-life type, characterized by a strong, focus on life after death in one's perception of death, and it included children with Christian background and those who had experienced death in their immediate family. The third was religious type, characterized by a strong belief in being able to still watch over one's family and friends after one's death, resulting in a positive faith in the after-life. The fourth was fearful type, characterized by a deeper fear of death in comparison to other types. The fifth was realistic type, characterized by a strong and positive assent to the perception of good death. Conclusion: The significance of the results of this paper's study to Nursing is as follows. In terms of understanding the subjectivity of school age children's perception of death in nursing practice, and understanding the compositional elements of death presented with strong emphasis in existing literature and studies, the results will expand these understandings and allow us to understand the level of perception in school age children regarding the definition of death, after-life, and good death, be utilized as useful material in developing an effective death education program for them according to their type characteristics, and become the fertilizer for enabling the children to live a proper life and preventing the tendency to make light of death that occur in adolescence and the spread of suicides. In terms of nursing theory, the description and examination of the subjective structures and the characteristics of the different, types of school age children's perception of death can be utilized as useful material for building a model of school age children's perception of death, and be further used for teaching respect for life. In terms of nursing research, the results can contribute to research describing the effects of nursing intervention strategies and developing tools for providing psychosocial nursing in terms of giving school age children a positive perception of death according to their types as well respect for life.

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A Study on Establishment of Reference Value of CA 72-4 (CA 72-4 참고치 설정에 관한 연구)

  • An, Jae-Seok;Kim, Ji-Na;Joe, Ye-Ji;Yoon, Sang-Hyuk;Kim, Yoon-Cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.25-28
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    • 2021
  • Purpose CA 72-4 is a tumor marker that uses two monoclonal antibodies, CC49 and B72.3, to measure tumor-related glycoprotein(TAG72) in the serum. CA 72-4 is used to diagnose stomach, ovarian, and pancreatic cancers, and is known to perform high specificity for stomach cancer. The purpose of this study is to re-evaluate the reference value provided by the manufacturer through revalidation of the reference value in CA 72-4. Furthermore this study was conducted to provide useful help when making a clinical diagnosis at gastric cancer center. Materials and Methods We selected 271 patients who had been to health care center in national cancer center for the month of November 2020. The gender of the subjects was 140 males and 131 females, and the age group was from 30s to 60s. The reagent used in the study was a CA 72-4 IRMA KIT (ISOTOPES, Hungary) and the results were measured using a Dream Gamma-10 gamma counter (Shinjin medics, Korea). Results Statistical analysis of the results of this study used Hoffmann's method and Bayesian's method, which are primarily used in setting reference value. As a result of measuring CA 72-4 of 271 patients, the mean value was 4.54 U/mL and the median value was 3.30 U/mL. 24 people who deviated from 3SD were excluded from the measured value, the mean calculated after that was 3.53 U/mL, median was 3.00 U/mL and SD was 1.89. The reference value calculated based on this results was set to 7.31 U/mL. Conclusion The reference value provided by the manufacturer is less than 4 U/mL. It is slightly different from the value calculated in this study, 7.31 U/mL, so it seems necessary to reset the reference value according to the laboratory environment. Currently, we are receiving inquiries about the reference value from the center for gastric cancer at National Cancer Center. If additional research is carried out along with this study, it will be possible to set more accurate reference value.

Application of the Extract of Zanthoxylum piperitum DC to Manufacturing Eco-friendly Nosocomial Infection Control Protective Materials (초피의 항균 활성을 이용한 원내 감염 제어 친환경 방호 소재 개발)

  • Shin Young Park;Ki Yun Kim;Do Youn Jun;Sung Chul Kim;Hyo-Il Jung;Young Ho Kim
    • Journal of Life Science
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    • v.33 no.10
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    • pp.820-827
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    • 2023
  • Since COVID-19 began at the end of 2019, the wearing time of protective clothing used to prevent pathogenic bacteria and virus infection has increased, and the development of safe protective materials that are human-friendly and have antibacterial and antiviral functions has been required. In this study, we investigated the possibility of developing natural antibacterial protection materials using ethanol extract of the medicinal plant Zanthoxylum Piperitum DC. The antibacterial activity assay of the 80% ethanol extract of Z. piperitum DC leaves against various nosocomial infectious bacteria, using the disk diffusion method, showed that Staphylococcus aureus ATCC 25923, Klebsiella pneumoniae ATCC 13883, Salmonella typhimurium, and Aeromonas hydrophila are sensitive to the inhibitory action of the extract. The IC50 values of the ethanol extract against S. aureus, K. pneumoniae, P. vulgaris and A. hydrophila were about 0.59 mg/ml, 0.50 mg/ml, 1.06 mg/ml, and 0.06 mg/ml, respectively. To determine whether the ethanol extract of Z. piperitum DC leaves can be applied to the development of antibacterial protective fabric, the ethanol extract was tested using a protective fabric from the KM Health Care Corp. using the JIS L1902-Absorption method. As a result, the bacteriostatic and bactericidal activity values of S. aureus ATCC 25923 and K. pneumoniae ATCC 13883 appeared to be more than 2.0 when treated with the ethanol extract at a concentration of 1% (w/v). Together, these results suggest that Z. piperitum DC leaves can be applied to develop natural antibacterial functional protective fabrics.

Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.153-173
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    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

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A Study on Risk Parity Asset Allocation Model with XGBoos (XGBoost를 활용한 리스크패리티 자산배분 모형에 관한 연구)

  • Kim, Younghoon;Choi, HeungSik;Kim, SunWoong
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.135-149
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    • 2020
  • Artificial intelligences are changing world. Financial market is also not an exception. Robo-Advisor is actively being developed, making up the weakness of traditional asset allocation methods and replacing the parts that are difficult for the traditional methods. It makes automated investment decisions with artificial intelligence algorithms and is used with various asset allocation models such as mean-variance model, Black-Litterman model and risk parity model. Risk parity model is a typical risk-based asset allocation model which is focused on the volatility of assets. It avoids investment risk structurally. So it has stability in the management of large size fund and it has been widely used in financial field. XGBoost model is a parallel tree-boosting method. It is an optimized gradient boosting model designed to be highly efficient and flexible. It not only makes billions of examples in limited memory environments but is also very fast to learn compared to traditional boosting methods. It is frequently used in various fields of data analysis and has a lot of advantages. So in this study, we propose a new asset allocation model that combines risk parity model and XGBoost machine learning model. This model uses XGBoost to predict the risk of assets and applies the predictive risk to the process of covariance estimation. There are estimated errors between the estimation period and the actual investment period because the optimized asset allocation model estimates the proportion of investments based on historical data. these estimated errors adversely affect the optimized portfolio performance. This study aims to improve the stability and portfolio performance of the model by predicting the volatility of the next investment period and reducing estimated errors of optimized asset allocation model. As a result, it narrows the gap between theory and practice and proposes a more advanced asset allocation model. In this study, we used the Korean stock market price data for a total of 17 years from 2003 to 2019 for the empirical test of the suggested model. The data sets are specifically composed of energy, finance, IT, industrial, material, telecommunication, utility, consumer, health care and staple sectors. We accumulated the value of prediction using moving-window method by 1,000 in-sample and 20 out-of-sample, so we produced a total of 154 rebalancing back-testing results. We analyzed portfolio performance in terms of cumulative rate of return and got a lot of sample data because of long period results. Comparing with traditional risk parity model, this experiment recorded improvements in both cumulative yield and reduction of estimated errors. The total cumulative return is 45.748%, about 5% higher than that of risk parity model and also the estimated errors are reduced in 9 out of 10 industry sectors. The reduction of estimated errors increases stability of the model and makes it easy to apply in practical investment. The results of the experiment showed improvement of portfolio performance by reducing the estimated errors of the optimized asset allocation model. Many financial models and asset allocation models are limited in practical investment because of the most fundamental question of whether the past characteristics of assets will continue into the future in the changing financial market. However, this study not only takes advantage of traditional asset allocation models, but also supplements the limitations of traditional methods and increases stability by predicting the risks of assets with the latest algorithm. There are various studies on parametric estimation methods to reduce the estimated errors in the portfolio optimization. We also suggested a new method to reduce estimated errors in optimized asset allocation model using machine learning. So this study is meaningful in that it proposes an advanced artificial intelligence asset allocation model for the fast-developing financial markets.

The influence of the four noted physicians of Geum-Won era on the completion of the medicine in the Chosun dynasty (금원사대가의학(金元四大家醫學)이 조선조의학(朝鮮朝醫學) 형성(形成)에 미친 영향(影響))

  • Cheong, Myeon;Hong, Won Sik
    • Journal of Korean Medical classics
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    • v.9
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    • pp.432-552
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    • 1996
  • The influence of the four noted physicians of Geum-Won era(金元代) on the completion of the medicine in the Chosun dynasty(朝鮮朝) can be summarized as follows. 1. The four noted physicians of Geum-Won era were Yoo-Wan-So(劉完素), Jang-Jong-Jung(張從正), Lee-Go(李杲), Ju-Jin-Heung(朱震亨). 2. Yoo-Wan-So(劉完索) made his theory on the basic of Nae-Kyung("內經") and Sane-Han-Lon("傷寒論"), his idea of medicine was characterized in his books, for exemple, application of O-Oon-Yuk-Ki(五運六氣), Ju-Wha theory(主火論) and hang-hae-seng-je theory(亢害承制論). from his theory and method of study, many deviations of oriental medicine occurred. He made an effort for study of Nae-Kyung, which had been depressed for many years, on the contrary of the way old study that Nae-Kyung had been only explained or revised, he applied the theory of Nae-Kyung to clinical care. The theory of Yuk-Gi-Byung-Gi(六氣病機) and On-Yeul-Byung(溫熱病) had much influenced on his students and posterities, not to mention Jang-Ja-Wha and Ju-Jin-Heung, who were among the four noted physicians therefore he became the father of Yuk-Gi(六氣) and On-Yeul(溫熱) schools. 3. Jang-Jong-Jung(張從正) emulated Yoo-Wan-So as a model, and followed his Yuk-Gi-Chi-Byung(六氣致病) theory, but he insisted on the use of the chiaphoretic, the emetic and the paregoric to get rid of the causes, specially he insisted on the use of the paregoric, so they called him Gong-Ha-Pa(攻下派). He insisted on the theory that if we would strenthen ourselves we should use food, id get rid of cause, should use the paregoric, emetic and diaphoretic. Jang-Jong-Jung'S Gang-Sim-Wha(降心火) theory, which he improved Yoo-Wan-So's Han-Ryang(寒凉) theory influenced to originate Ju-Jin-Heung'S Ja-Eum-Gang-Wha(滋陰降火) theory. 4. Lee-Go(李杲) insisted on the theory that Bi-Wi(脾胃) played a loading role in the physiological function and pathological change, and that the internal disease was originated by the need of Gi(氣) came from the disorder of digestive organs, and that the causes of internal disease were the irregular meal, the overwork, and mental shock. Lee-Go made an effort for study about the struggle of Jung-Sa(正邪) and in the theory of the prescription he asserted the method of Seung-Yang-Bo-Gi(升陽補氣), but he also used the method of Go-Han-Gang-Wha(苦寒降火). 5. The authors of Eui-Hak-Jung-Jun("醫學正傳"), Eui-Hak-Ib-Moon("醫學入門"), and Man-Byung-Whoi-Choon("萬病回春") analyzed the medical theory of the four noted physicians and added their own experiences. They helped organizing existing complicated theories of the four noted physicians imported in our country, and affected the formation of medical science in the Choson dynasty largely. Eui-Hak-Jung-Jun("醫學正傳") was written by Woo-Dan(虞槫), in this book, he quoted the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, especially, Ju-Jin-Heung was respected by him, it affected the writing of Eui-Lim-Choal-Yo("醫林撮要"). Eui-Hak-ib-Moon("醫學入門"), written by Lee-Chun(李杲), followed the medical science of Lee-Go and ju-jin-heung from the four noted physicians of Geum-Won era. Its characteristics of Taoism, idea of caring of health, and organization affected Dong-Eui-Bo-Kham("東醫寶鑑"). Gong-Jung-Hyun(龔延賢) wrote Man-Byung-Whoi-Choon("萬病回春") using the best part of the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, this book affected Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") partly. 6. our medical science was developed from the experience of the treatment of disease obtained from human life, these medical knowledge was arranged and organized in Hyang-Yak-Jib-Sung-Bang("鄕藥集成方"), medical books imported from China was organized in Eui-Bang-Yoo-Chwi("醫方類聚"), which formed the base of medical development in the Chosun dynasty. 7. Eui-Lim-Choal-Yo("醫林撮要") was written by Jung-Kyung-Sun(鄭敬先) and revised by Yang-Yui-Soo(楊禮壽). It was written on the base of Woo-Dan's Eui-Jung-Jun, which compiled the medical science of the four noted physicians of Geum-Won era. It contained confusing theories of the four noted physicians of Geum-Won era and organized medical books of Myung era, therefore it completed the basic form of Byun-Geung-Non-Chi (辨證論治) influenced the writing of Dong-Eui-Bo-Kham("東醫寶鑑"). 8. Dong-Eui-Bo-Kham("東醫寶鑑") was written on the base of basic theory of Eum-Yang-O-Haeng(陰陽五行) and the theory of respondence of heaven and man(天人相應說) in Nae-Kyung. It contained several theories and knowledge, such as the theory of Essence(精), vitalforce(氣), and spirit(神) of Taoism, medical science of geum-won era, our original medical knowledge and experience. It had established the basic organization of our medical science and completed the Byun-Geung-Non-Chi (辨證論治). Dong-Eui-Bo-Kham developed medical science from simple medical treatment to protective medical science by caring of health. And it also discussed human cultivation and Huh-Joon's(許浚) own view of human life through the book. Dong-Eui-Bo-Kham adopted most part of Lee-Go(李杲) and Ju-Jin-Heung's(朱震亨) theory and new theory of "The kidney is the basis of apriority. The spleen is the basis of posterior", so it emphasized the role of spleen and kidney(脾腎) for Jang-Boo-Byung-Gi(臟腑病機). It contained Ju-Jin-Heung's theory of the cause and treatment of disease by colour or fatness of man(black or white, fat or thin). It also contained Ju-Jin-Heung's theory of "phlegm break out fever, fever break out palsy"(痰生熱 熱生風) and the theory of Sang-Wha(相火論). Dong-Eui-Bo-Kham contained Lee-Go's theory of Wha-Yu-Won-Bool-Yang-Lib (火與元氣不兩立論) quoted the theory of Bi-Wi(脾胃論) and the theory of Nae-Oi-Sang-Byun(內外傷辨). For the use of medicine, it followed the theory by Lee-Go. lt used Yoo-Wan-So'S theory of Oh-Gi-Kwa-Keug-Gae-Wi-Yul-Byung(五志過極皆爲熱病) for the treatment of hurt-spirit(傷神) because fever was considered as the cause of disease. It also used Jang-Jons-Jung's theory of Saeng-Keug-Je-Seung(生克制勝) for the treatment of mental disease. 9. Lee-je-ma's Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") adopted medical theories of Song-Won-Myung era and analyzed these theories using the physical constitutional theory of Sa-Sang-In(四象人). It added Dong-Mu's main idea to complete the theory and clinics of Sa-Sang-Eui-Hak(四象醫學). Lee-Je-Ma didn't quote the four noted physicians of Geum-Won era to discuss that the physical constitutional theory of disease and medicine from Tae-Eum-In(太陰人), So-Yang-In(少陽人), So-Eum-In(少陰人), and Tae-Yang-In(太陽人) was invented from their theories.

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Normative blood pressure references for Korean children and adolescents (한국 소아 청소년 정상 혈압 참고치)

  • Lee, Chong Guk;Moon, Jin Soo;Choi, Joong-Myung;Nam, Chung Mo;Lee, Soon Young;Oh, Kyungwon;Kim, Young Taek
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.33-41
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    • 2008
  • Purpose : It is now understood that blood pressure (BP) measurement in the routine pediatric examination is very important because of the relevance of childhood BP to pediatric health care and the development of adult essential hypertension. There hasn't been a reference table of BP for Korean children and adolescents up to now. This study was to make normative BP references and to provide criteria of hypertension for Korean children and adolescents. Methods : BP measurements were done on 57,433 Koean children and adolescents (male: 29,443, female: 27,990), aged 7 to 20 years, in 2005. Heights and weights were measured simultaneously. Oscillometric devices, Dinamap Procare 200 (GE Inc., Milwaukee, Wi, USA), were used for the measurements. BPs were measured 2 times and mean levels were gathered for the analysis. Outliers of 2,373 subjects with overweight per height, over +3SD, were excluded for the analysis. For the BP centiles adjusted by sex, age and height, fixed modified LMS method which was adopted from the mixed effect model of 2004 Task Force in NHLBI (USA) was used. Results : Normative BP tables for Korean children and adolescents adjusted for height percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th), gender (male, female) and age(7 to 18 years) were completed. Height centiles of Korean children and adolescents are available from Korean Center for Disease Control and Prevention homepage, http://www.cdc.go.kr/webcdc/. Criteria of hypertension (95th, 99th percentile) and normal range of BP (50th, 90th) adjusted for height percentiles, age and gender were made. Conclusion : This is the first study to make normative BP tables and define hypertension for the Korean children and adolescents. Reliability and accuracy of Dinamap Procare 200 oscillometer for BP measurements remains debatable.

The factors associated with the efficacy of indomethacin treatment in premature infants with patent ductus arteriosus (인도메타신 투여 시 미숙아 동맥관개존 치료효과에 영향을 미치는 인자)

  • Yoon, Min Jeong;Yoon, Hye Sun;Chung, Sung Hoon;Han, Mi Young;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.531-535
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    • 2007
  • Purpose : Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively. Results : The single-administered group was 19 patients out of 29 (65.5%) and among the repeated-administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger ($3.66{\pm}0.8mm$ vs $2.55{\pm}0.8mm$, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated-administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities. Conclusion : In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.

Incidence of breast milk jaundice in healthy full-term infants (건강한 만삭아에서 모유황달의 발생 빈도)

  • Yoon, Yong Ho;Choi, Kyong Eun;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1072-1077
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    • 2007
  • Purpose : It has been described that the incidence of breastfeeding jaundice is 13% and that of breast milk jaundice is 2%. The incidence in Korea was believed to be higher, but there were no studies to prove this assumption. The purpose of this study was to investigate the incidence of jaundice of healthy breastfed full-term infants in Korea. Methods : 839 infants were enrolled who were admitted to the Postpartum Care Center of the Cheil General Hospital between January 1 and December 31, 2005, and were followed up for more than 7 days. Those infants were divided into 3 groups; Exclusive breastfeeding group; Partial breastfeeding group; Formula feeding group. If they became icteric, transcutaneous bilirubin (TcB) was measured by research nurses with JM-103 Jaundice meter (Konica Minolta sensing, Inc., Osaka, Japan). Using this method we investigated the incidence of breast milk jaundice of healthy breastfed full-term infants. Results : There were no significant differences in sex, birth weight, Apgar score, or obstetric risk factors among 3 groups but there were higher rates of vaginal delivery in the exclusive breastfeeding group. The incidence of breast milk jaundice was 10.8% in the exclusive breastfeeding group and 4.4% in the partial breastfeeding group. The incidence of breast milk jaundice in the breastfed infants was 6.3%. The incidence was significantly higher in the exclusive breastfeeding group than in the partial breastfeeding group. Conclusion : The incidence of breast milk jaundice of healthy breastfed full-term infants was 6.3%. It was found that the incidence of breast milk jaundice was higher in this study than in other countries. But it was not a population-based study, so further study with the large sample sizes is needed.