• Title/Summary/Keyword: cases report

Search Result 5,529, Processing Time 0.042 seconds

Child Abuse Experience, perception of the Cause of the Child Abuse and Need for counseling among Day Care Center Teachers (어린이집 아동학대에 대한 보육교사의 경험, 인식 및 상담 요구도 실태조사)

  • Kyung-Sook Lee;Jin-Ah Park;Myung-Hee Choi
    • Korean Journal of Culture and Social Issue
    • /
    • v.21 no.2
    • /
    • pp.227-252
    • /
    • 2015
  • This study was intended to examine child abuse experience, response to child abuse, perception of the cause of child abuse, and need for counseling to prevent and eliminate child abuse among 514 day care center teachers across the country. First, 17.9% (92) of the teachers had experience of witnessing child abuse at day care centers. After such witness, the teachers mostly "paid attention to abused children and provided them with warm treatment" when they were abused by other teachers and "took no actions" when they were abused by directors of the day care centers. The biggest reason of not taking any actions was: they "had no authority to intervene in child care of other teachers" in case of child abuse by other teachers and "were afraid of responsibilities or roles that could be placed on them after reporting" in case of child abuse by day care center directors. Second, the biggest reason of child abuse by teachers was job stress followed by excessive work and mental health of teachers. Third, necessary actions when child abuse cases were found and confirmed were suspension of involved teachers and psychological evaluation for involved children and parents. Fourth, 88.9% (457) of the teachers responded that they would use an organization specialized in child abuse if such organization was built and that the organization would help them to decide on whether to report child abuse and prevention of and intervention in child abuse. They also said that such organization should be installed in the Counseling Center in the Comprehensive Child Care Support Center. Fifth, 95.3% (490) of the teachers answered professional counselors specialized in development and counseling of infants and toddlers were needed to address child abuse at day care centers. They demanded that such counselors should be able to administer psychological evaluation for young children and assess child abuse cases. Qualification of the counselors was at least college graduates who majored in psychology and child care, three to five years of experience in the field, and appropriate certificates or licenses. Finally, the teachers said that training and professional counseling about child abuse were required to prevent and eliminate child abuse at day care centers. Implications and follow-up studies were provided and suggested based on these findings.

  • PDF

The Effect of COVID-19 on Pediatric Intussusception: A Retrospective Study of a Single Center in South Korea with 10-Year Experience (코로나바이러스감염증-2019 유행 후 소아 장중첩증의 변화: 단일기관 10년 의무 기록을 이용한 연구)

  • Yeo Jin Yoo;Bo-Kyung Je;Ga Young Choi;Jee Hyun Lee;Sunkyu Choi;Ji Young Lee
    • Journal of the Korean Society of Radiology
    • /
    • v.83 no.2
    • /
    • pp.304-316
    • /
    • 2022
  • Purpose To evaluate the effect of the emergence of coronavirus disease-19 (COVID-19) on pediatric intussusception. Materials and Methods Patients (< 18 years) who were diagnosed with intussusception and received enema reduction from 2011 to 2020 were included. We reviewed the demographics, yearly/monthly/seasonal incidence of intussusception, method and failure rate of enema reduction, recurrence rate of intussusception, surgical record, and pathologic report. Subsequently, we investigated the differences in mean age, failure rate of enema reduction, and recurrence rate of intussusception between the cases in 2020 and those in the period from 2011 to 2019. Results A total of 859 enema reductions were performed during the past decade, more in males and in the age < 1 year (mean age, 22.2 months). The yearly incidence was highest in 2014 and lowest in 2020, and the monthly incidence was highest on December and September. The cases in 2020 (n = 27) had a lower mean age (18.1 months vs. 22.8 months), higher failure rate of enema reduction (7.4% vs. 2.4%), and higher recurrence rate of intussusception (14.8% vs 7.3%) compared with those that occurred between 2011 and 2019 (n = 832). However, these results did not show statistical significance (p = 0.07, p = 0.15, p = 0.14, respectively). Conclusion With the emergence of COVID-19, the number of enema reductions was remarkably decreased with a lower mean age, higher failure rate, and higher recurrence rate.

Initial Experience of the Emergency Bypass System ($EBS^{(R)}$) for the Patients with Cardiogenic Shock due to an Acute Myocardial Infarction (급성 심근경색으로 인한 심인성 쇼크 환자에 대한 경피적 순환 보조장치($EBS^{(R)}$) 적용의 초기경험)

  • Ryu, Kyoung-Min;Kim, Sam-Hyun;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon;Kim, Young-Hwa;Park, Seong-Sik
    • Journal of Chest Surgery
    • /
    • v.41 no.3
    • /
    • pp.329-334
    • /
    • 2008
  • Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

A Study of Eight Cases According to Hyeongsang Diagnosis Applying Sa-am Acupuncture Therapy (8증례를 통한 사암침법(舍巖鍼法)의 형상의학적(形象醫學的) 운용에 관한 고찰)

  • Choi, Jun-Young;Nam, Sang-Soo;Kim, Yong-Suk;Lee, Jae-Dong
    • Journal of Acupuncture Research
    • /
    • v.29 no.1
    • /
    • pp.139-150
    • /
    • 2012
  • Objectives : The puropse of this study was to report the availability of Hyeongsang diagnosis compensating for visceral pattern identification in applying Sa-am acupuncture therapy. Methods : Eight cases was presented to substantiate the above. Results : According to the characteristic diagnostic method of Hyeongsang medicine by feature such as face, ears, eyes, nose and mouth shape, There are 8 pattern differentiations, including essence family, Qi family, spirit family, blood family, fish type, bird type, beast(running) type and crust(crustacea) type which are correlated with essence deficiency, heat harassing the heart spirit, Qi stagnation, blood stasis, kidney essence deficiency, intense heart fire, liver blood deficiency and lung Qi deficiency in the established visceral pattern identification, respectively. Eight patients was diagnosed by the above Hyeongsang 8 pattern differentiations, of whom Sinjeonggyeok(kidney reinforcing prescription) was applied to a patient with fish type and essence family to nourish kidney essence, and Giul prescription(Qi stagnation prescription) was given to a patient with Qi family for regulating Qi, and Sanghwa priscription(ministerial fire prescription) was delivered to a patient with Spirit family to clear the heart fire and tranquilize, and Sojangjeonggyeok(small intestine reinforcing prescription) was used for a patient with blood family to nourish blood and remove blood stasis, and Sinjeonggyeok(kidney reinforcing prescription), Simhangyeok(heart heat clearing prescription), Ganjeonggyeok(liver reinforcing prescription) and Pyejeonggyeok(lung reinforcing prescription) were utilized for fish type, bird type, beast(running) type and crust(crustacea) type respectively to reinforce the relevant visceral function. Conclusions : It was suggested that characteristic diagnostic method of Hyeongsang medicine should be helpful for enhancing the accuracy of the established visceral pattern identification, applying Sa-am acupuncture therapy more appropriately.

Clinical Analysis of the Recent Results of Coronary Artery Bypass Grafting (관상동맥 우회술의 최근성적에 대한 임상적 고찰)

  • Han, Sung-Ho;Kim, Hyuck;Lee, Chul-Bum;Chung, Won-Sang;Jee, Heng-Ok;Kang, Jung-Ho;Kim, Young-Hak
    • Journal of Chest Surgery
    • /
    • v.35 no.7
    • /
    • pp.523-529
    • /
    • 2002
  • Background: Previous reports present that the early results of coronary artery bypass grafting (CABG) has been improving with the accumulation of surgical experience. We conducted a retrospective analysis of the patients who received CABG to evaluate the recent results of CABG. Material and Method: Between January 1996 and August 2001, 154 patients underwent CABG at Hanyang University Hospital. There were 47 patients(group I) who were operated between 1996 and 1998, and 107 patients(group II) who were operated thereafter. The preoperative diagnosis, operative procedure, mortality, and complications were analyzed retrospectively. Result: There were 35 males and 12 females in group I, and 78 males and 29 females in group II, which shows similar ratio of sexes between the two groups. The average age of patients for group I and group II was $55.9{\pm}6.2$ years and $61.0{\pm}8.0$ years, respectively, showing a significant increase in group II(p<0.05). The average left ventricular ejection fraction(LVEF) for group I and group II was $54.6{\pm}11.8$% and $56.9{\pm}13.0$%, respectively. The number of patients who had previous MI in group I and group II were 13 patients(27.7%) and 14 patients(13.1%), respectively, which shows a significant difference (p<0.05). All procedures were performed using the cardiopulmonary bypass(CPB) and moderate systemic hypothermia. Myocardial protection was achieved using intermittent hypothermic ischemia under ventricular fibrillation state or cold crystalloid cardioplegic solution for most of group I patients, whereas cold blood cardioplegic solution was used for group II patients. The mean CPB times for group I and group II were $149.2{\pm}48.7$ minutes and $113.1{\pm}30.6$ minutes, respectively. The mean aortic cross clamp times for group I and group II were $81.3{\pm}26.5$ minutes $72.2{\pm}23.9$ minutes, respectively. These figures show that CPB and aortic cross clamp times were significantly reduced in group II(p<0.05). The use of the left internal thoracic artery(LITA) was increased from 42%(20/47) for group I to 81% (87/107) for group II. The mean number of grafts also significantly increased from $2.5{\pm}0.6$ for group I to $3.0{\pm}1.1$ for group II(p<0.05). Intra-aortic balloon pump(IABP) was applied in 7 cases in group I and 17 cases in group II. Of these, 28.6%(2/7) and 52.9%(9/17) were broadly applied preoperatively in patients with LVEF<40% or congestive heart failure. The operative mortalities for group I and II were 10.6%(5/47) and 0.9%(1/107), respectively, which shows significant decrease for group II(p.0.05). Conclusion: This report suggest that CABG using CPB can recently be performed more safely in virtue of the accumulation of surgical experience with reduction in CPB and aortic cross clamp times and improved surgical techniques and myocardial protection. And we think that the optimal treatment of patients with left ventricular dysfunction associated with congestive heart failure and the extended application of IABP, especially have contributed to the reduction of operative mortality and morbidity.

Establishment and Application of Molecular Genetic Techniques for Preimplantation Genetic Diagnosis of Osteogenesis Imperfecta (골형성부전증의 착상전 유전진단을 위한 분자유전학적 방법의 조건 확립과 적용)

  • Kim, Min-Jee;Lee, Hyoung-Song;Choi, Hye-Won;Lim, Chun-Kyu;Cho, Jae-Won;Kim, Jin-Young;Song, In-Ok;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.2
    • /
    • pp.99-110
    • /
    • 2008
  • Objectives: Preimplantation genetic diagnosis (PGD) has become an assisted reproductive technique for couples carrying genetic conditions that may affect their offspring. Osteogenesis imperfecta (OI) is an autosomal dominant disorder of connective tissue characterized by bone fragility and low bone mass. At least 95% of cases are caused by dominant mutations in the COL1A1 or COL1A2. In this study, we report on our experience clinical outcomes with 5 PGD cycles for OI in two couples. Methods: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of alkaline lysis and nested PCR protocol using heterozygous patient's single lymphocytes in the pre-clinical diagnostic tests for OI. We performed 5 cycles of PGD for OI by nested PCR for the causative mutation loci, COL1A1 c.2452G>A and c.3226G>A, in case 1 and case 2, respectively. The PCR products were analyzed by agarose gel electrophoresis, restriction fragment length polymorphism (RFLP) analysis with HaeIII restriction enzyme in the case 1 and direct DNA sequencing. Results: We confirmed the causative mutation loci, COL1A1 c.2452G>A in case 1 and c.3226G>A in case 2. In the pre-clinical tests, the amplification rate was 94.2% and ADO rate was 22.5% in case 1, while 98.1% and 1.9% in case 2, respectively. In case 1, a total of 34 embryos were analyzed and 31 embryos (91.2%) were successfully diagnosed in 3 PGD cycles. Eight out of 19 embryos diagnosed as unaffected embryos were transferred in all 3 cycles, and in the third cycle, pregnancy was achieved and a healthy baby was delivered without any complications in July, 2005. In case 2, all 19 embryos (100.0%) were successfully diagnosed and 4 out of 11 unaffected embryos were transferred in 2 cycles. Pregnancy was achieved in the second cycle and the healthy baby was delivered in March, 2008. The causative locus was confirmed as a normal by amniocentesis and postnatal diagnosis. Conclusions: To our knowledge, these two cases are the first successful PGD for OI in Korea. Our experience provides a further demonstration that PGD is a reliable and effective clinical techniques and a useful option for many couples with a high risk of transmitting a genetic disease.

Development of a Stock Trading System Using M & W Wave Patterns and Genetic Algorithms (M&W 파동 패턴과 유전자 알고리즘을 이용한 주식 매매 시스템 개발)

  • Yang, Hoonseok;Kim, Sunwoong;Choi, Heung Sik
    • Journal of Intelligence and Information Systems
    • /
    • v.25 no.1
    • /
    • pp.63-83
    • /
    • 2019
  • Investors prefer to look for trading points based on the graph shown in the chart rather than complex analysis, such as corporate intrinsic value analysis and technical auxiliary index analysis. However, the pattern analysis technique is difficult and computerized less than the needs of users. In recent years, there have been many cases of studying stock price patterns using various machine learning techniques including neural networks in the field of artificial intelligence(AI). In particular, the development of IT technology has made it easier to analyze a huge number of chart data to find patterns that can predict stock prices. Although short-term forecasting power of prices has increased in terms of performance so far, long-term forecasting power is limited and is used in short-term trading rather than long-term investment. Other studies have focused on mechanically and accurately identifying patterns that were not recognized by past technology, but it can be vulnerable in practical areas because it is a separate matter whether the patterns found are suitable for trading. When they find a meaningful pattern, they find a point that matches the pattern. They then measure their performance after n days, assuming that they have bought at that point in time. Since this approach is to calculate virtual revenues, there can be many disparities with reality. The existing research method tries to find a pattern with stock price prediction power, but this study proposes to define the patterns first and to trade when the pattern with high success probability appears. The M & W wave pattern published by Merrill(1980) is simple because we can distinguish it by five turning points. Despite the report that some patterns have price predictability, there were no performance reports used in the actual market. The simplicity of a pattern consisting of five turning points has the advantage of reducing the cost of increasing pattern recognition accuracy. In this study, 16 patterns of up conversion and 16 patterns of down conversion are reclassified into ten groups so that they can be easily implemented by the system. Only one pattern with high success rate per group is selected for trading. Patterns that had a high probability of success in the past are likely to succeed in the future. So we trade when such a pattern occurs. It is a real situation because it is measured assuming that both the buy and sell have been executed. We tested three ways to calculate the turning point. The first method, the minimum change rate zig-zag method, removes price movements below a certain percentage and calculates the vertex. In the second method, high-low line zig-zag, the high price that meets the n-day high price line is calculated at the peak price, and the low price that meets the n-day low price line is calculated at the valley price. In the third method, the swing wave method, the high price in the center higher than n high prices on the left and right is calculated as the peak price. If the central low price is lower than the n low price on the left and right, it is calculated as valley price. The swing wave method was superior to the other methods in the test results. It is interpreted that the transaction after checking the completion of the pattern is more effective than the transaction in the unfinished state of the pattern. Genetic algorithms(GA) were the most suitable solution, although it was virtually impossible to find patterns with high success rates because the number of cases was too large in this simulation. We also performed the simulation using the Walk-forward Analysis(WFA) method, which tests the test section and the application section separately. So we were able to respond appropriately to market changes. In this study, we optimize the stock portfolio because there is a risk of over-optimized if we implement the variable optimality for each individual stock. Therefore, we selected the number of constituent stocks as 20 to increase the effect of diversified investment while avoiding optimization. We tested the KOSPI market by dividing it into six categories. In the results, the portfolio of small cap stock was the most successful and the high vol stock portfolio was the second best. This shows that patterns need to have some price volatility in order for patterns to be shaped, but volatility is not the best.

Video-Assisted Thoracoscopic Surgery for Fibrinopurulent Empyema (섬유농성 농흉의 비디오 흉강경을 이용한 치료)

  • 손정환;모은경;지현근;김응중;신호승;신윤철
    • Journal of Chest Surgery
    • /
    • v.36 no.6
    • /
    • pp.404-410
    • /
    • 2003
  • Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

THE CERVICAL ISLAND FLAP FOR INTRAORAL RECONSTRUCTION FOLLOWING EXCISION OF ORAL CANCER -REPORT OF 3 CASES- (구강암 적출후 경부 도상 피판을 이용한 구강내 결손부의 재건 -3 치험례-)

  • LEE, Seong-Geun;LIM, Jong-Soo;KIM, Kyung-Hyun;JEON, So-Yeun;CHO, Young-Sung;SHIN, Sang-Hun;CHO, Young-Cheol;SUNG, Iel-Yong;KIM, Uk-Kyu;KIM, Jong-Ryoul;CHUNG, In-Kyo;YANG, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.20 no.3
    • /
    • pp.263-268
    • /
    • 1998
  • Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.

  • PDF

THE EFFECT OF ADHD CHILD MOTHER'S DEPRESSIVE MOOD, PARENTING STRESS, AND PARENTING RELATED ATTITUDE ON PARENTING BEHAVIOR (주의력결핍과잉행동장애 아동 어머니의 우울감, 양육 스트레스 및 양육 관련 태도가 양육 행동에 미치는 영향)

  • Choi, Yoon-Young;Cho, Sun-Mi;Hong, Sung-Do;Oh, Eun-Young;Kim, Ji-Hae
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.13 no.1
    • /
    • pp.153-162
    • /
    • 2002
  • Summary:This study was designed to examine the effect of mother's depressive mood and parenting related attitude on parenting behavior, focusing on the cases having an ADHD child. Method:A total of 82 parents, 31 parents having children with ADHD and 51 normal, were involved in this study. The children of ADHD and normal group were 6-11 years old. ADHD group were diagnosed as attention-deficit hyperactivity disorder by psychiatric doctor and psychological evaluations using DSMIV criteria and the normal group were excluded by using Diagnostic Rating Scale-Parent, Teacher Form. The mothers of both group completed a series of questionnaire about mother's depressive mood and parenting-related attitude. To investigate the relationships between each variables, Student's t-test, correlation, stepwise regression, and hierarchical regression analysis were performed. Result:In correlation analysis, Mothers with an ADHD child were likely to report more coercive parenting behavior, more negative parenting-related attitudes, and depressive mood than normal group. In regression analysis, mother's parenting stress, dysfunctional thoughts, parenting competence, and depressive mood predicted coercive parenting behavior significantly, total explaining 50% of its variance, and especially depressive mood explained 29% of their coercive parenting behavior. These Results indicated that mother's depressive mood accounted for a substantial portion of coercive parenting behavior. Conclusion:These findings suggested that it is significantly important to reduce Mother's depressive mood through dealing with parenting sense of competence and dysfunctional thoughts, so, both parent education program and cognitive-behavioral therapeutic approach are needed to change parent's coercive parenting behavior. Finally, limitation of the present study and suggestions were discussed for further studies.

  • PDF