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Etiology and Clinical Manifestations of Fever in Infants Younger than 3 Months Old: A Single Institution Study, 2008-2010 (3개월 미만 영아의 발열에 대한 원인 및 임상양상에 대한 단일기관 연구; 2008-2010)

  • Seok, Joon Young;Kang, Ji Eun;Cho, Eun Young;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.19 no.3
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    • pp.121-130
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    • 2012
  • Purpose : The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). Methods : A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. Results : Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count ($14,473{\pm}6,824/mm^3$ vs. $11,254{\pm}5,775/mm^3$, P=0.002) and the C-reactive protein ($6.32{\pm}8.51mg/L$ vs. $1.28{\pm}2.35mg/L$, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). Conclusion : This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.

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The Direction of Christian Education in the Post COVID-19 (코로나19 시기 이후의 기독교교육의 방향)

  • Kim, Sung-Joong
    • Journal of Christian Education in Korea
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    • v.63
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    • pp.39-64
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    • 2020
  • COVID-19 is sweeping the world, and it is in crisis in all aspects of politics, economy, culture, and religion. As people experience the beginning and spread of COVID-19, wince and re-spread, the people are living in anxiety and depression. Because of the COVOD-19 crisis, Korean churches were unable to provide on-site worship, and online worship began, and churches that started on-site worship also performed online worship. In the case of church schools, the functions of fellowship and education were paralyzed and many are offering online Sunday service only. Many people eagerly want to go back to what it was before COVID-19, but it seems difficult because COVID-19 has become a global issue and a pandemic situation. We can't wait to get better out of this. In the COVID-19 crisis, the church was unable to properly handle the church's original work and to fully fulfill the mission of education. The response of many churches was to postpone the planned ministry to the second half of 2020. Now, we should try to set a new direction and prepare specifically to move in the new direction. With this perspective, this paper studied the direction of Christian education in the post COVID-19. Specifically, the theoretical basis of the direction of Christian education in the post COVID-19 was found in the theory of Agape's encounter, Catechesis theory, and diakonia theory, and specific directions were suggested according to these theories. Specifically, based on the theory of Agape's encounter, Christian education that emphasizes the encounter with the natural environment, Christian education that emphasizes the encounter among family members, Christian education that emphasizes the encounter among citizens of the world, and Christian education that emphasizes the encounter through online were presented. Based on the Catechesis theory, Christian education copping with the attack of heresy was presented. Finally, based on the diakonia theory, Christian education of service for society and Christian education of service based on data were presented.

Relationship between health behaviors and nutrient supplement intake (건강행태와 영양제 복용 유무의 관련성)

  • Lee, Jong-suk;Kim, In-tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.498-508
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    • 2017
  • Purpose: The present study investigated nutrient supplement intake to examine the relationship between the health behaviors of nutrient supplement users and nonusers and nutrient supplement users and other drug users. The results provide baseline data to understand whether nutrient supplements actually perform as expected in view of the fact that healthy people that take nutritional supplements may become healthier, but may also develop nutritional supplement abuse problems. Among 7,006 household heads of 24,614 household members from the Korea Health Panel data in 2008, a total of 6,009 household heads were the respondents of the Korea Health Panel Survey (appendix) in 2009. Method: The subjects of the present study were targeted household heads. The respondents who reported that they had taken (planned to take) life/health promotion-related drugs (01. vitamins/nutritional supplements) for more than three months that were purchased at pharmacies during the past one year at the time of the survey were defined as nutritional supplement users. Those who took other drugs (05. hair-loss treatments, 06. obesity treatments, 10. others) were regarded as other drug users. A chi-squared test was performed to analyze the sociodemographic characteristics of the subjects and differences between groups. Multiple regression analyses were conducted to analyze health behaviors according to nutrient supplement intake. Result: Comparison of (A) nutritional supplement users and nonusers revealed that those who were women, 50 years or older, and spent more than average living expenses were more likely to take nutritional supplements, which was not significant in health behavior variables. Analysis of nutritional supplement users and other drug users (B) revealed that those who were high school graduates or above, had a spouse, were non-smokers, took drugs, ate regular meals, and were not stressed by economic or family conflicts were more likely to take nutritional supplements. Conclusion: The results of the present study indicated that people take nutritional supplements because of their psychological desire to be healthy, not because they are not healthy, have problems, or believe supplements will make them healthier.

End-use analysis of household water by metering (가정용수의 용도별 사용량 조사 및 원단위 분석)

  • Kim, Hwa-Soo;Lee, Doo-Jin;Kim, Ju-Whan;Kim, Jung-Hyun;Jung, Kwan-Soo
    • Proceedings of the Korea Water Resources Association Conference
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    • 2008.05a
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    • pp.869-877
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    • 2008
  • The purpose of this study is to investigate the trends and patterns of variou kind of water uses in a household by metering in Korea. Water use components are classified by toilet, washbowl, bathing, laundry, kitchen, etc. Flow meters are installed in 146 household selected by sampling in all around Korea. The data are gathered by web-based data collection system from the year 2002 to 2006, considering pre-investigated data such as occupation, revenue, family members, housing types, age, floor area, water saving devices, education, etc. Reliable data are selected by upper fence method for each observed water use component and statistical characteristics are estimated for each residential type to determine liter per capita per day. Estimated domestic per capita day show an indoor water use with the range from $150{\ell}pcd$ to $169{\ell}pcd$ for each housing type as the order of high rise apartment, multi-house, and single house. As the order of consuming amount among water use components, it is investigated that toilet($38.5{\ell}pcd$) is the first, and the second is laundry water($30.8{\ell}pcd$), the third is kitchen($28.4{\ell}pcd$), the fourth is bathtub($24.7{\ell}pcd$), the next is washbowl($15.4{\ell}pcd$). The results are compared with water uses in U.K. and U.S. As life style has been changed into western style, pattern of water use in Korea is tend to be similar with the U.S. water use pattern. Compared with the surveying results by Bradley, on 1985. Thirty liter of total use increased with the advancement of economic level, and a little change of water use pattern can be found. Especially, toilet water take almost half part of total water use and laundry water shows lowest as 11% in surveying at the year of 1985. But, this study shows that 39 liter, 28% of toilet water, has been decreased by the spread of saving devices and campaign. It is supposed that the spread large sized laundry machine make by-hand laundry has been decreased and water use increased. Unit water amount of each end-use in household can be applied to design factor for water and wastewater facilities, and it play a role as information in establishing water demand forecasting and conservation policy.

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AN EMPIRICAL STUDY ON DREAM, DAYDREAM AND HOPE IN CHILDREN(1):FROM DEVELOPMENTAL PERSPECTIVE (어린이의 꿈, 공상 및 희망에 대한 경험적 연구(1) : 발달학적 관점에서 고찰)

  • Kim, Soo-Jeong;Shin, Min-Sup;Nam, Min;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.3-21
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    • 1997
  • We examined the developmental characteristics of dream, daydream, and hope of elementary school students in their 1st, 3rd, and 5th grades, and studied the correlation between three variables. We summarized the results of this study as follows. 1) The contents of dream developed with the cognitive development and socialization process. In detail, appearance of animals, family members, and known persons gradually decreased, and appearance of self, same-sex peers, and strangers gradually increased. These results are comparable with the previous studies of dream. 2) Daydream, hope, and current state also developed with age. In detail, frequency of daydream increased, and the contents of daydream and hope changed toward more self-centered and more realistic. The changes of current state are thought to reflect the specific situation of Korea. 3) There are some correlation among dream, daydream, and hope. Especially happy mood and fearful mood had positive correlation with the relevant contents of dream, daydream, and hope. Also the contents of dream showed positive correlation with the same contents of daydream. This study is the first trial which investigate the developmental characteristics of dream, daydream, and hope of normal children in Korea. We verified that dream and daydream are on the continuous line of ‘reality-imitation-play-daydream-dream’ Finally, considering the facts that dream developed with age;responded to meaningful emotional experiences;and had the correlation with daydream, hope, and current state, the results of this study support the psychological meaning of dream.

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A Study of Oral Health Impact Profile 14 among the Elderly in Rural Area (일부 농촌노인들의 구강건강영향지수(Oral Health Impact Profile)14 평가)

  • Lee, Ga-Ryoung
    • Journal of dental hygiene science
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    • v.10 no.2
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    • pp.109-116
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    • 2010
  • Objective: The purpose of this study was oral health related quality of life among elderly population in some rural area, Korea. Methods: 546 participants (male 196, female 350) aged more than 65 years (mean $71.4{\pm}4.6\;years$) were surveyed cross-sectionally. All the subjects were examined short-form of Oral Health Impact Profile (OHIP-14) by face to face interview. Categorical responses of strata-adjusted Wilcoxon correlation and Kruskal-Willis test and multiple regression analysis after adjusting for socio-demographic variables were adapted for statistical analysis. Results: 1. As for sub-factors of the quality of living related to oral health, the drop in social ability was 4.61, the drop in mental ability 4.53, the drop in physical ability 3.99, mental inconvenience 3.98, social disadvantages 3.82, physical pains 3.77, and functional division 3.44, on the average. 2. As for the quality of living related to oral health, there were statistically significant differences in functional restrictions by gender, the educational level, and the presence of occupation, in physical pains by gender, the educational level, family members living together. mental inconvenience by gender, the educational level, the presence of occupation. and in the drop in physical ability by gender, the educational level, monthly incomes. There were statistically significant differences in the drop in physical ability by gender, the educational level. in the drop in social ability by the educational level, the presence of occupation, monthly income. and in social inconvenience by age, the presence of occupation, monthly income. 3. There were statistically significant differences in the general quality of living related to oral health by gender, the educational level, the presence of occupation.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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Relationship between Expression of XIAP Protein in Operable Non-small Cell Lung Carcinomas and Apoptosis Index and Postoperative Prognosis (비소세포폐암조직에서 XIAP 발현과 고사지수 및 수술 후 예후와의 관계)

  • Kim, Sang Hyun;Lee, Chang Hun;Sol, Mee Young;Song, Jin Mi;Lee, Jong Hyub;Lee, Min Ki;Kim, Jong Min
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.480-489
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    • 2005
  • Background : Dysregulation of apoptosis plays an important role in carcinogenesis, tumor progression, and resistance to chemotherapy. X-linked inhibitor of apoptosis (XIAP) is considered to be the most potent caspase inhibitor of all known IAP (inhibitor of apoptosis) family members. This study was designed to assess the pattern of expression and the prognostic value of XIAP in radically resected non-small cell lung carcinoma (NSCLC) patients. Method : The expression of XIAP and its relationship with clinicopathologic parameters (patient age, TNM stage, TNM-pT, TNM-pN, histologic type, VEGF expression, microvessel density, PCNA index) and overall survival were analysed with formalin-fixed, paraffin-embedded blocks from eighty cases of NSCLC. In addition, the apoptotic index (AI) was also assessed. Results : In a regard to histologic type, squamous cell carcinoma (SCC) showed XIAP expression in 91.3%(42/46) and adenocarcinoma (AC) in 61.8%(21/34). The difference was significant(p=0.001). There was no correlation between XIAP expression and other parameters. In the group of AC, XIAP expression showed the signifcant correlation with older age group ${\geq}58years$ and VEGF expression(p=0.028, p=0.014, respectively). The AI in the group with or without XIAP expression were $2.5{\pm}4.9%$ and $18.5{\pm}28.9%$, respectively(p=0.001). Both groups just aforementioned showed no significant difference in median survival time (42.5 months, 29.8 months, respectively). Conclusion : This study suggests that the XIAP expression in NSCLCs could have relation to inhibition of apoptosis, and show differential expression according to histologic type. However, its prognostic role during the progression of NSCLC needs to be further defined.

Prenatal Diagnosis of the 22q11.2 Duplication Syndrome

  • Lee, Moon-Hee;Park, So-Yeon;Lee, Bom-Yi;Choi, Eun-Young;Kim, Jin-Woo;Park, Ju-Yeon;Lee, Yeon-Woo;Oh, Ah-Rum;Lee, Shin-Young;Yang, Jae-Hyug;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.175-178
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    • 2009
  • The 22q11.2 duplication syndrome is an extremely variable disorder with a phenotype ranging from normal to congenital defects and learning disabilities. Recently, the detection rate of 22q11.2 duplication has been increased by molecular techniques, such as array CGH. In this study, we report a familial case of 22q11.2 duplication detected prenatally. Her first pregnancy was terminated because of 22q11.2 duplication detected incidentally by BAC array CGH. The case was referred due to second pregnancy with same 22q11.2 duplication. We perfomed repeat amniocentesis for karyotype and FISH analysis. Karyotype analysis from amniocytes and parental lymphocytes were normal, while FISH analysis of interphase cells presented a duplication of 22q11.2 in the fetus and phenotypically normal mother. The fetal ultrasound showed grossly normal finding. After genetic counseling about variable phenotype with intrafamilial variability with 50% recurrence rate, the couple decided to continue the pregnancy. The newborn had no apparent congenital abnormalities until 2 weeks after birth. We recommend that family members of patients with a 22q11.2 duplication be tested by the interphase FISH analysis. Also, we point out the importance of genetic counseling and an evaluation of the clinical relevance of diagnostic test results.

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