• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.754-759
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• 2008

Purpose : Abnormal activation patterns of Th1/Th2-cells have been suggested to increase the prevalence of allergic diseases. Prevention is regarded as an important corner stone in the management of allergic diseases. In this study, we have investigated the relationship between cord blood levels of IL-4, IL-10, and IL-12 in preterm newborns and the development of allergic respiratory diseases in infancy Methods : Forty-six preterm newborns born at the Ewha Womans University Mokdong Hospital between January 2003 and July 2005, were enrolled for this study, and consent was obtained to test their cord blood samples. Clinical history was obtained from the hospital records. Cord blood was obtained at birth and kept frozen until it was tested. The levels of IL-4, IL-10, and IL-12 were determined by enzyme-linked immunosorbent assay (ELISA). Results : All infants were followed-up for a median of $16.0months{\pm}13.2d$ (range, 12.0 to 36.0 months). Eighteen infants who developed wheezing showed lower cord blood levels of IL-12 ($366.60{\pm}140.40$ vs $435.09{\pm}91.20pg/mL$, P=0.009). Cord blood levels of IL-4 and IL-10 showed no significant difference between the two groups. Four newborns who later developed asthma, and infants with asthma showed lower IL-12 level in the cord blood than other groups. Conclusion : Lower concentration of cord blood levels of IL-12 in newborns who later developed wheezing and asthma suggested that they had abnormal activation patterns of Th1/Th2-cells at the time of birth, and cord blood IL-12 level can be used as a predictor of allergic respiratory diseases.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.671-689
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• 2008

The economic recession of North Korea has been prolonged, the need for humanitarian assistance for the women and children of DPRK has been raised. In March 2006, South Korean government signed MOU with World Health Organization (WHO) to financially support "Improving Women's and Children's Health in DPRK (IWCH)" project. The assistance projects through UNICEF and the non-government organizations of South Korea were also followed. IWCH project consists of three parts; nutrition, disease management, children and maternity care. The first term (2006-2007) of the project leading by WHO was finished, and the second term (2008-2010) is just begun. The projects driven by NGOs have relatively been delayed due to difficulties in negotiating on project contents and places with North Korea. Recently, however, re-modeling processes of an obstetric/gynecology hospital and a children hospital in Nampo were started. Up to recently, South Korean government has played only a limited role in the humanitarian assistance for North Korea. IWCH project is, however, a full-scale initiative driven by government based on a systematic review of need and priorities. A significant amount of budget and relatively long term (five year) project compare to the previous short term and small size programs were expected to make more meaningful achievement. Despite these positive aspects, the project remains a list of unsolved problems a lack of mutual trust, a different decision making process between South and North Korea, a lack of conflict management process, and unpredictability and complexity of international politics. In spite of such kind of political uncertainty, the health care sector will be a leading area in the process of improving relationship between South and North Korea, particularly, humanitarian assistance for women and children will play a crucial role in the process. The successful implementation of IWCH project, therefore, will contribute to provide the reference model in developing the mutually constructive relationship between South and North

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.813-819
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• 2005

Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.121-128
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• 1988

Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstertrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarised as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases(96.5%) were squamous cell carcinoma, in which 60 cases(30.0%) of carcinoma in situ, 9 cases(4%) of microinvasive, and 126 cases(62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old. ; In cases of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows. ; vaginal bleeding(47.5%), abnormal cytology(15.4%), and abnormal vaginal discharge(9.4%). 5. Duration of the chief complaints was most commanly less than 6 months(73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years 0Id(46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5~8 times, and average 6.2 times. The parity was 61.9% in 1~4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases(31.8%), stage II, 54 cases(42.9%), stage III, 11 cases(8.7%), and stage IV, 8 cases(6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows. ; large cell keratinizing type, 25 cases(19.8%), large cell nonkeratinizing type, 101 cases(80.2%). 10. In the cytologic diagnosis, class I was 2 cases(l.9%), class II was 16 cases(15.1%), class III was 33 cases(31.1%), class IV was 31 cases(29.3%), class V was 24 cases(24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1073-1078
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• 2006

Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.247-255
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• 2002

Purpose : This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. Methods : The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in $MegaCult^{TM}-C$(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte( CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. Results : The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. Conclusion : This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using $MegaCult^{TM}-C$ media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.71-78
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• 2001

Objectives：Few studies have examined the psychiatric properties or child developmental problems associated with inversion of chromosome 9. The purpose of this study is to examine the psychiatric properties of child patients who have inversion of chromosome 9, focused on behavioral problems and child developmental problems like motor or language developmental delay, intellectual impairment, and growth retardation. Methods：1) The authors examined the cases referred for cytogenetic examination from 1984 to 2000 at Seoul National University Hospital in Korea. The cases with the examination result of inversion of chromosome 9 were collected and informations about the departments which referred and the main reasons for referral were also checked. 2) 12 child subjects with inversion of chromosome 9 and their parents underwent psychiatric interview and parent questionnaire(child and adolescent past history questionnare, CBCL). 45 normal students whose sex and age were matched to patients were selected as a control group. Results：1) There were 165 cases of inversion of chromosome 9. The major departments which referred were Obstetrics and Gynecology(47.3%), Pediatrics(23.6%) and Child and Adolescent Psychiatry(17.0%). The major reasons for referral from the Pediatrics and the Child and Adolescent Psychiatry department (67 cases total) were intellectual impairment(35.8%), language or motor developmental delay(31.3%), suspected Fragile X syndrome(23.9%), and growth retardation(20.9%). 2) Compared to normal control group, the rate to be included in the clinical range with regard to the social problems profile was higher in patient group according to the CBCL results. The patient group had language and motor developmental delay. Conclusion：There is a possibility of inversion of chromosome 9 to be associated with child developmental problems or behavioral problems. This study is the first approach to evaluate the developmental aspects associated with inversion of chromosome 9.

• Journal of Haehwa Medicine
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• v.2 no.2
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• pp.219-246
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• 1993

In 1991, Obesity rate of South Korea has reached to 18.7%. Because of economical development, the pattern of diet is exchanged from carbohydrate to rich protein and fat. The more problem is not only obesity of adult but also one of little child. Obesity is induced to diabetes mellitus, hypertension, artherosclerosis, hyperlipoidemia. heart and C.V.A disease, etc. In Woman, special important ploblem is the complex of beauty about Woman's figure. In Oriental Medicine, the factor of obesity is mainly regarded as dampness. And there are many treatments and methods to body weight loss, but obesity patients dislike to use them because of their side effects and inconvenience, intolerance. Now ear acupuncture is applied on so many disease because of its easy handly, non-side effect and high efficiency in clinics. Here obesity acupuncture is used to ear and whole body acupuncture. Because they react eachother for lack point. Therefore, in order to investigate the effect of obesity acupuncture and develop non-drug, non-starvation etc, we analyzed 453 the cases of body weight loss patients treated with ear and whole body acupuncture in Oriental Medicine Hospital of Jeon-Ju Woo-Sug University from April.1.1992. to March.17. 1993. The results were summarized as follows. 1. Distribution of sex ; male (4.4%), Female(95.6%) 2. Distribution of age in descending order ; 30s, 20s, 40s, 10s, 50s, below 10s, abowe 60s. The 20s-30s are group made up 60.7% of the group. 3. Distribution of occupation in descending order; housewife, student, service, salaried, merchant, teacher, farmer, inoccupation. 4. Distribution of human coporal constitution in descending order : Tae-Eum-In, So-Eum-In, So-Yang-In. 5. Distribution of body height and weight, 155-164cm ; 71.1%, 60-70kg, 74.6% are majority. 6. Distribution of weight variation, 2-6kg(71.0%) is majority, also 13-14kg(0.4%). 7. Distribution of duration in descending order ; 1-3 years, 3-6 years, 1-12months, above 10 years but in success, 1-12 months, 1-3 years, 3-6 years, above 10 years. Therefore, we know that the shorter duration of obesity is, the more loss of body weight. 8. Past experiences to body weight loss; Yes(69.5%), No(30.5%). The success rate accordant with the past temporary experiences shows that the cases without experience is higher than the ones with experience. 9. In distribution of times(treatments), 10 times is top. The rate of body weight loss is the highest in 14 times. Therefore, I think that one would need at least 10 times. in order lose body weight 10. Distribution of body weight variation in treatments times is at 2 times(3-4kg loss), and surprisingly is 14kg loss at above 15 times. 11. Distribution of symptoms improvement, in descending order ; heavy sense in body, dec. of appetite, inc.of exercise, lumbago, edema, knee pain, inc.of urine, inc. of fullness sense, thirsty, disease of gynecology, white tung, chest burning, heart burning, dec.of tobacco, drink taste. motion sickness, allergy, water eczema, arthma, belching. 12. Distribution of snack; Yes(87.4%), No(78.6%) 13. Distribution of exercise; Yes(21.4%), No(78.6%) 14. Distribution of sleeping times, above 7 hours(79.0%) 15. Distribution of the reason to body loss, the complex of beauty(68.7%) is top. 16. Distribution of side effect in obesity acupuncture, constipation (17.4%) is top. 17. Distribution of method in body weight loss ; dietary treatment (31.1%), sauna(26.7%), exercise(19.7%), the center of body weight loss (15.0%) herb-med and starvation treatments (5.1%), hand-finger acupuncture (hand-foot acupuncture) is 1.6%, diet pill(0.3%), etc(0.6%).

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.135-164
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• 2003

The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

• Journal of Korean Biological Nursing Science
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• v.2 no.1
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• pp.1-19
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• 2000

The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.