• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.1
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• pp.331-343
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• 2014

The purpose of this study was to evaluate the appropriateness and applicability of a evidence-based peri-operative hypothermia management guideline developed by NCC-NSC in Korea using expert group. The expert group was composed of 180 registered nurses in surgical units and recovery room, and physicians (surgeons and anesthesiologists) who had enough experiences and knowledgeable on the management of surgical patients. Validity of guidelines were evaluated in terms of appropriateness and applicability using 9 point scale. Most of the recommendations in the guideline received high score of above 6-8 point both in appropriateness and appropriateness. However, most of the recommendations were received significantly lower score in applicability than appropriateness. This research can be used as a step to develop more acceptable hypothermia management guideline for the patients undergoing abdominal surgery in Korean. In addition, further studies which identify the barriers that inhibit applicability of recommendations should be investigated.

• Journal of Korean Clinical Nursing Research
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• v.20 no.3
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• pp.359-371
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• 2014

Purpose: This study was done to identify the core concepts and structure of difficult experiences of charge nurses in general hospitals. Methods: Data were collected from August 1 to September 5, 2014. Participants were 10 nurses from general hospitals in D and S cities. Parse research method was applied to examine lived experiences of the participants. The procedure of study was based on dialogical engagement and data were analyzed by extraction-synthesis and interpreted heuristically. The research question was "Would you tell me about your difficult experiences as a charge nurse?" Results: Job-related difficulties of the charge nurses were conflicts due to ineffective communication, heavy workload, not feeling respected, role conflict, and struggling to overcome difficulties with sense of responsibility to the work. The conceptual integration was: to be in the process of being originated and transformed through connecting-separating and enabling-limiting with valuing. Conclusion: Structural conversion of these concepts reveals that charge nurses suffer from the job-related difficulties identified in this study, but they endure to proceed with a sense of mission. It is suggested that supportive interventions should be made to let charge nurses express their feelings, identify their needs, and develop self-care or coping skills for themselves.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.1
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• pp.30-35
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• 2013

The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.38-46
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• 2002

Disaster psychiatry is a new emerging area of psychiatry, in which psychiatrists help to minimize psychological impact of a disaster and to reduce secondary morbidities. In our society, more children and adolescents are facing disasters nowadays. Thus, the necessity for the disaster psychiatry is increasing. After a trauma, children express various symptoms in relevance to their age, development, and their environmental support. The recovery from the disaster and its long-term effect are also influenced by those factors. Psychiatric intervention in a disaster consists mainly of crises intervention and supportive psychotherapy, which includes counseling the victims, educating and providing information to the public, providing support and consultation to the community, and referring of at-risk or severely impaired individuals for more intensive clinical evaluation and care. In addition to a summarized concept of disaster psychiatry, this article presents the adverse psychological effects of children and adolescents exposed to disaster and issues related to the psychiatric intervention.

• Annals of Clinical Neurophysiology
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• v.2 no.2
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• pp.81-88
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• 2000

Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is characterized clinically by acute flaccid paralysis, areflexia, and albumino-cytologic dissociation. Based on electrophysiology and pathology, GBS can be divided into either predominantly demyelinating or predominantly axonal patterns. Objectives : The clinical and laboratory status of probable acute axonal GBS occurring at a mental hospital was evaluated. Methods : Eight schizophrenia patients with probable acute axonal GBS were analyzed. Results : The mean age of the patients was 38 years old. Most of the patients were men. All patients showed an acute ascending paraparesis and/or quadriparesis with areflexia, and all have a history of schizophrenia for 3~20 years. The diseases occurred predominantly in the summer and electrodiagnostic studies revealed axonal patterns. The patients were treated by supportive care, except one patient with intravenous immunoglobulin. The prognosis was improved in 3 ; no change in 4 and 1 became aggravated. One patient with acute motor-sensory axonal neuropathy had a recurrence after 10 months of the first attack. Conclusions : Axonal GBS has been considered uncommon clinically or electrophysiologically, but 8 probable acute axonal GBSs occurring at a mental hospital have been diagnosed in 3.5 years.

• Neonatal Medicine
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• v.18 no.2
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• pp.409-411
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• 2011

In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.

• Journal of Society of Preventive Korean Medicine
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• v.11 no.2
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• pp.101-112
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• 2007

Oriental public health programs have been introduced for the purpose of providing comprehensive oriental health care services to community people including vulnerable classes, increasing the accessibility of oriental medicine and the public benefit, and further more elevating the health promotion and the quality of life of community people. Promoting these programs since 2002 in earnest, it is evaluated that it has made a lot of performances. In the other side, it showed many problems and policy issues also. This study is accomplished to analyze the problems made since the system was introduced and until now, 2007, and with this analysis, to examine policy issues and the reasonable recommendations for its development Major problems are as follows. First, fundamental notions and identity of oriental public health programs are not positioned accurately. Second, the infra-structure construction for effective propulsion of business is insufficient. Third, it is short of the capacity for program implementation of oriental public health doctors, related manpower, and health centers. Fourth, oriental health promotion programs that can fulfill the various health needs of community people are deficient. Fifth, active aid of the government and the oriental medical world as well as legal and systematical support for oriental public health programs is insufficient. As a result, to solve the problems and induce the successful settlement of the program, the policy recommendations such as (i) the fundamental notions of the program and establishment of approach strategies, (ii) reinforcement of the foundation of the program implementation, (iii) capacity enhancement of the manpower of the program implementation, and (iv) effective building of supportive system of the program are presented.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.72-76
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• 2016

Infantile osteopetrosis is a rare congenital disorder caused by abnormal bone resorption. Patients with osteopetrosis can have severe anemia, thrombocytopenia, hepatosplenomegaly, rickets, visual impairment, and deafness. Cytomegalovirus also can cause a congenital infection with anemia, thrombocytopenia, hepatosplenomegaly, and calcifications in the brain. We report a 38-day-old infant with severe hepatosplenomegaly, thrombocytopenia, hypocalcemia, and growth failure. Real time polymerase chain reaction detected cytomegalovirus in the plasma. Skeletal radiography revealed generalized bone sclerosis. He was diagnosed with osteopetrosis along with cytomegalovirus infection. Only the test for mutation of the CLCN7 gene, representing the most common and heterogeneous form of osteopetrosis, was available, and the result was negative. With supportive care and antiviral treatment, severe thrombocytopenia due to the cytomegalovirus infection almost normalized despite the possible immunosuppression caused by osteopetrosis. We present the first report of an infant who suffered from osteopetrosis and CMV infection which was successfully treated by long term antiviral agent therapy.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.601-608
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• 1989

We sought the relationship between the pulmonary artery development and cardiac performance from the analysis of the 36 cyanotic congenital heart disease patients [mainly TOF] who were operated and indwelled the pulmonary artery and left atrial pressure monitoring catheters for the postoperative care at the department of Thoracic and Cardiovascular Surgery SNUH in 1988. They were pre-evaluated of the pulmonary artery index from the cineangiographic films and post-operatively, calculated the cardiac index from the arterial and mixed venous blood gas and also measured the mean left atrial pressure and total inotropic supporting amount after operation. The post-operative cardiac indices were 3.46 * 1.03 1/min/M2 [immediate postoperative], 3.31 [ 1.08 [postoperative 6 hrs], 3.29 [ 1.01 [12 hrs], 3.54 * 1.02 [24 hrs], 3.92 * 1.14 [48 hrs], respectively. We divided the patients the group A and group B from the size of the pulmonary artery index, that is, group A was below 200 mm2/M2 and group B above 200 mm2/M2 of the pulmonary artery index. The cardiac indices and left atrial pressure between the group A and B were not different in the view of the statistical significance but the total post-operative inotropic amount of group A was more than group B and it was significant statistically. We concluded that the smaller the pulmonary artery index is, the more postoperative supportive treatment [for example, inotropics] for the enhancement of cardiac performance is needed, and indirectly, which means that the pulmonary artery index was correlated with the postoperative cardiac performance in cyanotic congenital heart disease.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.565-569
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• 2006

Rothmund-Thomson syndrome (RTS), is a rare autosomal recessive disorder, characterized by : skin photosensitivity, poikiloderma, sparse hair, sparse eyebrows/lashes, short stature, skeletal abnormalities, cataracts, and an increased risk of malignancy. Skeletal abnormalities include : dysplasia, absent or malformed bones, such as absent radii, osteopenia, and delayed bone formation. RTS is thought to result from chromosomal instability, and children with RTS are at risk of cancer. Reported cancers in children with RTS include : basal cell carcinoma, squamous cell carcinoma of the skin and osteosarcoma of bone. We report an 11 year-old boy, who presented to our institution with poikilodermatous skin change with telangiectasia and hyperpigmentation, absence of radius and thumb, and the development of osteosarcoma of the left tibia. The patient is now receiving supportive care and is receiving maintenance chemotherapy after surgery for osteosarcoma.