• Journal of Oriental Neuropsychiatry
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• v.21 no.1
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• pp.89-108
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• 2010

Objectives: This study was to investigate the relation of Pittsburgh Sleep Quality Index(PSQI) and Diagnos system of oriental medicine(DSOM) in the Insomnia Patients. Methods: For this study, we carried out PSQI and DSOM of 92 patients with insomnia who have come to Kijang public health center and Donguei oriental hospital of Donguei university from November 2008 to October 2009. We verified the association of PSQI and DSOM using crosstabulation analysis, independent sample T-test, one-way ANOVA and correlation analysis. Results: 1. Blood-deficiency(血虛) is the most frequent pathogenic factor and frequency of nightmare has positive correlation with that factor including heart(心) in total insomnia patients. 2. Female patients have a higher percentage of chronic insomnia than male patients. 3. As patients aged, maintaining sleep gets harder, sleep time is lessening, taking hypnotics is increasing and quality of sleep gets worse. 4. There is high frequency of chronic insomnia in 40~50 years and over 60 years old. Also, the people who are over 60 years of age tend to sleepless and urinated frequently during the middle of the night. The people with the age of 20~30 years tend to take less sleeping pills and frequency of sleeping during daytime is higher than the other age groups but the quality of sleep is quite good. 5. The patient with over 6 months of chronic insomnia tend to be older in age than the patient with less than 6 months. And the patient with chronic sleeping disorder has frequent pain and the quality of sleep is very poor. 6. The patient who took hypnotics tend to be older than hypnotics non-user and frequency of urination was relatively high. 7. The patient who visited oriental medical hospital were tend to be older and get difficult in maintaining sleep. And frequency of taking hypnotics and urinating during night were tend to be higher and the quality of sleep was poor compared with the patient who visited public health center. Conclusions: This study provides insights into the complicated relations of the associated symptom of insomnia with Diagnos system of oriental medicine. And especially this study showed apparent correlation between nightmare in insomnia patients and pathogenic factor of blood-deficiency and heart. Specific correlations and characteristics in this study could be connect develop of new questionaire of insomnia.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.23-36
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• 2006

Purpose : The purpose of this study was to evaluate the effects of back muscle stretching on the flexibility of spinal column. Methods : The subjects were consisted of healthy adults (18 of females, 22 males ; mean aged 21.83) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group. back muscle stretching group received back muscles stretching for 20 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results : The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group rather than the control group(p>0.5). 5. The length of the spinal column of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group rather than the control group(p<0.5). Conclusion : These data suggests that 3-week back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.7-15
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• 2017

Purpose: Influenza vaccination coverage in adolescents is an important goal of informed vaccination policies and programs. This study aimed to estimate the influenza vaccination coverage rate and investigate the factors influencing influenza vaccination coverage in Korean adolescents. Methods: The study population consisted of 5,213 adolescents (aged 12 to 18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2014 (except for 2013). We analyzed influenza vaccination coverage in relation to the demographics, lifestyle, and medical characteristics of the participants. Results: The influenza vaccination coverage rate, during the study period, was 23.2% (range, 21.1% to 24.7%). Logistic regression analysis revealed that factors influencing influenza vaccination were elementary school age (odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526 to 1.906), good self-rated health status (OR, 1.192; 95% CI, 1.057 to 1.344), a drinking status of non-drinker (OR, 1.769; 95% CI, 1.474 to 2.122), a smoking status of non-smoker (OR, 1.459; 95% CI, 1.144 to 1.860), and a past diagnosis of pneumonia (OR, 1.469; 95% CI, 1.076 to 2.006). Conclusions: Influenza vaccination coverage in Korean adolescents is relatively low. Special efforts are needed to increase vaccination coverage for adolescent groups with low vaccination rates including adolescent smokers and drinkers, middle and high school age adolescents, and adolescents with a poor self-rated health status.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.1-6
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• 2017

Purpose: We investigated the effectiveness of the delta neutrophil index (DNI) for the prediction of neonatal bacteremia and compared it to other indices. Methods: A total of 146 pediatric patients, aged less than 31 days, admitted to the neonatal intensive care unit of Wonju Severance Christian Hospital with fever before or during hospitalization were enrolled in this study. We divided the patients into two groups based on the existence of neonatal bacteremia and performed blood culture tests on both groups. We examined white blood cell count, absolute neutrophil count, DNI, platelet count, and C-reactive protein (CRP) test. We used a receiver operating characteristic (ROC) curve to evaluate their diagnostic significance. Results: Seventy-seven patients were diagnosed with neonatal bacteremia. The mean gestational age was 38.74 weeks and the mean birth weight was 3.20 kg. The mean gestational age of the control group was 33.34 weeks and the mean birth weight was 2.20 kg. Causative organisms of bacteremia included Staphylococcus aureus (n=22), Staphylococcus epidermidis (n=18), and Streptococcus agalactiae (n=8). Both DNI and CRP were significantly associated with neonatal bacteremia after adjusting for gestational age and birth weight. The area under the ROC curve (AUC) for DNI (0.70) was higher than that for CRP (0.68). Conclusions: The DNI can be used to effectively predict neonatal bacteremia. The prediction will be more accurate if DNI is used in conjunction with other indices. In future, it will be useful to compare DNI with other indices and investigate its relationship with prognosis.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.44-53
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• 2017

Purpose: The aim of this study was to investigate the risk factors for posttransplant lymphoproliferative disorder (PTLD) and to evaluate the association between Epstein-Barr viral load and the development of PTLD in pediatric heart transplant recipients. Methods: We reviewed children aged <18 years who underwent heart transplantation and quantitative analysis of blood Epstein-Barr virus (EBV) viremia at our institute from January 2006 to March 2015. Clinical characteristics and EBV viral loads were compared according to the presence of PTLD. Results: Over 9 consecutive years, a total of 40 heart transplant recipients, were included. Among 28 children with available EBV viral load measurements, seven patients (25%) had EBV viremia only defined as at least one time of ${\geq}457copies/mL$. PTLD occurred in three recipients (7.5%) 4.3, 6.3, and 17.0 months after transplant and all PTLD cases had preceding EBV viremia. The median age at transplant was 5.3 years (range, 0.5 to 6.0 years) in the PTLD group, compared with 11.9 years (range, 0.3 to 17.8 years) in the non-PTLD group (P=0.021). The median values of the peak EBV levels in the PTLD group were 3,452,170 copies/mL (range, 46,750 to 7,622,910 copies/mL); the peak EBV levels in the non-PTLD group were 3,112 copies/mL (range, 2,250 to 103,000 copies/mL). Conclusions: Younger age at transplant and presence of EBV viremia were associated with the development of PTLD in pediatric heart transplant recipients. A prospective study will be required to determine the blood EBV load for predicting the development of PTLD in these patients.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.54-59
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• 2017

Purpose: Urinary tract infection (UTI) is the most common serious bacterial infection in infants younger than 3 months of age. Lumbar puncture is routinely performed to evaluate febrile young infants for sepsis. However, there is no clear consensus on the use of routine lumbar puncture to diagnose concomitant meningitis in infants with UTI. We evaluated the prevalence of coexisting bacterial meningitis and sterile cerebrospinal fluid (CSF) pleocytosis in young infants with UTI. Methods: We retrospectively reviewed the medical records of 85 infants with UTI, aged from 29 to 99 days, who were admitted to Daegu Catholic University Medical Center from January 2013 to May 2016. We included 80 patients who had undergone lumbar puncture. Demographic features, clinical features, and laboratory findings were analyzed. Patients were divided into two groups based on the presence of sterile CSF pleocytosis and we compared these groups and assessed the differences between them. Results: Of the 80 UTI patients enrolled, 34 (43%) had sterile CSF pleocytosis. None had bacterial meningitis, and CSF polymerase chain reaction for enterovirus was positive in two patients without CSF pleocytosis. There were no significant differences between the two groups with regards to age, body temperature, peripheral white blood cell count, urinalysis, and duration of hospital stay. Conclusions: Though sterile CSF pleocytosis is common in young UTI patients, coexisting bacterial or viral meningitis is very rare. Indications for lumbar puncture in these patients depend on clinical condition.

• Journal of Preventive Medicine and Public Health
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• v.38 no.4
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• pp.415-419
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• 2005

Objectives : We wanted to evaluate the relationship between obesity and left colonic adenomatous polyps in Korean adult men. Methods : This study was conducted among 575 adults men (aged between 40 and 69), who had colonoscopy done from January to December 2002 during a routine health examination at Health Promotion Center, Ulsan University Hospital. The patients' colons were examined up to splenic flexure by using fiberoptic colonoscopy. A questionnaire survey on behavioral factors and physical measurements were also done. The body mass index (BMI) and waist-hip ratio (WHR) were used as the indices of obesity. The BMI was categorized into three levels: normal ($BMI{\leq}22.9$), overweight ($23{\leq}BMI{\leq}24.9$), and obese ($BMI{\geq}25.0$). The WHR was categorized into four levels with cutoff points at the 30th, 60th, and 90th percentile of the control group. Age, education, smoking, alcohol use and exercise were controlled for by performing multiple logistic regression analysis. Results : There were 99 cases of colonic adenomatous polyps. Four hundred seventy six subjects with normal colonoscopy findings served as the control. The BMI and WHR were associated with the adenomatous polyps (odds ratio, 1.81 [95% CI=1.02-3.19] for a $BMI{\geq}25.0$ as compared with a $BMI{\leq}22.9$, odds ratio, 3.94 [95% CI=1.77-8.77] for a $WHR{\geq}0.95$ as compared with a $WHR{\leq}0.86$). The BMI was not associated with the risk of adenomatous polyps after additional adjustment was made for the WHR, but the association between the WHR and adenomatous polyps was still positive and independent of the BMI (odds ratio, 4.15 [95% CI=1.63-10.59]). Conclusions : The results support that obesity, and particularly abdominal obesity, can be associated with an increased risk of incurring colonic adenomatous polyps.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.261-270
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• 2009

The study examined the relationship between the compressed breast thickness and Average Glandular Dose (AGD) among 1,969 outpatients who went through breast X-ray in a university hospital for 10 months from July 1st, 2007 to April 30th, 2008. Then it analyzed the result acquired from 3,900 cases of Cranio-Caudal (CC) view, especially, when the breasts were compressed (13-15daN). The following is the conclusion driven from the relationship analysis. 1. The subjects aged in 40s and 50s were 2,679 out of 3,900 cases and this figure was 68.69% in all. 2. In terms of distribution depending on focus/filter, 41.0% was Mo/Mo, 34.8% was Mo/Rh, and 24.2% was Rh/Rh. 3. In terms of compressed breast thickness depending on focus/filter, the average thickness was 26.91 mm at Mo/Mo, 38.84 mm at Mo/Rh, and 48.80 mm at Rh/Rh. The average thickness of the entire cases was shown to be 36.27 mm. 4. AGD depending on focus/filter was 1.27 mGy at Mo/Mo, 1.55 mGy at Mo/Rh, and 1.42 mGy at Rh/Rh. The average glandular dose of the entire cases was shown to be 1.43 mGy. 5. The relationship of AGD depending on compressed breast thickness at Mo/Mo was y=0.0318x + 0.470 while it was y=0.0206x + 0.709 at Mo/Rh and y=0.0248x + 0.335 at Mo/Rh. It was highly influenced by the compressed breast thickness, however, more variation was detected at Mo/Mo depending on breast thickness.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.48-54
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• 1997

Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.180-186
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• 2015

Background: Extracorporeal membrane oxygenation (ECMO) has recently attracted interest as a treatment for severe acute respiratory distress syndrome (ARDS). However, the outcomes of this procedure in post-surgical settings have not yet been characterized. In this study, we evaluated the outcomes of ECMO in patients with severe postoperative ARDS. Methods: From January 2007 to December 2012, a total of 69 patients (aged $58.3{\pm}11.5$ years, 23 females) who underwent venovenous ECMO to treat severe postoperative ARDS were reviewed. Of these patients, 22 (31.9%) had undergone cardiothoracic surgery, 32 (46.4%) had undergone liver transplantation, and 15 (21.7%) had undergone other procedures. Results: Thirty-four patients (49.3%) were successfully weaned from ECMO, while the other 35 patients (50.7%) died on ECMO support. Among the 34 patients who were successfully weaned from ECMO, 21 patients (30.4%) eventually died before discharge from the hospital, resulting in 13 hospital survivors (18.8%). Multivariable analysis showed that the duration of pre-ECMO ventilation was a significant independent predictor of death (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.29 to 3.90; p=0.004), whereas the concomitant use of continuous venovenous hemodialysis (CVVHD) was associated with improved survival (OR, 0.55; 95% CI, 0.31 to 0.97; p=0.038). Conclusion: Although the overall survival rate of patients treated with ECMO for postoperative ARDS was unfavorable, ECMO offered an invaluable opportunity for survival to patients who would not have been expected to survive using conventional therapy. CVVHD may be beneficial in improving the outcomes of such patients, whereas a prolonged duration of pre-ECMO ventilator support was associated with poor survival.