A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

골반 경사로 인한 요추부 측만증에서 신발 높이기의 효과

김용민,김동수,최의성,손현철,박경진,김융성 대한척추외과학회 2004 대한척추외과학회지 Vol.11 No.2

중추성 요붕증으로 발현된 랑거한스세포 조직구증식증 1례

김준성,윤원상,김근모,최영권,박기원,김병희,유용상 대한소아내분비학회 2004 Annals of Pediatirc Endocrinology & Metabolism Vol.9 No.1

3차 의료기관 응급실로 내원한 안면부 열상 환자에 대한 임상적 고찰

김양원,안성훈,류석용,김홍용,전병민,김기태 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: Facial laceration is a common clinical problem in the emergency room that is frequently associated with other craniofacial injuries. It elicits an emotional response from the patient because of the underlying concern of permanent scar and secondary facial disfigurement, so they demand prompt and adequate treatment. The aim of this study is to analyze the incidence, etiology, depth, and site of facial lacerations to provide basic data for further understanding. Method: This study reviewed 1,043 facial-laceration patients treated in the emergency room at Pusan Paik Hospital between March 1999 and February 2000. This retrospective study was done by reviewing and analyzing the sex and age distributions, the monthly and daily distributions, the causes of injury, the types of injury, the sites of injury, the lengths of the lacerations, and associated injuries. Results: The sex ratio of men to wemen was 2.4:1, and the 0~10 age group was at the top of the age distribution. The number of patients was the highest on sundays and during March. About 9.2% of the patients visited the emergency room between 10:00 P.M. and 11:00 P.M. Falls(38.1%) were the most common cause of facial laceration, and deep laceration(51.8%) was the most common type of facial laceration. The most common laceration site was the forehead, followed by the chin and the nose. The most common associated craniofacial injury was facial bone fracture(39%), Facial-lacerations were sutured by plastic surgeons(80%), emergency physicians(10%), and oromaxillofacial surgeons(10%). We found statistical significance in the types and lengths of lacerations between men and women, among age groups(p<0.05). Conclusion: Facial laceration is one of the most common craniofacial injuries in the emergency room. By now, most lacerations have been repaired by plastic surgeons, But, the causes of lacerations are diverse and many patients are admitted due to the associated injuries. Therefore, emergency physicians should participate more aggressively in the care of facial-laceration patients to improve the outcome of the patients.

Investigation of Weld Corrosion Eff ects on the Stress Behavior of a Welded Joint Pipe Using Numerical Simulations

Yong‑Sang Kim,Jung‑Gu Kim 대한금속·재료학회 2019 METALS AND MATERIALS International Vol.25 No.4

In this paper, the infl uence of weld corrosion on the mechanical behavior of a welded joint pipeline was investigated usingcorrosion and mechanical simulations simultaneously. In the corrosion simulation, the modeling results (i.e., the corrosionpotential and current density) revealed that the welded joint is preferentially corroded and the corrosion rate is higher in theoutside environment due to the severe corrosion factors. The increase in corrosion degradation according to the operationtime increases the stress concentration on the welded joint, indicating that the failure risk of the welded joint is increasedwith increasing corrosion degradation. These results can be used to evaluate the lifetime of welded joints exposed to corrosionand suggest guidelines for the maintenance of structures.

병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성

김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5

목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.

골다공증의 위험인자 : 아산시 지역 주민을 대상으로

김용배,장원기,황보영,김화성,안규동,이병국,이용진,이남수,이상건,이상범,이상우,이선정,이성수 순천향대학교 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

Objective : As the average lifespan of human increases, osteoporosis and osteoporosis-related fractures have become major health care problems. Despite recent advances in medical treatment, few studies have assessed the recognition of osteoporosis in general adults. This study examined the recognition of osteoporosis and analyzed the relating factors. Method : A population-based sample of 1086 adults in Asan-city, Korea was investigated with questionnaires and height, weight, Information regarding the general characteristics(gender, age, economic state), lifestylef exercise, smoking, alcohol),medical history(progestin, GH, steroid, calcitonin, PTH), demographic parameter, obesity, stress, and family history was collected through an interview using a structural questionnaire. The level of obesity was measured by the body mass index(BMI). BMD(Bone mineral density) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. Osteoporosis was considered to be T-score below -2.5. Results : The prevalence of osteoporosis increased progressively with age, decreased with BMI and predominant in women by the result of x^(2) -test, T-test. Age, weight, BMI were significantly correlated with osteoporosis by the result of Pearson correlation ana1ysis(P<0.05). And age, gender, BMI, family history of osteoporosis were proved to be significant risk factors of osteoporosis by the result of multiple logistic regression(P<0.05). Conclusion : These results suggest that age, gender, BMI might be the most important risk factors of osteoporosis. And the history taking about family history of osteoporosis is helpful for diagnosing osteoporosis.

A Study of the Yang-gyeong-gyu-il-ui (兩景揆日儀) in the Joseon Dynasty

Yong Sam Lee,Sang Hyuk Kim,Byeong-Hee Mihn 한국우주과학회 2015 Journal of Astronomy and Space Sciences Vol.32 No.1

The Yang-gyeong-gyu-il-ui (兩景揆日儀) is a kind of elevation sundial using three wooden plates. Sang-hyeok Lee (李尙爀, 1810~?) and Byeong-cheol Nam (南秉哲, 1817~1863) gave descriptions of this sundial and explained how to use it in their Gyu-il-go (揆日考) and Ui-gi-jip-seol (儀器輯說), respectively. According to Gyu-il-go (揆日考) there are two horizontal plates and two vertical plates that have lines of season and time. Subseasonal (節候) lines are engraved between seasonal (節氣) lines, subdividing the interval into three equal lines of Cho-hu (初候, early subseason), Jung-hu (中候, mid subseason) and Mal-hu (末候, late subseason); there are 13 seasonal lines for a year, thus resulting in 37 subseasonal lines; also, there are 12 double-hour (時辰) lines for a day engraved on these plates. The only remaining artifact of Yang-gyeong-gyu-il-ui was made in 1849 (the 15th year of Heon-jong) and is kept at the Korea University Museum. We have compared and analyzed Yanggyeong- gyu-il-ui and similar western sundials. Also, we have reviewed the scientific aspect of this artifact and built a replica. Yang-gyeong-gyu-il-ui is a new model enhanced from the miniaturization development in the early Joseon Dynasty and can be applied to the southern part of the tropic line through a structure change.