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.

抗癌丹을 投與한 大腸癌 患者 83例에 대한 臨床報告

이용연,서상훈,유화승,최우진,조정효,이연월,손창규,조종관 대한한방종양학회 2000 대한한방종양학회지 Vol.6 No.1

Climical studies were carried out 83 cases of patients with colorectal cancer treated bv Hangamdan(抗癌丹) from January lth 1998 to September 30th 2000. The results were summarized as follows; 1. Distribution of those attached by colorectal cancer, by sex, showed that Male is more then Female, by age, showed that the numbber of fifties is majorith. 2. distribution of diagnostic stage, in descending order; stage Ⅲ(53%, top), stagew Ⅵ(45.8%). 3. The effects of maintenance and improvement in the symptoms with traditional oriental therapy(83.3%) and combined treatment of westem and oriental therapy(92.1%)were boserved. The effects of the symptoms were as folows: diarrhea(37.3%),abdominal pain (25.3%), general body weakness(22.9%), nausea(20.5%) and etc. in orders. 4. Analysis of hematology attached by colorectal cancer, maintenance and increasing of WBC(89.9%), RBC(74.7%), Hgb(81.1%), Platelet(92.4%) were Observed. After taken Hangamdan, the satety of the liver and kidney were as follows; maintenance and decreasting of AST(85.9%), ALT(94.8%) , GTP(87.5%), Creatinine(90.9%) were observed. 5. of IL-12 and IFN-λ attached by colorectal cancer, increasing of IL-12(53.3%), IFN-λ(80%) were observedl. 6. Analysis of QOL attached by colorectal cancer, maintenance and improvement of combined treatment of western and oniental therapy(89.6%), traditional oriental therapy(83.3%) were observed. 7. Analysis of survival in patients with Ⅳ stage of colorectal cancer, above 7 months(18.4%), 12 months(65.8%). 8. Analysis of antitumor effects, maintenance of traditional oriental therapy(83.3%) and maintenance and improvement of combined treatment of western and oriental therapy(80.5%) were observed. Analysis of tumor marker attached by colorectal cancer, maintenance and decreasing of CEA(78.8%) were boserved 9. Analysis of curative valuation, maintenance and improvement of traditional oriental therapy(83.3%), combined treatment of westem and oriental therapy(72.7%) were observed.

개인의 능력수준이 직무성과에 미치는 영향에 관한 연구 : 실제 인사고과 자료분석을 통해

정연앙,손일상 中央大學校經營硏究所 2002 經營學論集 Vol.28 No.2

퍼머제의 중금속 농도에 관한 연구

윤복연,문덕환,박명희,황용식,함성애,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted to prepare the fundamental data on heavy metal concentration in hair permanents agents and to prevent the health impairment due to heavy metal. Methods and Material : The author determined of 5 heavy metals(Pb, Cr, Mn, Ni, and Cu) concentration hair permanent agents in the market with flameless atomic absorption spectrophotometer. Results : The results were as follows: 1. The geometic mean concentrations of total subjects were 0.04㎍/g for Pb, 0.09㎍/g for Cr, 0.06㎍/g for Mn, 0.03㎍/g for Ni, and 0.04㎍/g for Cu. 2. The most highest mean concentrations of heavy metals in hair permanent agents by using type were Cr for wave agent and straight cream agent, Cu for setting iron agent, Cr and Cu for coating perm agent. 3. Metal most hlghest mean concentrations of heavy in hair permanent agents by type of color was green for Cu. 4. The mean concentration of Cu among 5 heavy metals in hair permanent agents by marker was most highest. 5. There was most statistically significant difference on mean concentration in hair permanent agents between domestic and foreign products. 6. The exposure amount of heavy metal concentration by one time using the permanent agent were 4.O㎍ for Pb, 9.O㎍ for Cr, 6.0㎍ for Mn, 3.O㎍ for Ni and 4.0㎍ for Cu. Conclusion : As above results author suggest to prepare the preventive program of health impairment due to heavy metal by long term chronic exposure to who were using the hair permanent agents hair designer and customers.

PTFE 이식편을 이용한 대퇴동맥과 슬관절이하 동맥 우회로술의 결과 분석

문성민,손민수,이길연,이상목,고석환,홍성화,윤충,오수명,박호철 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

급박 하지 허혈증에 대한 비수술적 치료의 장기 추적 결과

최재영,손민수,이길연,이상목,고석환,홍성화,윤층,오수명,박호철 대한혈관외과학회 2003 Vascular Specialist International Vol.19 No.1

Crawford Ⅲ형과 Ⅳ형 흉복부 대동맥류 4예 보고

문성민,손민수,이길연,이상목,고석환,홍성화,윤충,오수명,박호철 대한혈관외과학회 2003 Vascular Specialist International Vol.19 No.2

西歐 代替醫學의 癌 治療에 關한 硏究

兪和承,李容淵,徐祥熏,崔宇鎭,曺政孝,李淵月,孫彰奎,趙鍾寬 대한한방종양학회 2000 대한한방종양학회지 Vol.6 No.1

At here, we investigated the historical background, current stage, and concrete therapies of altematives in cancer therapy. We obatined the conclusion below. 1. Alternative medicine(AM) is a unothodoxial medical physiology, medical practice or intervension that overcome the side effects. faults, limits of coventional medicine. 2. Recentely, as emerging New-age movement, collgpse of Decarte's mecanical cosmology, and emphasis on patient rights, the interest of AM is increased, and foreign & domestic use rates of AM are risen. 3. After coventional medicine in cancer therapies tha depends on poerations, radiations, and chemotherapy is bounded, Altematives in cancer therapy are rapidly developed, and the majority of users are often considered satisfactory. 4. Alternatives in cancer therapy are classified six boundaries; Diet and Nutrition, MInd-body Technique, Integrated System, Pharmacologic and Biologictreatments, Immuno Enhanced Therapy, Immuno Enthaced Therapy, Natural and herbal medicine. 5. Looking at contents of Alternatives in cancer therapy, we get to know most of them are similar to the treatment of oriental medicine in holistic method, therapy, philosophy. If we synthesize the alternative medicine's treatment mentioned above and investigate it with oriental medical viewpoint, that may help us approach the conquest of cancer and improve the rate of cure. that may help us approach the conquest of cancer and improve the rate of cure. 6. It is certain that foreign AM will be imported reversely, and we must prepare for rebuilding of Korean traditional AM systemically, investing for activity positively, making national policy for medical system.

肺癌에 있어서 職業과의 關聯性 硏究

김두희,박완섭,손지연,이종영,홍성철 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

폐암에 대한 직업의 관련성을 밝히기 위하여 1993년 11월에서 1994년 8월까지 대구 시내 2개 종합병원에 입원하여 병리 조직학적으로 진단된 168명의 폐암 환자와 같은 병동에 있는 내과 환자를 연령군과 성별로 빈도 짝짓기하여 168명의 대조군으로 선정하였다. 직업력과 유해 물질의 폭로력, 거주 환경, 흡연에 관한 정보는 설문지를 통하여 얻었다. 흡연 상태를 보정하고 연령군과 성별에 대한 짝지은 자료에 대하여 직업과 산업 분류에 대한 폐암 발생의 상대 위험은 농업 종사자에서 유의하게 높았고(OR=1.84 ; 95% 신뢰구간 1.16-2.94) 생산직, 가내 수공업, 운수창고통신업, 숙박음식업, 건설업에서도 높게 나타났으나 유의하지 않았다. 그러나 가사(OR=0.31 ; 95% 신뢰구간 0.11-0.89), 관리직(OR=0.22 ; 95% 신뢰구간 0.08-0.61), 공공 행정업(OR=0.23, 95% 신뢰구간 0.08-0.66), 공공 사회및 개인 서비스직(OR=13 ; 95% 신뢰구간 0.03-0.56)에서는 폐암 발생의 상대 위험이 유의하게 낮았으며, 전문직, 도소매업에서도 낮게 나타났으나 유의하지 않았다. 거주 환경에 따른 폐암 발생의 상대 위험은 연탄난로 사용자(OR=3.00 ; 95% 신뢰구간 1.06-8.52)와 농약 사용시(OR=2.14 ; 95% 신뢰구간 1.36-3.37)에 통계학적으로 유의하게 높았고, 공장지대 거주자에서도 높게 나타났다(OR=1.97 ; 95% 신뢰구간 0.92-4.27) 그러나, 중앙집중식난방사용자(OR=0.5 ; 95% 신뢰구간 0.28-0.89)에서는 낮게 나타났으며 통계학적으로 유의하였다. 유해 물질 폭로에 따른 폐암 발생의 상대 위험은 농약(OR=2.07 ; 95% 신뢰구간 1.31-3.26)과 용접 및 흄(OR=10.56 ; 95% 신뢰구간 1.07-103.90)에 폭로시 유의하게 높게 나타났다. 흡연에 의한 폐암 발생의 상대 위험은 비흡연자에 비하여 흡연자(OR=3.98 ; 95% 신뢰구간 1.88-8.45)와, 과거흡연자(OR=4.50 ; 95% 신뢰구간 1.99-10.16)에서 높게 나타났다. 이상의 결과로 비록 흡연이 폐암의 중요한 원인이지만 흡연의 영향을 보정한 후에도 대기오염 및 직업과 폐암과 관련성이 있음을 보여주고 있으며, 앞으로 이러한 직업에서 어떠한 위험 요인이 있는지에 대한 추구가 필요하여 그에 대한 예방 대책을 밝히는 연구가 필요하다. The relationship between occupation and risk of lung cancer was analyzed in hospitalbased case-control study conducted in Taegu on 168 patients with histologically confirmed lung cancer and age group(30-39, 40-49,etc) and sex frequency-matched 168 controls admitted into hospitals for other internal medicine problems. A self adminstered questionnaire was used to obtain occupation, resident environment, smoking histories and specific agent exposure history. The conditional logistic regression was used to estimate oddsratio for age group and sex frequency matched, after controlling for smoking status(non smoker, exsmoker, current smoker) Significant association was observed for farmer[odds ratio(OR), 1.84 ; 95% confidence interval(CI), 1.16-2.94], briquette stove users[OR, 3.0 ; 95% CI, 1.06-8.25], agricultural chemicals users[OR, 2.14 ; 95% CI, 1.35-3.37], and welding/fume exposures[OR, 10.56 ; 95% CI, 1.07-103.90]. Although there were elevated risks associated with production, home industry, transportation/storage/communication, lodgement/food worker and construction, none were statistically significant. The effect of smoking was showed significantly increased risk for exsmoker [OR, 4.50 ; 95% CI, 1.99-10.16] and current smoker [OR, 3.98 ; 95% CI, 1.88-8.45]. As results, although smoking is important risk of lung cancer, occupation and resident environment are showing association of lung cancer. So further evaluation is necessary for occupation risk and take preventive measures.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.