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.

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

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

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

土壞 및 植物體 중 窒酸態 窒素 簡易測定 方法 探索

鄭英祥,梁在義,韓連奎,崔文憲 江原大學校 附設 環境硏究所 1996 環境硏究 Vol.13 No.-

Feasibility of simple rapid methods to determine nitrate concentration in soil and plant sap in siltu was assessed using Merckoquant strip method and Cardy NO_(3)- sensor. The saturated extract of a soil was sampled readily in field by a simple apparatus which consists of a syringe, a vial and a hand vacuum pump with a vacuum valve. The simple measurement methods for saturated extract were tested for soil samples obtained from the thirty three farm vinyl houses around Chuncheon, Kang-weon-Do and Kuri, Kyeonggi-Do. The methods were tested for soil and plant sap samples grown under different fertilization in a vinyl house at Kangweon National University. The main treatments were with or without organic fertilizer, and subtreatments were four nitrogen levels ; 0, 100, 200 and 400kg/ha for lettuce and 0, 150, 300 and 500k9/ha for cucumber. The Cardy sensor method showed a high confidence for soil and plant sap nitrate measurement. The Merckoquant strip method was also reliable, but checking electrical conductivity was recommended for better reliability. The soil nitrate concentration above 10mmo1/L was not desirable for lettuce yield, and 15mmo1/L for cucumber. The respective electrical conductivities of saturated extracts were 3 to 4ds/m at these concentrations. The soil nitrate concentration could be monitored by Amberlite IRN-150 Resin-bag. A good correlation was obtained between the soil nitrate concentration and the nitrate absorbed by the resin bag. Therefore, use of the resin bag could be recommended to monitor nitrate in soil, minimizing soil destruction.

중합효소연쇄반응으로 조사한 관절염 환자의 관절액에서 Tropheryma whipplei DNA 검출

김성연,정문현,최새로운,김은실,이진수,박원,김미경,강재승 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : Whipple병은 Tropheryma whipplei에 의한 전신적인 감염 질환으로 소장과 관절 침범이 특징이며, 흔히 병의 초기에는 수년 동안 다른 증상 없이 관절염 소견만 보이므로, 일부 환자는 염증성 관절염으로 진단받을 가능성이 있다. 또한 류마티스 관절염을 포함하여 여러 염증성 관절염에서는 아직 병인이 밝혀지지 않았지만 감염이 관련될 가능성은 꾸준히 언급이 되었다. 저자들은 국내에서도 T. whipplei가 존재할 것이라는 가정 하에 한국인에서 중합효소연쇄반응으로 T. whipplei DNA를 조사하였다. 재료 및 방법 : 대상 환자군은 1997년부터 2002년 사이에 인하대병원 류마티스 내과에 관절 종창으로 내원한 환자들로, 류마티스 관절염 환자 33명, 골관절염 환자 18명, 기타 질환에서 관절 이상인 환자들로 5명이 포함되었다. 건강한 성인 8명의 타액과 22명의 위내시경을 받은 환자의 위액을 채취하여 검사하였다. 중합효소연쇄반응은 T. whipplei heat shock protein의 일부 유전자를 증폭할 수 있는 2개의 시동체를 사용하였다. 표준 균주를 얻기가 어려워 양성 대조군 없이 중합효소연쇄반응을 시행하였다. 결과 : 관절염 환자의 관절액, 정상인의 타액, 위내시경을 받은 사람의 위액에서 모두 중합효소 연쇄반응으로 핵산을 증명할 수 없었다. 결론 : 양성대조군이 없어 검사 잘못일 가능성도 배제할 수 없으나, Whipple병이 염증성 관절염의 흔한 원인이 아니거나 관절의 직접 침범보다는 위장관 감염 후 생기는 면역 반응에 의한 반응성 관절염일 가능성이 있다. 관절액 이외의 검체에서 조사한다면 다른 결과를 얻을 수도 있으리라 생각하며 앞으로 이들에 대한 조사가 필요하다. Background : Whipple's disease is a chronic systemic infection caused by Tropheryma whipplei which chiefly involves gastrointestinal tract and joints. Because arthritis is often the first sign of Whipple's disease, Whipple's disease may be misdiagnosed in the early stage of illness as non-infectious inflammatory arthritis. Rheumatoid arthritis may also be caused by infectious agents, including T. whipplei. To elucidate the relationship between T. whipplei infection and various arthritis, we examined T. whipplei DNA in Korean patients by polymerase chain reaction (PCR). Materials and Methods : With two T. whipplei-specific primers dervied from the partial heat shock protein 65 gene sequence, PCR was performed on 56 joint fluid samples : 33 samples from RA patients, 18 samples from OA patients, and 5 samples from patients with other unflammatory arthritis. In addition, the same method was applied to find out the DNA of T. whipplei in 8 normal adults' saliva and 22 patients' gastric juice. Due to the difficulty in obtaining the reference strain of T. whipplei, the PCR was performed without the positive control. Results : The PCR method did not reveal T. whipplei in joint fluid from 56 patients with arthropathies, 8 samples from saliva, and 22 samples from gastric juice. Conclusion : Though technical errors can not be excluded as a cause of absence of a positive case, our results suggest that T. whipplei infection may not be a common cause of various arthritis in Korea; T. whipplei may be associated with inflammatory arthritis indirectly by immune-mediated mechanism rather than by direct joint invasion. The examination of specimens other than joint fluid could be helpful and the study of larger number of patient is highly desirable.

간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

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.

담낭절제술 후 발현된 간, 신장 및 복막을 침범한 유전분증 1예

김성연,김덕영,김경아,송준호,이승우,한지영,김문재 대한내과학회 2003 대한내과학회지 Vol.65 No.1

저자 등은 최근 담낭절제술을 시행받은 후에 발생된 간기능 이상과 조절되지 않는 복수를 주소로 내원한 환자에서 진단된 유전분증 1예를 경험하였기에 보고하는 바이다. Amyloidosis is a heterogenous group of often fatal disorders characterized by extracellular deposition of a proteinaceous material with a unique fibrillar form in various tissues and organs. Deposition of amyloid may cause widespread dysfunction of the involved organs. Recently, we experienced a case of 40-year-old male patient with nephrotic syndrome, uncontrolled ascites and jaundice, which developed after cholecystectomy. We confirmed systemic amyloidosis involving kidney, liver and peritoneum by kidney and liver and peritoneum biopsy. The case that, having about a month of incubation period after cholecystectomy, amyloidosis occurred in a healthy man before the operation, and that amyloid was deposited in the peritoneum site incised during the operation provides grounds that amyloidosis may be triggered by cholecystectomy. Given the rarity of this case, the following is a report of this case and a review of the relevant literatures.

BC₃H1 혈관평활근세포의 증식 및 분화과정에 있어서 Polyamine 대사의 역할에 관한 연구

최상현,문창택,민본홍,전보권,천연숙 고려대학교 의과대학 1992 고려대 의대 잡지 Vol.29 No.3

The influences of spermine (SM) and DFMO. an irreversible ODC-inhibitor, on the polyamine metabolism, CK-activity, [^(3)H]-thymidine DNA synthesis, and isoactin mRNA expression of BC_(3)H1 in culture were studied, with the references of phosphodiesterase(PDE)-inhibitors including isobutyl-methylxanthine (IBMX) and KR30075. BC_(3)Hl cells cultured in 10% fetal bovine serum (FBS)-DMEM for 24 hrs (the first : pre-drug phase) were cultivated in 10% FBS-DMEM added with one of the test drugs for further 96 hrs(the second proliferation phase), and then continue to grow in 2% FBS-DMEM for 48 hrs (the third : differentiation phase). The putrescine content of BC_(3)Hl harvested after the first phase was relatively higher in comparison with those of the other phases and was gradually decreased through the full phases of culture, and the spermine content was little changed. The spermidine (SD) content was. unlike other polyamines, increased by 26.5% at the end of the second phase, but that SD increase was moderately attenuated by PDE-inhibitors, particularly KR30075, and furthermore. the SD content of BC_(3)Hl cultured in the presence of DFMO, unlike other polyamines. showed the marked and gradual decrease throughout the full phases of culture. The [^(3)H]-thymidine DNA synthesis during the third : differentiation phase was not affected by IBMX and slightly inhibited by KR30075, but was significantly inhibited by SM plus DFMO or each of them. And the creatine kinase (CK) activity gradually increased in advancing with culture duration was not changed by PDE-inhibitors. but both SM and DFMO significantly enhanced the increase of CK activity. The synthesis of BC_(3)Hl α-actin and β-/ γ-actin mRNAs was significantly enhaced by DFMO, and the DFMO-induced enhancement was dramatically inhibited by SM. And PDE-inhibitors and SM little affected the synthesis of α-actin mRNA, but PDE-inhibitors attenuated the synthesis of β-/ γ-mRNAs, especially in the second phase. These results suggest that polyamines have a pivotal role in the proliferation and differentiation of BC_(3)Hl cells, that the enhancement induced by DFMO of expression of VSM isoactin gene seems to be an attractive subject to be studied in future, and that PDE-inhibitors may inhibit the synthesis of VSM β-/ γ-actin mRNAs.