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.

노치 형상 및 냉각속도에 따른 Zr-2.5Nb 압력관의 DHC거동

김상재,김영석,임경수,김성수,정용무 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The objective of this study is to investigate the delayed hydride cracking (DHC) velocity and the incubation time for the water-quenched and furnace-cooled Zr-2.5Nb tube with the different radius of a notch tip. DHC tests were carried out at constant K_1 of 20 MPa√m and 250℃ on the cantilever beam (CB) specimens subjected to furnace cooling or water quenching after electrolytic charging with 57 or 72 ppm hydrogen, respectively. An acoustic emission sensor was attached to the CB specimens to detect the incubation time before the start of DHC. The shape of the notch tip changed from the fatigue crack to the dull crack with its radius ranging from 0.1 to 0.15 mm. The DHC incubation time increased remarkably with the increasing radius of the notch tip, which appeared more strikingly on the furnace-cooled CB specimens than on the water-quenched ones. However, both furnace-cooled and water-quenched CB specimens indicated little change in the DHC velocity with the radius of the notch tip unless their notch tip exceeded 0.125mm. These results demonstrate that the uncleation rate of hydrides at the notch tip determines the incubation time and the DHC velocity becomes constant after the concentration of hydrogen at the notch tip reaches the terminal solid solubility for dissolution (TSSD). This observation agrees well with Kim's DHC model. A difference in the incubation time and the DHC velocity between the furnace-cooled and water-quenched specimens is discussed in terms of the uncleation rate of hydrides at the notch tip and the hysteresis of hydrogen solubility.

한국인 제1형 당뇨병에서 체도 세포질 항체의 양성률 : 항GAD항체, 항ICA512항체, 항phogrin항체의 조합 측정으로의 대체 가능성 Possible Replacement with Combined Measurement of Anti-GAD, Anti-ICA512, and Anti-phogrin Antibodies

김경아,김동준,정재훈,민용기,이문규,김광원,진동규,고경수,김상진,이명식 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 당뇨병의 분류를 새로 제정함에 있어 자가항체가 양성이면 임상형에 상관없이 제1형 당뇨병으로 분류하자는 제안이 나옴으로써 자가항체의 중요성은 더욱 커질 것으로 예상된다. 특히 우리나라와 같이 비비만형인 제2형 당뇨병이 많은 나라에서는 당뇨병의 병인 규명에 자가항체가 중요한 위치를 차지할 것으로 사료된다. 자가항체 중에서 전통적으로 측정되어온 췌도 세포질 항체(ICA)는 표준화하기 어렵고 기술적으로 제한점이 많으며 현실적으로도 췌장 공여자가 적은 점 등이 문제로 알려져 있다. ICA의 대응 항원들로는 GAD(glutamic acid decarboxylase), IA­2(islet­associaated antigen­2;ICA512), IA­2β(phogrin)등이 있다. 이러한 대응 항원에 대한 특이적인 자가항체의 측정은 ICA에 비해 표준화되었으며 최근에는 방사면역측정법(radioimmunoassay;RIA)키드까지 등장하여 손쉽고 정확히 이를 측정할 수 있게 되었다. 연구자들은 한국인 제1형 당뇨병에서 측정법이 표준화 되어 있는 항GAD항체 및 항ICA512항체 조합(combimation)의 조합으로 ICA의 측정을 대신할 수 있는지를 조사하였고 더 나아가 항phogrin항체의 조합 측정으로 임상적 유용성이 있는지 보고자 하였다. 방법: ICA는 면역조직화학 염색법을 이용하였다. 항 GAD항체는 상업화 된 키드(RSR??, United Kingdom)를 이용하였다. 항 ICA512항체와 항phogrin항체의 측정은 in vitro transcription&translation한 후 이를 이용해 방사면역 침전법을 이용하였다. 대상 환자로는 전형적 제1형 당뇨병 76명, 지진형 제1형 당뇨병 22명, 제2형 당뇨병 39명이었으며 각 군간의 연령은 각각 22.8±14.0, 37.9±13.9, 45.3±12.3세였다. 결과:1)전형적인 제1형 당뇨병에서는 ICA의 양성률이 30%, RIA조합만의(항GAD항체 또는 항 ICA512항체 또는 항phgrin항체 한가지에라도 양성인 경우)양성률이 57%이었다. 지진형 제1형 당뇨병에서는 각각 18%, 50%이었다. 제2형 당뇨병에서는 각각 7.7%, 5.1%이었다. 2)각 군에서 ICA가 양성인 군에서 RIA조합 양성률을 보면 전형적 제1형 당뇨병에서는 96%, 지진형 제1형 당뇨병에서는 100%에서 양성이었고 제2형 당뇨병에서는 RIA 조합 양성이 없었다. 각 군에서 ICA가 음성인 군에서도 RIA 조합시 전형적 제1형 당뇨병에서는 40%, 지진형 제1형 당뇨병에서는 39%에서 양성이었고, 제2형 당뇨병에서는 5.6%에서 양성이었다. 3)전형적 제1형 당뇨병에서 ICA가 양성인 군(n=23)에서 96%가 RIA조합 양성이었는데 이때 각각의 RIA유형을 보면 항GAD항체 양성이 87%였다. 한편 항 ICA512항체 양성이 48%, 항phogrin항체 양성이 44%이고 항GAD항체 도는 항ICA512항체 양성이 96%를 차지한다. 지진형 제1형 당뇨병에서는 ICA가 양성인 군(n=4)에서는 항 GAD항체 양성이 3명, 항ICA512항체 양성이 1명이었다. 따라서 기존의 ICA를 RIA조합으로 대체할 수 있을 것으로 사료되었는데 이때 항GAD항체와 항ICA512항체의 조합이 도움이 되겠고 항phogrin항체의 추가적인 검사는 일부의 환자에서만 도움이 되리라 사료된다. 4)이환 기간에 따라 ICA와 RIA조합을 비교시 ICA는 차이가 없었으나 RIA조합의 양성률은 지진형 제1형 당뇨병에서 4년 이상의 이환 기간이 지나면 그 이전보다 떨어졌다. 5)발병 연령에 따라 ICA와 RIA조합을 비교시 ICA 양성률이 전형적 제1형 당뇨병에서 15세 이전에 발병한 그룹에서 그 이후에 발병한 그룹보다 유의하게 높았다. 결론:이상의 결과를 요약하면 항GAD항체 및 항ICA512항체 측정의 조합은 ICA보다 민감도가 높아 기존의 ICA를 대체함은 물론 임상적 이용에서 현격한 우월성을 보이며, 성인에서 발병한 비전형적인 당뇨병의 분류에도 도움이 될 것으로 사료되었다. 추가적인 항phogrin항체의 측정은 임상적 유용성이 없었다. Background : Type 1 diabetes includes all forms of autoimmune-mediated and idiopathic beta-cell destruction leading to an absolute insulin deficiency. Evidence of an autoimune pathogenesis was assessed by studying cytoplasmic islet cell antibodies (ICA), antibodies to glutamic acid decarboxylase (GADA), antibodies reacting with an islet tyrosine phosphatase-related molecule referred to as ICA 512 (ICA 512A), or its homologue phogrin (phogrin-A). In comparison with ICA, the best validation to assess the risk of type 1 diabetes, shows that a combination of antibodies to GADA with ICA 512A has the power to detect a majority of ICA and 97 ~ 100% of subjects who progressed to overt diabetes. These findings suggest the possibility of replacing the laborious ICA test in the screening programs to identify subjects at risk of progressing to type 1 diabetes or for classifying the stage of diabetes at the time of diagnosis. Up to now, it is unclear whether these results are applicable to the slowly progressive type 1 diabetes that appears to be more prevalent in Asian than in western countries. The prevalence of combined autoantibody testing (1≥ of GADA, ICA512A, or phogrin-A) was investigated in the patients with type 1 diabetes (typical and slowly progressive) and type 2 diabetes, and compared with that of ICA which is a more laborious and insensitive test. Methods : The ICA assay was performed using immunoenzymatic staining of frozen human (blood group O) pancreatic sections with serial dilutions of serum samples with peroxidase-labeled protein A. For the GADA determination, commercially available GADA radiommunoassay kits utilizing the ^125I-labeled recombinant GAD65 (RSR®, United Kingdom) as an antigen was used. Either ICA512A or phogrin-A were detected by a radioligand-binding assay after in vitro transcription and translation using the clone ICA512bdc or phogrin c DNA. Serum was obtained from 76 patients with type 1 diabetes(mean age 45.3± 12.3 years). Typical and slowly progressive type 1 diabetes patients had the disease for between 4.0±4.6 and 10.1±9.5 years, respectively at the earliest serum sampling. Results: 1) In typicaltype 1 diabetes, 30% of patients tested positive for ICA and 57% for the combined autoantibody test. In type 2 diabetes, 7.7% and 5.1% tested positive, respectively. 2) Ninety-six percent of ICA-positive patients expressed one or more of the 3 auto-antibody specificities in typicaltype 1 diabetes. Among the 53 ICA-negative patients with typicaltype 1 diabetes, 40% had one or more of these auto-antibodies. In the slowly pregressive type 1 diabetes, 100% of the ICA-positive and 39% of the ICA-negative patients expressed one or more of the 3 autoantibody specificities. 3) Of the 23 patients with ICA-positive typical type 1 diabetes patients, 87% had a positive result for GADA, 48% FOR ICA512A, 44% for phogrin-A, and 96% for GADA or ICA512A. Of the 4 patients with ICA-positive slowly progressive type 1 diabetes, three had a positive result for GADA, and 1 for ICA512A. 4) When the prevalence of combined autoantibody testing was analyzed according to the duration of diabetes, the prevalence in patients tested within 4 years after the diagnosis and more than 4 years after the diagnosis was 61% and 52%, respectively in typical type 1 diabetes. Furthermore, that for the ICA was 37% and 21%, respectively. In the slowly progressive type 1 diabetes, the prevalence of combined auto-antibody testing was 88% and 25%, respectively (p<0.05), while that of ICA was 25% and 13%, respectively. 5) In typical type 1 diabetes, ICA were detected more frequently in patients younger than 15 years of age (48%) than in older patients (23%) (p<0.05), while the prevalence of combined auto-antibody testing -was not different according to the onset age(65% vs 53%). Conclusion : Combined autoantibody testing for GADA and ICA512A is more sensitive that ICA in type 1 diabetes. Therefore, it could replace the laborious ICA measurement and may be useful for discriminating the etiology of adult onset a typical diabetes(J Kor Diabetes Asso 25 :430~445, 2001).

산후에 발병한 특발성 부갑상선 기능저하증 I 예

김정인,김상용,신병철,김경남,서영욱,이범주,김진화,배학연 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

Hypoparathyroidism is usually the result of an inadvertent surgical removal of all the parathyroid glands, In some instances, not all the tissues are removed, but the remainder undergoes vascular supply compromise secondary to the fibrotic changes in the neck after surgery, Previously, the surgery for hyperthyroidism was the most frequent cause of acquired hypoparathyroidism. Idiopathic hypoparathyroidism is a relatively rare disease that is characterized by hypocalcemia and hyperphosphatemia due to a parathyroid hormone deficiency of an unknown cause, It usually develops at a young age, and shows various clinical symptoms and signs accompanied with hypocalcemia. In addition, it is rarely associated with polyglandular autoimmune syndrome during the follow-up. Hypocalcemia and idiopathic hypoparathyroidism associated with labor and lactation are rarely reported condition previously. We here describe a case of a woman in whom the symptomatic severe hypocalcemia appeared after her delivery. We reviewed all the previously reported cases and suggest a possible physiological explanation for the association between pregnancy, lactation, and the appearance of symptomatic hypocalcemia.

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.

경련성 환아 부모들의 인식에 대한 연구

이경화(Kyoung Hwa Lee),서은숙(Eun Sook Suh),김영창(Yong Chang Kim),김창휘(Chang Hwi Kim),이동환(Dong Whan Lee) 대한소아신경학회 1996 대한소아신경학회지 Vol.3 No.2

Convulsive disorder is the most part of the pediatric neurologic disease. As far as the treatment of convulsive disorder concerned, we must consider familys' understanding, and the close cooperation between the epileptic child, parents, and doctors. We compared to Kim's report in 1985, to study the change of parents of epileptic children thinking. A prospective study was undertaken the analysis of 100 epileptic children parents visited to the pediatric dept, of Soonchunhyang university hospital from May to July, 1995. Psychological assessment, questionnaires which contains 17 items were given them, and these items were compared to Kims report in 1985 The results were as follows: 1) Parents of epileptic children answered convulsive disorder has influenced to children growth and development( 60.8% in 1985, 65.0% in 1995 ). 2) For asking the causes of children disease, 40.5% of them in 1985 and 50.0% of them in 1995 answered to uncertain, but only 7.8% of them in 1985 and 7.0% of them in 1995 answered to relation with familial inheritance. 3) The feelings at time of the diagnosis were gloomy or uncomfortable: 52.3% in 1985, 38.0% in 1995 and shameful 28.1% in 1985, 9.0% 1995. parents had belived in the epilepsy was treatable disease: 41.0% in 1995. 4) According to the this survey, patients explained reasons why their children take the medication increased from 23.5% in 1985 to 65.0% in 1995. 5) Only family, knew that their children had the convulsive disorder about 50.3% in 1995 and 22.0% in 1995. Family, patients and other people except family knew that their children had the convulsive disorder about 6.5% in 1985 and 43.0% in 1995. 6) The parents opinion and expectation toward the medical doctors were that they wanted to get full explanation for the disease 81.0% in 1985 and 35.1% in 1995, and others were explantation about toxicity and side effects of the medication and advises for the childrens life and activities.

市民農園의 利用者와 非利用者에 관한 意識 調査 硏究

金龍基,盧庚兒 成均館大學校 科學技術硏究所 1993 論文集 Vol.44 No.1

The purpose of this study is to suggest the proper direction of the civic garden in suburban area and to suffice the citizen's spare time needs. The study is intended to consider non-user's cognition(by the survey in YMCA) and the user's present situation, satisfaction with the civic garden. The results are as follows : (1) Based on the non-user survey, the civic gardens are recognizied by most people. They are willing to use them, and specially the farming school to educate the children. (2) It is desired to develop the unused farming land in the suburb as a civic garden for the efficient land use. (3) It is the most important to select the location for promoting frequent use, which can be affected by the distance, transportation mode and surrounding scenery. (4) As a result from the user's survey, the most unsatisfactory factor is the supporting facilitiess for nest convenience. They should be reflected in designing the civic garden. (5) During the weekend the housewife and her family visits in civic garden. Therefore it is necessary to develop the program for the family visitors.

토마토의 PCR 적정 조건 연구

김보경,김용철,최인수 밀양대학교 농업기술개발연구소 2000 農業技術開發硏究所報 Vol.4 No.1

The most fundamental step for the experiments such as RAPD is to optimize the PCR condition. The purpose of this study was to optimize PCR condition in tomato. 3×3×3 factorial experiment for template DNA concentration, MgCl2 concentration, and amount of taq polymerase was conducted. Another factorial experiment for reaction temperature(denature, annealing, extension) was also conducted. The most clear and reproducible bands were observed from 60ng(0.5unit taq polymerase and 2.5mM MgCl2, 0.5unit taq polymerase and 4.5mM MgCl2). The best MgCl2 concentration was 2.5mM(60ng template DNA and 0.5unit taq polymerase, 60ng template DNA and 1unit taq polymerase), and 4.5mM(40ng template DNA and 1unit taq polymerase and 60ng template DNA and 0.5unit taq polymerase). And, the amount of taq polymerase for the optimal PCR condition was 0.5unit(60ng template DNA and 2.5mM MgCl2, 60ng template DNA and 4.5mM MgCl2), and 1unit(40ng template DNA and 2.5mM MgCl2, 40ng template DNA and 4.5mM MgCl2, 40ng template DNA and 7.0mM MgCl2, and 60ng template DNA and 2.5mM MgCl2). When we consider results from template DNA concentration, MgCl2 concentration, and amount of taq polymerase, 4 conditions(60ng of template DNA, 2.5mM MgCl2 and 0.5unit taq polymerase; 60ng of template DNA, 4.5mM MgCl2 and 0.5unit taq polymerase; and 60ng of template DNA, 2.5mM MgCl2 and 1unit taq polymerase; and 40ng of template DNA, 4.5mM MgCl2 and 1unit taq polymerase) were best combinations for the optimal PCR condition. Reaction temperature for the optimal PCR condition was 92℃, 36℃, 72℃.

고등학교 멀티미디어 역학 실험장치 개발

김경윤,이희복,김용복 공주대학교 사범대학 과학교육연구소 1998 과학교육연구 Vol.29 No.1

본 연구에서 개발한 멀티미디어 시스템은 컴퓨터의 멀티미디어 기능과 실험장치로서의 기능을 결합하나 고등학교 역학실험용 멀티미디어학습시스템이다. 멀티미디어 기능은 CAI로서 그래픽이나 애니메이션, 동영상 등을 보여줄 수 있고, 시늉실험을 하게 할 수 있다. 또한 컴퓨터는 실험데이터를 정확하게 수집할 수 있다. 전통적으로 역학용 탐구실험에서 물체의 운동을 기록하기 위하여 사용하고 있는 기존의 타이머는 실험 데이터를 구하는 데 복잡하고 부정확하다. 본 연구에서 개발한 시스템은 기존 타이머의 부정확한 점을 개선하고, 실험과 관련된 내용을 학습할 수 있도록 멀티미디어 기능을 접속시켰다. The Multimedia system for mechanics experiments in high school is a leading learning aids which combines a multimedia function of computer with a computer controlled experiments. Multimedia functions are very helpful for computer aided instruction (CAI) by showing graphics, animations, videos, and also by practising simulation programs. And also a computer can acquire experimental data very accurately. A conventional timer which is widely used for measuring the motion of an object in mechanics experiments, a traditional faculty for inquiry study, is too complicated and inaccurate for dealing with data. The Multimedia system for mechanics experiment developed in this study was designed to improve the accuracy of the measurement in mechanics experiments along with learning subjects related to the experiments.

국소도포용 불소제재에 의한 복합레진 수복물의 표면변화와 그 적용시간에 따른 구강내 불소 잔류량에 관한 연구

김용기,김경원 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

The aim of this study is to determine the influence of topical fluoride on the resin surface and oral fluoride retention following the application of various topical fluorides. We compared the oral retention of foam-type topical fluoride agents with gel-type in the clinical setting. 40 children were participated in this study and the topical fluoride agents used were 1.23% APF for the experimental and NaF for the control group. The results obtained were follows : 1. Foam-type showed higher amount of oral fluoride retention than gel-type regardless of application time and 4-minute application of gel-type showed higher oral retention than that of 1-minute. 2. Significantly greater weight loss of resin was found in 4-minute group than 1-minute group regardless of physical form of topical fluoride, and resin surface treated 4-minute APF showed the general increase in surface roughness than 1-minute group. 3. 1-minute application of foam-type fluoride agent may be recommended to decrease the possible systemic ingestion and protect the surface of resin restoration.