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.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

직장 Dieulafoy 병변으로 다량의 혈변을 보인 1 예

김태영;이상헌;김지현;배영환;정은주;김승만;지삼룡;설상영 인제대학교 2011 仁濟醫學 Vol.32 No.-

Dieulafoy’s lesion is very rare cause of gastrointestinal bleeding, Deiulafoy’s lesion is exposure of non ulcerative, abnormally large tortuous, thick- walled artery in the muscularis mucosa through a small submucosal defect. It is usullay found on stomach antrum and lesser curvature side of the proximal body, and possibly found on any sites throughout whole gastrointestinal tract, but rarely on rectum. The principal of treating Dieulafoy’s lesion was the surgical resection of lesion, but recently remarkable advances in endoscopic technique make endoscopic approach more popular. We report a case of rectal Dieulafoy’s lesion successfully treated with endoscopic hemoclipping in an elderly female patient.

3-(1,2,4-Triazol-5-yl)methylene-2-oxo-1,2,3,4,-tetrahydroquinoxaline의 간편한 합성에 관한 연구

金浩植,金恩慶,李城旭,金成湜,金銅恩 대구효성가톨릭대학교 1996 연구논문집 Vol.53 No.2

The reaction of 3-methoxycarbonylmethylene-2-oxo-1,2,3,4-tetrahydroquinoxaline(14) with hydrazine hydrate gave 3-hydrazinocarbonyl-methylene-2-oxo-1,2,3,4-tetrahydroquinoxaline(15), whose reaction with phenyl isothiocyanate provided 3-(4-phenyl-3,4-dihydro-3-thioxo-2H-1,2,4-triazol-5-yl)methylene-2-oxo-1,2,3,4-tetrahydroquinoxaline(16). The tautomeric behavior of compound 15 was investigated on the basis of the tautomer ratio determined by the ¹H-nmr spectral data. The structures of the synthesized compounds were confirmed on the basis of ir, ¹H-nmr and mass spectral data.

Caffeine이 지구성 운동 수행능력에 미치는 영향과 억제성 아미노산에 의하여 활성화되는 이온통로의 조절작용

김은경,김영표,천병옥,이계영,김연정,임백빈,조영욱,김창주,김성수 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

To investigate the effect and mechanism of caffeine on endurance exercise, two experiments were performed. First, to test caffeine effect on aerobic exercise, 200-300g Sprague-Dawley rats were used and three groups, control group, low caffeine injection group and high caffeine injection group, were divided. Blood smpling by heart puncture were done at rest, after 30 min treadmill exercise, and after maximal exercise. Blood glucose, free fatty acid concentration were detected and following results were obtained. Glucose concentration showed significant difference between groups(p=0.0305) and also significant changes were exhibited between time(p=0.0004). Free fatty acid concentration had no difference between groups. but had significance between times(p=0.00065). Exercise endurance performance time showed significant difference(p=0.02350 in high caffeine injection group compared to control group. In this experiments, endurance exercise capacity was increased by caffeine injection. Therefore, second experiment was performed to investigate the effect of caffeine on ion current induced inhibitory amino acid neurotransmitter. GABA and glycine. Single periaqueductal gray neuron was acutely dissociated and nystatin perforated patch clamp was performed under voltage clamping condition. Caffeine evoked outward current in PAG neuron dose dependent manner. 1mM of caffeine application had no response. but 3mM caffeine evoked about 32.5±8.539pA outward ion current and 10mM caffeine evoked about 215.46±19.4pA outward current. 10^-2mM GABA activated Cl￣current and recorded by inward current. Caffeine inhibited GABA activated Cl￣ current concentration dependent manner. 10^-2mM of caffeine had no effect on 1-^-2mM of GABA response. but 10^-1mM caffeine inhibited GABA activated Cl￣ current about 5.74±2.13%, 1mM caffeine inhibited about 17.25±2.70%, 10mM caffeine inhibited GABA response about 45.31±7.71%. 10^-1mM of glycine activated Cl￣ current and also recorded by inward current. Caffeine inhibited glycine activated Cl￣ current concentration dependent manner. 10^-2mM caffeine decreased glycine activated Cl￣ current about 4.61±1.650%, 10^-1mM caffeine decreased about 6.49±2.24%, 1mM caffeine decreased about 26.82±4.27%, and 10mM caffeine decreased glycine response about 94.47±1.39%. These results suggest that caffeine inhibite inhibitory amino acid, GABA and glycine, this response causes excitation of CNS and this seems to be the basic mechanism of increasing effect to aerobic exercise performance by caffeine.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

편광현미경에 의한 형태와 구성성분에 의한 토양의 비교분석에 관한연구(Ⅱ)

김은호,김재균,김명덕,신윤열,장성길,박성우,김영만 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

장기간의 에어로빅스 운동이 골형성 및 각종 호르몬과의 상관관계

김종인,김은희,김주혁,김수진,김도형,장성동 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.3

Selected girl mid㎗e school of 14- and 15- years-old who got 35% body fat rate and are obese, and have them aerobics exercise for 20 weeks, the conclusion on the matter of change between Osteoporosis and Hormones showed. The contents of Calcium has significant difference(p<.05) between 9.38±0.34㎎/㎗ pre-exercise and 9.34±0.29㎎/㎗ post-exercise, and the contents of Glucose has significant difference (p<.05) between 78.0±5.38㎎/㎗ pre-exercise and 81.3±5.91㎎/㎗ post-exercise. parathyroid hormone (PTH) is shown as 11.2±3.06pg/㎖ at pre-exercise arid 13.8± 4.41pg/㎖ at post-exercise, hyperparathyroidism and osteoporosis (Osteocalcin) is shown as 6.04±3.56ng/㎖ at pre-exercise and 5.29±4.92ng/㎖ at post exercise, there is no significant difference. Deoxypyridinoline is shown as like 8.18±2.43nM/mMcre pre-exercise arid 9.97±2.76nM/mMcre post-exercise, Alkaline phosphatase (ALP), which has an effect on the born disease, is shown 229.7±61.66[U/㎖ pre-exercise and 224.3±8.27 [U/㎖ post-exercise, there is significant difference(p<.0l). There is significant difference (p<.05) between Growth Hormone and Parathyroid hormone(PTH) which is bone absorption hormone, the Osteocalcin which is the mark of born-formation, there is no significant difference among the index of born formation mark, lipid, and hormones.

자궁내막암 환자에서 복강경하 자궁적출술과 복식 자궁적출술의 비교 연구

김종혁,이상수,김천복,김대연,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

목적 : 자궁내막암 환자에서 시행된 복강경 수술의 임상적 결과를 평가하고 수술적 지표 및 재발률에 대하여 기존의 개복 수술과 비교하고자 하였다. 연구 방법 : 1997년 8월부터 2003년 11월까지 저자들은 임상적 병기 I기인 79명의 자궁내막암 환자에서 복강경하 자궁적출술과 골반 및 부대동맥 림프절 절제술을 시행하였다. 총 79명의 환자 중, 수술적 병기 I기와 II기로 판명된 74명의 환자를 연구 대상으로 하였다. 대조군으로는 같은 기간 동안에 개복수술을 시행한 환자중 복강경 수술군과 병기가 같은 168예를 선정하였다. 결과 : 평균 수술 기간, 수혈량은 양군에서 비슷하였으며, 평균 재원 기간은 복강경 수술군에서 유의하게 짧았다. 수술전후 및 만성 합병증의 발생은 개복 수술군에서 유의하게 증가되었으며, 획득한 림프절의 수는 복강경 수술군에서 유의하게 더 많았다. 복강경 수술군에서 1예, 개복 수술군에서는 2예에서 재발하였고, 2년 무병 생존률은 복강경 수술군과 개복 수술군에서 각각 97.5%와 98.6%으로 유의한 차이는 관찰되지 않았다. 결론 : 자궁내막암 치료로서 복강경 수술은 기존의 개복술을 대신할 수 있는 안전하고 효과적인 시술 방법이다. 개복 수술과 비교해 볼 때, 재발 및 생존율 면에서 차이가 없었지만, 향후 전향적이고 더 오랜 추적기간을 갖는 연구가 필요하다고 사료된다. Objective : To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer. Methods : From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, We selected 168 cases for the laparotomy group of the same stages. Results : The mean duration of surgery, the amount of blood transfusion and hemoglobin chamges were similar in both the laparoscory and the convertional alparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763). Conclusion : Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective altematives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.