An 8-year-old boy presented with abdominal pain and poor oral intake for two months. Serum amylase and lipase levels were elevated. CT of the abdomen and chest X-ray showed two pseudocysts at the pancreatic uncinate process, pancreatitis with a parenchymal defect, a large amount of ascites, and a right pleural effusion. MR cholangiography and endoscopic retrograde cholangiopanreaticography revealed a pancreatic duct disruption. The patient was successfully treated with a chest tube placement and percutaneous drainage. After surgery, his general condition improved; the serum level of amylase normalized and the pleural effusion resolved. Pancreatic injuries are rare in pediatric blunt trauma; however, diagnostic difficulty is common with isolated blunt trauma. Therefore, a high index of suspicion should follow such an injury. We report the case of an 8-year-old boy with pancreas transection, ductal disruption, ascites, and pleural effusion who was successfully treated.
Abdomen ; Abdominal Pain ; Amylases ; Ascites ; Chest Tubes ; Child* ; Cholangiography ; Drainage ; Humans ; Lipase ; Male ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Pleural Effusion* ; Thorax

PURPOSE: To investigate the effect of early enteral trophic feeding within 24 hours after birth compared with being started within 7 days after birth in extremely low birth weight infants (ELBWIs). METHODS: We retrospectively analyzed the medical records of all ELBWIs with gestational age of 26 weeks and less, and birth weight below 1,000 g, admitted within 24 hours after birth to neonatal intensive care unit of Samsung Medical Center from January 2000 to June 2006 who were alive at the time of discharge. Data for nutritional status and morbidities were compared between Era 1 (n=76), in which early enteral trophic feeding was started within 7 days after birth and Era 2 (n=46), started within 24 hours after birth. RESULTS: Compared to era 1, despite that gestational age and enteral feeding strarting time of ELBWIs was significantly earlier (25(+4)+/-0(+6) vs. 24(+6)+/-1(+5) weeks, 4.5+/-5.1 vs. 0.7+/-1.3 days), the time to achieve full enteral feeding was significantly shorter, and the weight gain at corrected age of 36 weeks was significantly higher in era 2. Also the incidence of early and total confirmed sepsis, total parenteral nutrition induced cholestasis, was lower and the duration of hospitalization was significantly shorter in era 2 compared to era 1, without differences in the incidence of NEC, moderate to severe BPD, and severe IVH (> or =Gr III) between two eras. CONCLUSION: Early enteral trophic feeding in ELBWI within 24 hours after birth was safe and beneficial.
Birth Weight* ; Cholestasis ; Enteral Nutrition ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Nutritional Status ; Parenteral Nutrition, Total ; Parturition* ; Retrospective Studies ; Sepsis ; Weight Gain

PURPOSE: The aim of this study was to investigate the incidence and associated clinical factors of delayed absorption of subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment. METHODS: This study involved 36 eyes of 36 consecutive patients who underwent successful surgery for rhegmatogenous retinal detachment. A complete ophthalmologic evaluation, including clinical fundus examination, optical coherence tomography, and indocyanine green angiography, was conducted before and after surgery. Delayed absorption was defined as the presence of residual concave SRF or an SRF bleb at 6 months after surgery. Clinical factors and choroidal features on indocyanine green angiography were compared according to the presence and absence of delayed absorption. RESULTS: Eighteen of 36 eyes (50%) showed delayed absorption. Macular involvement and worse preoperative visual acuity were significantly related to the presence of delayed absorption (p = 0.001 and p = 0.034, respectively). On indocyanine green angiography, preoperative choroidal vascular hyperpermeability was noted in 70% of eyes with delayed absorption and in 14% of eyes without it (p = 0.010). CONCLUSIONS: Delayed absorption of SRF after retinal reattachment surgery was not rare, with a 50% of incidence in this study. Macula-off status was significantly related to the incidence of delayed SRF absorption, and choroidal features such as choroidal vascular hyperpermeability might be responsible in part, possibly through the resultant exudative property of choroid.
Absorption* ; Angiography ; Blister ; Choroid* ; Humans ; Incidence ; Indocyanine Green ; Retinal Detachment ; Retinaldehyde* ; Subretinal Fluid* ; Tomography, Optical Coherence ; Visual Acuity

OBJECTIVES: The aim of this 7-year study was to examine regional differences in scaling experience rate. METHODS: This study used data on scaling experience rate from the Community Health Survey (CHS) obtained between 2008 and 2014. The standardized frequency of scaling experience rate was analyzed using the SPSS 20.0 program, and shown as a Box Plot. Using the Map Wizard for Excel 10.0, the scaling experience rate in each region was illustrated using Geographic Information System (GIS). RESULTS: The scaling experience rate in 2008 was 18.6% and in 2014, was 34.9%. From 2008 to 2014, the annual rate of scaling experience increased approximately 1.8 times. The scaling experience appeared to form clustering on GIS, and there were differences in scaling experience rate between cities, towns, and districts. Although the scaling experience rate increased, the gap between regions seems consistent. CONCLUSIONS: The Scaling Experience rate increased annually, but regional differences did not decrease. Therefore, oral health care professionals in each community should strive to improve the scaling experience rate.
Geographic Information Systems ; Health Surveys ; Oral Health

OBJECTIVES: To evaluate the Community-Based Participatory Research (CBPR) professional periodontal care program model for patients with hypertension and diabetes. METHODS: This descriptive case study included 151 participants of the professional periodontal care program. The CBPR-based professional periodontal care program consists of 5-steps: ‘Issue identification and prioritization’ (Step 1), ‘Strategy development’ (Step 2), ‘Entry into community’ (Step 3), ‘Implementation’ (Step 4), and ‘Transition’ (Step 5). Quantitative data were analyzed using frequency analysis, and descriptive data with PASW 23.0 (SPSS Inc., Chicago, IL, USA). The results of the Focus group interview (FGI) were classified as ‘general opinions regarding the program planning and operation receptiveness’, ‘sustainability’, ‘potential spread of the program’, and ‘improvement of program’. The interviews were qualitative research involving seven people. RESULTS: 1. Participants increased their interest in health and oral health by managing their hypertension, diabetes, and periodontal disease using community resources. Through this, healthy practices and improved awareness helped to prevent complications and manage periodontal diseases. 2. Community organizations actively cooperated, resulting in positive changes in oral health practices (increased registration of patients in education centers for hypertension and diabetes, and increased number of patients visiting the local dental clinic). In the future, it was positive to participate in the program continuously. CONCLUSIONS: The most important step is ‘Entry into community’, which has led to active participation and cooperation of community organizations and participants. Therefore, community organizations and strategy development should be discussed, and the role of community leaders should be emphasized to build cooperative relationships. In addition, participation in and collaboration with health-based projects should be achieved through a search of various community organizations.
Chronic Disease ; Community-Based Participatory Research ; Consumer Participation ; Cooperative Behavior ; Education ; Focus Groups ; Humans ; Hypertension* ; Oral Health ; Periodontal Diseases ; Qualitative Research

Background/Aims: Despite proper use of pharmaceuticals, adverse drug reactions (ADRs) can lead to problems related to patient safety. We analyzed the characteristics of ADRs, particularly serious adverse events (SAEs), in a single tertiary medical institution. Methods: Spontaneous ADR report data collected from 2010 to 2019 in Seoul National University Hospital were assessed. Causality was evaluated according to the World Health Organization-Uppsala Monitoring Centre criteria. Age, sex, onset, severity, seriousness, and system organ class (SOC) of ADRs and SAEs were analyzed. Results: During the study period, a total of 49,955 individual case safety reports were assessed as possible, probable, or certain. Although the number of gastrointestinal ADR reports was high (25.9%), severe cases were uncommon (2.6%). By contrast, the number of hematologic disorders was low (6.6%) but 39.2% of them were severe. Among ADRs, 10.2% were assessed as SAEs, the proportion of which was high at extreme ages and in males. Body as a whole-general disorders were the most frequently reported SOC for SAEs, followed by skin and appendage disorders. Antineoplastic agents and antibiotics were the most common causative agents of SAEs and ADRs. Anaphylactic reaction was the most frequent SAE (6.5%). Conclusions The proportion of SAE differs according to SOC and drug. Attention should be paid to SAEs in children and older adults because the rate of SAEs is significantly higher at extreme ages.

Background/Aims: Despite proper use of pharmaceuticals, adverse drug reactions (ADRs) can lead to problems related to patient safety. We analyzed the characteristics of ADRs, particularly serious adverse events (SAEs), in a single tertiary medical institution. Methods: Spontaneous ADR report data collected from 2010 to 2019 in Seoul National University Hospital were assessed. Causality was evaluated according to the World Health Organization-Uppsala Monitoring Centre criteria. Age, sex, onset, severity, seriousness, and system organ class (SOC) of ADRs and SAEs were analyzed. Results: During the study period, a total of 49,955 individual case safety reports were assessed as possible, probable, or certain. Although the number of gastrointestinal ADR reports was high (25.9%), severe cases were uncommon (2.6%). By contrast, the number of hematologic disorders was low (6.6%) but 39.2% of them were severe. Among ADRs, 10.2% were assessed as SAEs, the proportion of which was high at extreme ages and in males. Body as a whole-general disorders were the most frequently reported SOC for SAEs, followed by skin and appendage disorders. Antineoplastic agents and antibiotics were the most common causative agents of SAEs and ADRs. Anaphylactic reaction was the most frequent SAE (6.5%). Conclusions The proportion of SAE differs according to SOC and drug. Attention should be paid to SAEs in children and older adults because the rate of SAEs is significantly higher at extreme ages.

PURPOSE: The aims of this study were to determine the factors affecting the outcome of patent ductus arteriosus ligation in very low birth weight infants (VLBWI) and demonstrate the safety of PDA ligation in VLBWI performed in the neonatal intensive care unit (NICU). MATERIALS AND METHODS: From October 1994 to July 2006, medical records of 94 VLBWI weighing < 1,500g who underwent PDA ligation in the NICU of Samsung Medical Center were reviewed retrospectively. Factors affecting the final outcome of PDA ligation were evaluated by dividing the infants into 3 groups according to mortality and major morbidities as follows: mortality group (Mo), major morbidity group (Mb), and no major morbidity group (NM). RESULTS: In the Mo group, birth weight was significantly lower and the preoperative mean FiO(2) and mean dopamine dose were significantly higher than those in the other 2 groups. There was no significant difference in gestational age, incidence of RDS, number of courses of indomethacin, surgery-related factors, including weight and age at surgery, perioperative vital signs, and complications after surgery between the 3 groups. During surgery in the NICU, there were no significant hemodynamic instability or serious acute complications. CONCLUSION: The factors affecting the outcome of surgery in VLBWI are not the factors related to surgery but the preoperative conditions related to the underlying prematurity. PDA ligation of VLBWI performed in the NICU is safe without serious complications.
Ductus Arteriosus, Patent/*surgery ; Humans ; Infant, Newborn ; *Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal/*statistics & numerical data ; Ligation/*methods ; Treatment Outcome

The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.
Cross-Sectional Studies ; Data Collection ; Dental Hygienists ; Discrimination (Psychology) ; Education ; Expert Testimony ; Humans ; Hygiene ; Learning* ; Medical Assistance ; Oral Health* ; Oral Hygiene* ; Social Security