OBJECTIVES: The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. METHODS: A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. RESULTS: More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. CONCLUSION: The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.
Adolescent Psychiatry ; Adolescent* ; Child* ; Cognitive Therapy ; Consultants ; Cooperative Behavior ; Counseling ; Education ; Fellowships and Scholarships ; Female ; Group Practice ; Humans ; Korea ; Mental Health ; Parents ; Play Therapy ; Private Practice ; Psychiatry* ; Public Sector ; Seoul

BACKGROUND: The pandemic swine origin influenza A/H1N1 2009 virus (H1N1 2009) was rapidly spread out all over the world after it was first found in April, 2009. This study was made to compare the performance of nasopharyngeal swabs and nasopharyngeal aspirates for the SD Bioline rapid influenza antigen test. METHODS: From Aug to Nov, 2009 the SD Bioline rapid influenza antigen tests were conducted with the nasopharyngeal swabs and the nasopharyngeal aspirates from the 244 specimens of patients who had come to the hospital with influenza-like illness. The data from the examination were compared with the multiplex RT-PCR as a reference standard to obtain sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: The sensitivity and the specificity of the SD Bioline rapid influenza antigen tests with the nasopharyngeal swabs were 75.8%, and 93.3% respectively, and the sensitivity and specificity with the nasopharyngeal aspirates were 61.3%, and 98.3% respectively. CONCLUSION: Even if the nasopharyngeal aspirates showed the lower sensitivity than the nasopharyngeal swabs, since the specificity is higher, the nasopharyngeal aspirates are more useful because we can reduce false positive rate.
Humans ; Influenza, Human ; Pandemics ; Sensitivity and Specificity ; Swine ; Viruses

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness measured by time domain (Stratus) and spectral domain (3D) optical coherence tomography (OCT). METHODS: Sixty-nine normal subjects and 92 glaucoma patients were included in the present study. Peripapillary RNFL thickness was measured with Stratus fast RNFL scan and 3D optic disc cube scan on the same day. The relationship between RNFL thickness measurements of the two OCTs were evaluated using a Pearson's correlation analysis. A Bland-Altman plot was used for the comparison of Stratus-OCT and 3D-OCT. RESULTS: In all subjects, average, superior, and inferior quadrant RNFL thicknesses measured by Stratus-OCT were thicker than those measured by 3D-OCT. In contrast, temporal and nasal quadrant RNFL thicknesses measured by 3D-OCT were thicker than those measured by Stratus-OCT. Although there were absolute value differences in RNFL thicknesses, high correlation was observed between Stratus-OCT and 3D-OCT (average: r = 0.897, temporal quadrant: r = 0.728, superior quadrant: r = 0.811, nasal quadrant: r = 0.678, and inferior quadrant: r = 0.905). Bland-Altman plots showed that Stratus-OCT values were greater than 3D-OCT values with relatively high RNFL thickness and the opposite with low RNFL thickness. CONCLUSIONS: For thicker RNFL, Stratus-OCT measurements tend to be greater than 3D-OCT, while for thinner RNFL, 3D-OCT measurements tend to be greater than Stratus-OCT. This difference must be taken into account if comparing measurements made with a Stratus-OCT to the measurements of a 3D-OCT.
Glaucoma ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence

Several outbreaks of Getah virus (GETV) have been reported in horses and pigs, causing large economic losses. However, there have been no reports describing serological survey for GETV in South Korea pigs. The present study conducted serological survey of GETV in South Korean pigs. A total of 670 whole blood samples were collected from domestic pigs. The overall seropositive rate was 26.4%, higher than the rates observed in racehorses in 2013–2014. Preparations for epidemics of novel diseases caused by climate change should include regular serological survey for these diseases, including GETV, and the development of vaccines against novel pathogens.

A 73-year-old woman with a history of chronic hypertension and severe chronic obstructive pulmonary disease, presented to a district general hospital with thoracic pain in a profound state of shock. She was diagnosed with cardiac tamponade, severe mitral regurgitation, and Stanford type A (Debakey type I) intramural hematoma. Her ascending aorta was of a significant size and therefore emergent repair was done to replace the ascending aorta and mitral valve. After 6 months, an increased aneurysmal size of 6.0 cm was observed in a follow up contrast-enhanced computed tomography angiography. The patient was successfully treated by a staged hybrid procedure involving initial supra-aortic reconstruction.
Aged ; Aneurysm ; Angiography ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Cardiac Tamponade ; Chimera ; Endovascular Procedures ; Female ; Follow-Up Studies ; Hematoma ; Hospitals, General ; Humans ; Hypertension ; Mitral Valve ; Mitral Valve Insufficiency ; Pulmonary Disease, Chronic Obstructive ; Shock ; Vascular Grafting

BACKGROUND: Flow cytometry analysis of paroxysmal nocturnal hemoglobinuria (PNH) is significantly affected by the methodology used. The lack of data on the effect of age and refrigeration on PNH clone stability motivated us to study these aspects using flow cytometry. METHODS: Peripheral blood was collected from six patients, of which two presented with PNH. All samples were tested immediately and stored at room temperature (RT, 20–25℃) and at 4℃ for re-analysis at 24, 48, 72 hr and 7 days. Anti-CD59-fluorescein isothiocyanate (Beckman Coulter, USA) and anti-CD235a-phycoerythrin (PE; Beckman Coulter) were used to stain red blood cells (RBCs). Fluorescein-labeled proaerolysin (Cedarlane, Canada), anti-CD15-PE (Beckman Coulter), anti-CD24-PE-cyanin 5 (Beckman Coulter), and anti-CD45-PE-cyanin 7 (Beckman Coulter) were used to stain granulocytes. Flow cytometry was performed using a FC500 flow cytometer (Beckman Coulter). The effects of time and temperature were analyzed using generalized estimating equations. RESULTS: No significant differences in the gated percentage of RBCs and PNH clone size of RBCs were observed between the RT and 4℃ groups up to 7 days of testing. The percentage of gated neutrophils decreased with specimen age (P<0.001) and a better correlation with baseline was obtained at 4℃ than at RT (P=0.014). Neutrophil PNH clones were stable until 48 hr and 72 hr at RT and 4℃, respectively, and could not be analyzed at 7 days. CONCLUSIONS: RBC analysis was successfully performed up to 7 days. For neutrophils, testing within 48 hr is recommended, because the number of gated cells decreases significantly with age.
Clone Cells ; Erythrocytes ; Flow Cytometry ; Granulocytes ; Hemoglobinuria, Paroxysmal ; Humans ; Neutrophils ; Refrigeration

Background: Open gastrectomy causes severe postoperative pain. Therefore, we investigated the opioid-sparing effect of the ultrasound-guided bilateral erector spinae plane block (ESPB) after open gastrectomy. Methods: Adult patients undergoing open gastrectomy were randomly assigned to either the ESPB group (ESPB + fentanyl based intravenous patient-controlled analgesia [IV-PCA]) or a control group (fentanyl based IV-PCA only). The primary outcome was total fentanyl equivalent consumption during the first 24 hour postoperatively.Secondary outcomes were pain intensities using a numeric rating scale at the postanesthesia care unit (PACU) and at 3, 6, 12, and 24 hour postoperatively, and the amount of fentanyl equivalent consumption during the PACU stay and at 3, 6, and 12 hour postoperatively, and the time to the first request for rescue analgesia. Results: Fifty-eight patients were included in the analysis. There was no significant difference in total fentanyl equivalent consumption during the first 24 hour postoperatively between the two groups (P = 0.471). Pain intensities were not significantly different between the groups except during the PACU stay and 3 hour postoperatively (P < 0.001, for both). Time to the first rescue analgesia in the ward was longer in the ESPB group than the control group (P = 0.045). Conclusions Ultrasound-guided ESPB did not decrease total fentanyl equivalent consumption during the first 24 hour after open gastrectomy. It only reduced postoperative pain intensity until 3 hour postoperatively compared with the control group. Ultrasound-guided single-shot ESPB cannot provide an efficient opioid-sparing effect after open gastrectomy.

Nephrogenic systemic fibrosis (NSF) is a progressive systemic fibrosing disease that may occur after gadolinium contrast exposure. It can lead to severe complications and even death.NSF is highly prevalent among patients with advanced chronic kidney disease (CKD). In this report, however, we describe the case of a patient with NSF that occurred during early CKD. A 65-year-old man with stage 3a CKD was transferred to our hospital because of lower extremity edema. The medical history revealed that he was exposed to gadolinium 185 days earlier, and the result of his tibial skin biopsy was consistent with NSF. The patient underwent a combined therapy with ultraviolet-A1 phototherapy and methotrexate and steroid therapy for 6 months. The combined therapy stopped the systemic progression of NSF.

PURPOSE: Brain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance. METHODS: We attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration. RESULTS: Serum C-reactive protein level (P<0.0001), serum alanine aminotransferase concentration (P=0.0032), white blood cell count (P=0.0030), and left ventricular mass index (P=0.0024) were positively related with log-BNP, and hemoglobin level (P<0.0001), serum albumin level (P<0.0001), Na+ concentrations (P<0.0001), left ventricular fractional shortening (P=0.0080), and peak early diastolic tissue velocity of the left ventricular basal lateral segment (P=0.0045) were negatively related to the log-BNP concentration. Multiple regression analysis showed that serum albumin concentration (R2=0.31, P=0.0098) and left ventricular mass index (R2=0.09, P=0.0004) were significantly associated with the log-BNP concentration. CONCLUSION: Elevated BNP levels during the acute phase of Kawasaki disease may be attributable to cardiac dysfunction associated with the increase in left ventricular mass, and log-BNP concentration may be a quantitative biochemical marker of myocarditis in Kawasaki disease.
Alanine Transaminase ; Biomarkers ; Brain ; C-Reactive Protein ; Child ; Hemoglobins ; Humans ; Leukocyte Count ; Linear Models ; Mucocutaneous Lymph Node Syndrome ; Myocarditis ; Natriuretic Peptide, Brain ; Plasma ; Serum Albumin

PURPOSE: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. METHODS: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. RESULTS: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. CONCLUSION: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.
Adult ; Child ; Education ; Hospice Care ; Human Rights ; Humans ; Korea ; Palliative Care* ; Parents ; Seoul ; Surveys and Questionnaires