• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1559-1570
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• 2002

Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1340-1345
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• 2002

Purpose : We studied the prevalence of snoring and its association with diseases, obesity and environmental factors, as well as sleep disturbance arising from snoring, in school-aged children. Methods : The survey was performed by a special questionnaire on 1,707 children at elementary schools from 1 to 30 July 2001 in Gwangju City. The prevalence of snoring, associated factors, and sleep disturbance were evaluated. Results : 266(16.5%) of the children snored at least once a week. 73(4.3%) of the children snored almost every day. Regarding the associated factors of snoring : There was a statistically significant difference between snoring and nonsnoring groups due to gender, obesity, sinusitis, tonsillar hypertrophy, bronchial asthma and allergic rhinitis. Of them, male gender, tonsillar hypertrophy, and obesity were significant risk factors for development of snoring. Especially, the odds ratio increased to 1.048(CI, 1.004-1.659), 1.748(CI, 1.175-2.599), and 2.266(CI, 1.300-3.950) in children with an obesity index of 20-29%, 30-49%, ${\geq}50%$, respectively. There was a statistically significant association of snoring with decreased sleep duration, sleep talking, and drowsiness during the day as a result of sleep disturbance. Conclusion : 16.5% of school-aged children snored at least once a week. The association of snoring with tonsillar hypertrophy, obesity and gender as risk factors was demonstrated in this study.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1389-1396
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• 2002

Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.77-84
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• 2019

Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1165-1171
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• 2008

Purpose : This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. Methods : The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg-negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. Results : The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non-responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). Conclusion : The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1320-1323
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• 2008

Purpose : The aim of this study was to investigate the epidemiologic status of Kawasaki disease (KD) in infants ${\leq}6months$ of age. Methods : For the epidemiologic study of KD in Korea, data from 22,674 KD patients were collected from 1997 to 2005 on a 3-year basis by a retrospective survey. From this survey, data of 1,739 KD patients ${\leq}6months$ of age were analyzed and compared with those of KD patients >6 months of age. Results : A total of 1,739 patients ${\leq}6months$ of age, including 1,088 males and 651 females, represented 7.7% of total KD patients. These subjects included 22 patients aged <1 month, 171 patients aged 1-2 months, 304 patients aged 2-3 months, 407 patients aged 3-4 months, 372 patients aged 4-5 months, and 463 patients aged 5-6 months. Their mean age of onset was 4.3 months, and the male-to-female ratio was 1.67:1. Incidences of coronary arterial (CA) abnormalities (21.0% versus 18.7%) and CA aneurysms (4.7% versus 3.1%) detected by echocardiography showed differences between patients with KD younger and older than 6 months, respectively. Conclusion : Comparison of data from KD patients >6 months old with data from 1,739 KD patients ${\leq}6months$ old showed significantly higher incidences of CA abnormalities and CA aneurysms in the younger patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.23-29
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• 2010

Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.218-224
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• 2000

Purpose : In Korea, vivax malaria has been reemerged since 1993 after being abscent for more than 10 years. There are several possibilities of casuality of recent epidemic, although it is still unclear. The epidemiologic studies including case analysis and entomological reseach have been undertaken for a successful control measure. But, unfortunately those studies have been rarely dealt with cases of children. Therefore, this study was designed to figure out the characteristics of epidemiolgic and clinical features in children with indigenous vivax malaria. Methods : The study 21 cases below 15 years of age, who were diagnosed as vivax malaria and resided in kyounggi-do province area during 1998. 9~1999. 8. We retrospectively analyzed epidemiologic data concernig with occurrence of vivax, and clinical manifestations, abnormal laboratory findings and outcomes including therapeutic responses. Results : All cases were inhabitants of the endemic areas for vivax malaria in northwestern part of Kyonggi-do or western Kangwon-do, and Paju-gun was the most prevalent. Indigenous malaria cases of this study were more prevalent in children above 10 years old age, and in male. Seasonally, vivax malaria in children occurred throughout the year except January, March and November, and the incidence was the highest in July. Clinical manifestations revealed that 48 hour cyclic fever pattern was the major fever pattern, and other symptoms such as headache, vomiting, poor appetites, chilling, abdominal pain and diarrhea were concomitantly developed. And splenomegaly revealed the main abnormal findings on physical examination, and anemia was the most frequent abnormal finding in laboratory examinations. Young trophozoite was frequently observed on peripheral blood smears. The therapeutic responses of chlorquine were very good in all cases, and no recurrence developed in follow up cases. Conclusion : Geographical and seasonal occurrence distributions of indigenous vivax malaria cases in children were very similar to those of adults as followings; Inhabitants of the endemic region, more prevalent in male, and more common during the summer season. Clinically, 48 hour cyclic fever pattern, splenomegaly and anemia were most frequent and important manifestations in children cases, and clinical courses were not serious. On blood smears, young trophozoite was most dominantly examined in children. Generally, the therapeutic outcomes were excellent, and recurrences were not observed.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.73-80
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• 2004

Purpose : The serial clinical findings, biochemical results, and serological hepatitis B virus(HBV) markers in Korean children with chronic HBV infection were analyzed to determine the relationships among these factors. Methods : Ninety children have been chosen from those who have visited to the Department of Pediatrics at St. Vincent's Hospital in The Catholic University of Korea from July 1st, 1995 to June 30th, 2000. The sample patients were followed up for over six months. HBV markers and liver function tests were all performed. Results : All children were asymptomatic at presentation. Eighty-three percent of the children had a history of chronic HBV infection in their families. Eighty-one percent were HBeAg positive, 16% were anti-HBe positive, while 3% were all HBeAg and anti-HBe negative. The prevalence of HBeAg among three age groups : 0~5; 6~10; and 11~15 year-old was 90%, 96% and 61% respectively. The prevalence of HBeAg in less than 10 year-old group was significantly higher than 11~15 year-old group(P=0.001). Serum ALT levels were within 40 IU/L in 64% children, 41~80 IU/L in 17%, 81~200 IU/L in 10%, and beyond 201 IU/L in 9%. The percentage of abnormality of ALT levels in HBeAg positive patients was significantly higher than that of HBeAg negative(P=0.036). Eleven of the 73 HBeAg positive children lost their HBeAg and seroconverted to anti-HBe. In these cases, all had transient elevations in ALT levels before HBeAg seroconversions. The annual rates of spontaneous seroconversion of HBeAg and HBsAg were 9.7% and 0.6%, respectively. Conclusion : Recognition of the dynamics of these changes in viral markers and biochemical findings is needed in the selection and evaluation of therapeutic regimens, establishment of treatment, and calling for controlled trials with adequate follow-up. The hepatitis B carrier state may be asymptomatic in children however, continued surveillance of carriers is important to determine the individual adverse prognostic factors of chronic HBV infections.

• Journal of Life Science
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• v.14 no.1
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• pp.1-7
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• 2004

The root of Stnchys Sieboldif MIQ was extracted three times with methanol and extract was found to contain 3.02% of polyphenols and 1.97% of flavonoids. DPPH radical scavenging method, ferric thiocyanate method, and nitrite scavenging ability method were employed to investigate the constituents of the extract and to measure their activity on antioxidation. The fraction extracted by ethylacetate showed higher anti oxidation value than that of $\alpha-tocopherol$, butylated hydroxyanisole (BHA), and butylated hydroxytoluene (BHT) at the same concentration. UV-VIS spectral data of the extract by ethylacetate that was isolated on a silica gel column proved adsorption maxima in the range of 280∼330 nm. The fraction ES-RS that has $\lambda_{max}(nm)$ of band 1, 325nm and band II, 289nm exhibitd the strongest activity on antioxidation. ES-R5 fraction showed similar pattern to flavones by the analysis of UV-VIS spectral data.