• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.387-394
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• 2005

Purpose : We performed this study to compare the TSH and free $T_4$ levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. Methods : Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than $20{\mu}IU/mL$) or abnormal free $T_4$ levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. Results : Serum TSH and free $T_4$ values revealed no significant difference according to sex, delivery type, and Apgar score. The free $T_4$ levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than $20{\mu}IU/mL$ or free $T_4$ lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. Conclusion : In this study, neonatal free $T_4$ levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH > $20{\mu}IU/mL$ or free $T_4$ <1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.431-444
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• 1997

This research was carried out to compares the treatment effects of Horizontal and Vertical type activators in Angle's Class II div. 1 maloccusion patients with mandibular retrusion dand to find out whether different treatment effects or growth pattern were observed between sexes in each study groups. The results were as follows: 1. In Horizontal activator group, forward positioning of mandible and vertical increase in anteror face as examplified by increase of LAFH and AEM were observed when pre and post-treatment datas were evaluated. 2. Males samples in Horizontal activator group showed increase in mandiular length accmpanied by posterior positioning of maxilla, wheras female samples in Horizontal activator group showed increase in mandibular body length, labial inclination of mandibular incisors and increase in lower anterior facial height .3. In vertical activator group, increase in AFH, LAFH, PFH and LPFH were observed when pre and post treatment datas were evaluated. 4. Male samples in Vertical activator group showed increase in mandibular body length and anterior and posterior facial heights, whereas females samples of Vertical activator group showed mainly increase in anterior facial height. 5. When pre and post treatment datas of Horizontal and Vertical activator groups were compared, skeletal difference were mainly observed in pretreatment datas but dental difference were observed in post treatment datas ,indicating that two actiators differ only in their effects to dental variables. 6. Difference between sexes were noted after treatment although no difference were observed between sexs in each groups before treatmentt. This indicates that inherent growth effects in each sex exerts more influence 1km appliances used for treatment.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.630-634
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• 2006

Purpose : This study was conducted to assess the current(2003-2005) prevalence of anti-HBs and immunologic memory for Hepatitis B vaccine in children from the central area of Korea. Methods : Subjects were chosen from children and adolescents who received tests for hepatitis B surface antigen(HBsAg) and anti-HBs at Dankook University Hospital from March 2003 to May 2005. Among these, antibodies to hepatitis B core antigen(IgG anti-HBc) were checked. A single booster vaccination was performed on children whose anti-HBs titers were under 10 mIU/mL. One month after booster vaccination we rechecked the anti-HBs titer. Results : A total of 3,277 subjects were tested for HBsAg/anti-HBs, and 1,913(58.4 percent) of them were positive for anti-HBs. Of these, 29 subjects(0.9 percent) were positive for HBsAg. Positive results for anti-HBs by age were 78.6 percent for 6-12 months of age, 62.7 percent for 1-3 years of age, 51.9 percent for 4-6 years of age, 49.5 percent for 7-12 years of age, 63.4 percent for 13-15 years of age and 72.2 percent for 16-18 years of age. The 80 subjects who were tested negative for HBsAg/anti-HBs received a single booster vaccine, 71 subjects were tested positive for antibodies. IgG anti-HBc titer was checked for 169 of the subjects, 5 subjects were positive. Conclusion : In our study, a significant anamnestic response was observed in 88.8 percent of children. This is believed to be a result of the relatively long immunologic memory effect of the hepatitis B vaccination in children from the central area of Korea.

• Clinical and Experimental Pediatrics
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• v.52 no.6
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• pp.661-666
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• 2009

Purpose : To determine the prevalence and clinical features of codetected respiratory etiological agents for acute respiratory infection in hospitalized children. Methods : Nasopharyngeal aspirates were obtained from hospitalized children with acute respiratory infection at Dankook University Hospital from September 2003 through June 2005. Immunofluorescent staining and culture were used for the detection of respiratory viruses (influenza virus [IFV] types A, B; parainfluenza virus [PIV] types 1, 2, 3; respiratory syncytial virus [RSV]; adenovirus [AdV]). Polymerase chain reaction (PCR) assays were used for Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT) detection, and PCR and culture were performed for enterovirus detection. Acid-fast staining and culture were performed for tuberculosis detection. The demographic and clinical characteristics were reviewed retrospectively from the patients medical records. Results : Evidence of two or more microbes was found in 28 children: RSV was detected in 14, PIV 3 in 10, AdV in 10, MP in 8, PIV 2 in 8, CT in 4, and PIV 1 in 3. Codetected agents were found as follows: RSV＋PIV 2, 6 patients; AdV＋MP, 4 patients; AdV＋PIV, 3 patients; RSV＋MP, 3 patients; PIV 1＋PIV 3, 3 patients. Distinct peaks of codetected agents were found in epidemics of MP and each respiratory virus. Conclusion : The codetected infectious agents were RSV, PIV, AdV, and MP, with distinct peaks found in epidemics of MP and each respiratory virus. Although advances in diagnostic methods have increased the prevalence of codetection, its clinical significance should be interpreted cautiously.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.729-735
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• 2008

Purpose : Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. Methods : For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. Results : A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. Conclusion : C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.527-533
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• 2005

Purpose : Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants. Methods : Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[$25(OH)D_3$], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated. Results : Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01). Conclusion : This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.865-870
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• 2003

Purpose : We measured the umbilical cord arterial concentrations of isoprostane($8-iso-PGF_{2{\alpha}}$) and intended to decide whether the umbilical cord arterial concentrations of isoprostane could be used as a useful parameter for lipid peroxidation in newborn infants. Methods : The isoprostane and malondialdehyde(MDA) concentrations of the umbilical cord were measured by enzyme immunoassay and TBARS(thiobarbituric acid reactive substance) assay in 33 preterm and 28 term infants, respectively. The concentrations of isoprostane and MDA were compared between preterm infants and term infants, and were analysed for association with perinatal risk factors and neonatal complications. Results : Umbilical cord arterial concentrations of isoprostane were $704.7{\pm}635.6pg/mL$ and $421.9{\pm}306.5pg/mL$ in preterm and term infants, respectively. Umbilical cord arterial concentrations of MDA were $44.0{\pm}22.9{\mu}M/L$ and $26.2{\pm}10.7{\mu}M/L$ in preterm and term infants, respectively. Umbilical cord arterial concentrations of isoprostane and MDA in preterm infants were significantly higher than those in term infants(P<0.05). The umbilical cord arterial concentrations of isoprostane were significantly associated with perinatal risk factors such as fetal distress, oligohydramnios, and breech delivery in preterm infants and pregnancy-induced hypertension in term infants(P<0.05). Conclusion : Umbilical cord arterial concentrations of isoprostane in preterm infants were higher than those in term infants, and those are significantly associated with some perinatal risk factors.

• Korean Journal of Cognitive Science
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• v.16 no.4
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• pp.305-322
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• 2005

Watermarking is a widely employed method tn protecting copyright of a digital image, the owner's unique image is embedded into the original image. Strengthened level of watermark insertion would help enhance its resilience in the process of extraction even from various distortions of transformation on the image size or resolution. However, its level, at the same time, should be moderated enough not to reach human visibility. Finding a balance between these two is crucial in watermarking. For the algorithm for watermarking, the predefined strength of a watermark, computed from the physical difference between the original and embedded images, is applied to all images uniformal. The mean brightness or contrast of the surrounding images, other than the absolute brightness of an object, could affect human sensitivity for object detection. In the present study, we examined whether the detectability for watermark noise might be attired by image statistics: mean brightness and contrast of the image. As the first step to examine their effect, we made rune fundamental images with varied brightness and control of the original image. For each fundamental image, detectability for watermark noise was measured. The results showed that the strength ot watermark node for detection increased as tile brightness and contrast of the fundamental image were increased. We have fitted the data to a regression line which can be used to estimate the strength of watermark of a given image with a certain brightness and contrast. Although we need to take other required factors into consideration in directly applying this formula to actual watermarking algorithm, an adaptive watermarking algorithm could be built on this formula with image statistics, such as brightness and contrast.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.163-170
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• 2009

Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.147-155
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• 2006

Purpose : The purpose of this study is to evaluate epidemiological data of pathogens obtained from stool exams and compare them with the clinical course in pediatric patients with symptoms of acute gastroenteritis. Methods : Subjects were selected from patients presenting with symptoms of acute gastroenteritis who visited the outpatient clinic or who were admitted to the Dankook University Hospital from December of 2004 to December of 2005. Stool exams for 17 pathogens was performed. RT-PCR was used to detect norovirus and enzyme-linked immunoabsorbant assay (ELISA) was used to detect rotavirus, adenovirus and astrovirus in the subjects stool samples. Ten different species of bacteria(Salmonella spp., Shigella spp., Clostridium perfrigens, Campylobacter spp., Escherichia coli, Vibrio spp., Staphylococcus aureus, Bacillus cereus, Yersinia spp., and L. monocytogenes) were each selectively cultivated and enzyme immunoassays(EIA) was used to test for antigens for C. parvum, E. histolytica and G. lamblia. Retrospective chart review was performed for comparisons of clinical manifestations. Results : A total of 215 subjects was selected and of these 89 cases(41.4%) showed positive results for at least one pathogen. Male to female ratio was 1.3:1. Age distribution showed 4 cases less than one month(4.5%), 4 cases from 1~2 months(4.5%), 24 cases from 3~12 months(26.7%), 47 cases form 13~48 months(52.8%), 10 cases greater than 48 months (21.2%). Viruses showed the greatest proportion of cases with 68 subjects(77.5%), of these rotavirus being the most commonly reported in 50 cases. Bacteria was identified in 26 cases (29.2%), of these nontyphoidal salmonella was noted in 10 cases. Protozoa followed with 21 cases(23.6%), of these C. parvum was noted in 11 cases and G. lamblia was noted in 10 cases. Mixed infections with more than two pathogens were seen in 22 cases(24.7%), of these viral infection with accompanying parasitic infection was seen in 12(54.5%) cases. Conclusion : In this study we examined various pathogens known to cause acute gastroenteritis in children. Further studies for various pathogens can provide useful information for management of the acute gastroenteritis.