• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.75-80
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• 2009

Purpose : In adults, valproate (VPA) has been reported to be associated with thrombocytopenia. However, few studies have investigated this association in children, and the factors affecting platelet counts remain controversial. This study was undertaken to investigate changes in platelet counts following VPA therapy and related factors in children with epilepsy. Methods : Our subjects comprised 75 epileptic children who had received VPA monotherapy for at least 1 year between January 2000 and December 2005. We regularly examined platelet counts at intervals of 6 to 12 months after baseline platelet counts before VPA treatment. We analyzed changes in platelet counts according to several factors such as sex, seizure type, underlying causes of epilepsy, age at the start of medication as well as at the last follow up, duration of VPA administration, VPA dose, serum VPA level, and body weight at the last follow up. Results : Overall, the platelet counts decreased significantly after VPA therapy. The average baseline platelet count was $312.5{\pm}109.1{\times}10^6/mL$. At the last follow up, the average platelet count was $261.7{\pm}72.2{\times}10^6/mL$. We observed the relationship between platelet counts and serum levels of VPA; while children with serum VPA <$75{\mu}g/mL$ showed no change in platelet counts (P=0.102), children with serum VPA >$75{\mu}g/mL$ showed a significant decrease in platelet counts. Conclusion : VPA may cause a significantly decreased platelet count in children with epilepsy. High serum VPA levels were associated with development of thrombocytopenia.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.28-32
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• 2010

Purpose : Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. Methods : Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. Results : Absolute eosinophilia (>$700/mm^3$) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia ($700-999cells/mm^3$), 27 (51.9%) exhibited moderate eosinophilia ($1,000-2,999cells/mm^3$), and 3 (5.8%) exhibited severe eosinophilia (>$3,000cells/mm^3$). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P <0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P<0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P<0.05). Conclusion : Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.179-184
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• 2007

Purpose: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. Methods: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. Results: When the mean of ages ($10.5{\pm}1.6$ vs. $10.7{\pm}2.0$ years), total cholesterol levels ($183.0{\pm}29.1$ vs. $183.7{\pm}31.3$ mg/dL), HDL-cholesterol levels ($53.0{\pm}10.2$ vs. $55.7{\pm}13.0$ mg/dL), LDL-cholesterol levels ($113.4{\pm}30.2$ vs. $113.0{\pm}30.0$ mg/dL), triglyceride levels ($99.4{\pm}62.9$ vs. $114.2{\pm}47.3$ mg/dL), obesity indexes ($44.7{\pm}12.2$ vs. $47.9{\pm}15.1%$), and body fat percentages ($32.7{\pm}5.0$ vs. $34.0{\pm}4.8%$) of group 1 (ALT${\leq}$40 IU/L) were compared with those of group 2 (ALT${\geq}$41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG${\geq}$110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). Conclusion: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.129-137
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• 2007

Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.178-185
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• 2013

Objective: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. Methods: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. Results: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia ($9.71{\pm}1.09g/dL$); 46 had neutropenia ($803.70{\pm}263.09cells/mm^3$); and 23 had transient thrombocytopenia ($142,434.78{\pm}86,835.18cells/mm^3$). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. Conclusions: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.

• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.133-143
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• 2014

Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using ${\chi}^2$ test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (${\geq}5cm$) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.

• Neonatal Medicine
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• v.17 no.2
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• pp.201-206
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• 2010

Purpose: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. Methods: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. Results: The mean gestational age and birth weight (BW) of all infants were $27^{+6}{\pm}1^{+6}$ weeks and 951${\pm}$245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033${\pm}$285 g vs. 821${\pm}$126 g, P=0.048) and weight on operation day (1,195${\pm}$404 g vs. 893${\pm}$151 g, P=0.042), longer hospital days (105${\pm}$29 vs. 141${\pm}$39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative $FiO_2$ (0.29${\pm}$0.06 vs. 0.38${\pm}$0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. Conclusion: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high $FiO_2$ might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.207-221
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• 2000

Purpose: Cost-effectiveness of myocardial SPECT for the diagnosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. Materials and Methods: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (${\Delta}QALY$) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases. $Cost/{\Delta}QALY$ was calculated and compared between four different tactics according to pre-test probability. Results: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective. Conclusion: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.

• Journal of Gifted/Talented Education
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• v.17 no.2
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• pp.365-391
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• 2007

As a previous study to investigate recognition gap of creativity between Korea and America, this study has examined Korean university students' implicit creativity toward Korea and America. The research method using in this study was as follows: The subject were university students in Korea, and they were asked to answer multiply for open-ended questions. For the analysis of the answers, a frequency analysis was used. The results were as follows: 1) It showed that Korean university students considered creativity trait as cognitive trait, personality, cultural trait, research and development areas and arts areas. This result means that Korean university students tend to recognize creativity similarly to the ways of established theories of creativity. 2) For the case of Korea, environmental trait like sociocultural background had great importance for all cases of creativity trait and non-creativity trait. 3) American creativity was recognized focused on individual tendency, on the while, community spirit was considered as creativity trait in Korean creativity. 4) It is considered that American culture had better condition for displaying creativity than Korean culture. 5) Traditional culture of Korea was recognized as creativity trait in terms of originality and superiority, and the possibility of modernistic use of Korean culture. 6) Creative people were ranked by artists, executives, rulers and scientists who were well-known to Korean university students. 7) In the comparison of creativity trait between the two countries revealed the traits of creative people, American creativity was reflected more than Korean creativity, This result seems that those people were favored by Korean university students who were familiar with American culture. In conclusion, this study has found another possibility of creativity of the East among cross-cultural creativity studies. Moreover, this study has suggested that traditional culture and tradition renewal, and values of the East are superior cultural resources which are not exist in the West, and those are expected to play a role in developing creativity.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.5.2-5
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• 1982

With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.