• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.367-371
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• 2008

Purpose : The surfactant dysfunction may play an important role in meconium aspiration syndrome (MAS). We aim to evaluate the effect of surfactant lavage in the treatment of term infants with MAS. Methods : The medical records of 15 neonates with severe MAS admitted at Yongdong Severance Hospital from 2005 to 2007 were reviewed and analyzed. Seven infants with severe MAS necessitating mechanical ventilation underwent tracheobronchial lavage with 20 mL/kg of diluted (5.3 mg phospholipid/mL) surfactant saline suspension ($Newfactan^{(R)}$). Data regarding clinical outcomes was assessed by comparison with 8 control infants with equally severe MAS retrospectively. Results : In the lavage group, radiological improvement was evident after 6 hours of treatment. The duration of artificial ventilation and duration of hospital day were also significantly shorten in the lavage group compared with the control group. The mean oxygen index, mean ventilation index improved significantly within the first 6 hours after treatment. No differences were found in the incidence of major complications and mortality between the two groups. Conclusion : The surfactant lavage seems to be an effective and safe method for treatment of severe MAS. A multicenter, large scaled randomized controlled trial is needed for further study.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.532-537
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• 2010

Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.

• Journal of Gifted/Talented Education
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• v.21 no.1
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• pp.57-81
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• 2011

The purpose of this study was to explore the quality of life of musically talented students as measured by their external experiences (e.g., activities, companions) and internal experiences (e.g., flow, emotion). The participants in this study were 33 musically talented students (10 males, 23 females) aged 13 to 19. Study data were collected for 7 consecutive days using the Experience Sampling Method (ESM), which employs a cellular-phone as a signaling device. The results were as follows: First, in response to the 1625 random signals, musically talented students reported that 40.9% of their time was spent on productive activities. An additional 33.4% of time was used for maintenance activities and the rest of their time was spent on leisure/social activities. Also, musically talented students reported that 48.5% of their time was spent alone. When they were alone, they spent a lot of time engaging in productive activities (44.3%). Second, in order to measure the flow of their life, two methods were used. One used a 4-channel flow model (i.e. apathy, boredom, flow, anxiety) and the other used 8 dimensions and conditions of the flow experience (i.e. concentration, self-consciousness disappears, action and awareness merge, distorted sense of time, freedom from worry about failure, clear goals, immediate feedback, balance between challenges and skills). According to the former, when engaged in music-related activities, musically talented students usually reported flow (54.0%), while they felt apathy (41.3%) for daily routines activities. According to the latter method, musically talented students experienced flow for most productive activities, while they experienced flow least for maintenance activities. Emotional variables of ESF are comprised of 10 semantic scales (i.e. happy-sad, strong-weak, active-passive, sociablelonely, proud-ashamed, involved-detached, excited-bored, clear-confused, relaxed-worried, cooperative-competitive). Musically talented students reported experiencing the most positive emotion for social activities and experiencing the most negative emotion for maintenance activities. Results of this study assert that musically talented students had to trade off immediate enjoyment for developing their special gifts. They could not afford as much time for socializing with friends, and they had to spend more time alone compared to their peers without such gifts. Consequently, they were found to deprive themselves of the spontaneous good times that teenagers usually thrive on. They were helped in this respect by their autotelic personality traits, especially their strong need for achievement and endurance. The downside, however, is that the moment-to-moment quality of their moods suffered. The argument concerning musically talented students applies for all adolescents. The choices that talented students must make between immediate gratification and long-term development, and between solitude and companionship, are the same choices every young person must make, regardless of her or his level of talent. All of us have gifts that are potentially useful and worthy of being appreciated. But to develop these latent talents we must cultivate them, and this takes time and the investment of mental energy. The lifestyle that musically talented students develop can show us some of the choices all of us must make in order to cultivate our gifts.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.555-563
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• 2004

The pH of beverages is known to be low and have, therefore, been implicated in the increasing incidence of erosion. Erosion is believed to be the predominant cause of teeth wear in children and young adults, although there will always be a contribution from attrition and abrasion. The aim of the present study was to evaluate the effect of yogurt on the progression of erosive demineralization in human enamel using demineralization model in vitro. In 4 yogurts, available on the market, pH, buffering capacity and the concentrations of calcium, phosphate and fluoride were determined. The buffering effect was determined by titration with NaOH. 50 milliliters of each drink was then titrated with 1M sodium hydroxide, added in 0.5 milliliters increments, until the pH reached about 7. Human deciduous enamel(n=40) samples were divided into four groups and exposed to 80ml of the yogurt for 30,60, 90 and 120min. Enamel surface microhardness(VHN) was examined before and after each exposure. 1. The average PH of fermented milk was 3.77 and this pH value was acidic enough to cause tooth erosion. 2. All of the fermented milks were found to be erosive(p<0.05) 3. The teeth exposed to the fermented milk all showed erosion like lesions and microhardness measurements showed that enamel surface hardness decreased proportionately with increased time of immersion in all tooth specimen groups. 4. After immersion for 30 and 60 minutes, reduction rate of microhardness values was not significantly different between the groups(p>0.05). However, after 90 and 120 minutes, reduction rate of each group was significantly different(p<0.05).

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1073-1079
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• 2003

Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.44-49
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• 2009

Purpose : Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. Methods : We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. Results : The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). Conclusion : Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effects on bronchopulmonary dysplasia are limited. Therefore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1180-1185
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• 2006

Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.

• Journal of Korean Home Economics Education Association
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• v.19 no.4
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• pp.91-117
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• 2007

This study was to compare the contents and practical problems addressed, the process of teaching-learning method, and evaluation method of Korean Home Economics curriculum and of the Oregon and Ohio's Practical Problem Focused Family & Consumer Sciences Curricula. The results are as follows. First, contents of Korean curriculum are organized by major sub-concepts of Home Economics academic discipline whereas curricular of both Oregon and Ohio states are organized by practical problems. Oregon uses the practical problems which integrate multi-subjects and Ohio uses ones which are good for the contents of the module by integrating concerns or interests which are lower or detailed level (related interests). Since it differentiates interest and module and used them based on the basic concept of Family and Consumer Science, Ohio's approach could be easier for Korean teachers and students to adopt. Second, the teaching-learning process in Korean home economics classroom is mostly teacher-centered which hinders students to develop higher order thinking skills. It is recommended to use student-centered learning activities. State of Oregon and Ohio's teaching-learning process brings up the ability of problem-solving by letting students clearly analyze practical problems proposed, solve problems by themselves through group discussions and various activities, and apply what they learn to other problems. Third, Korean evaluation system is heavily rely on summative evaluation such as written tests. It is highly recommended to facilitate various performance assessment tools. Since state of Oregon and Ohio both use practical problems, they evaluate students mainly based on their activity rather than written tests. The tools for evaluation include project documents, reports of learning activity, self-evaluation, evaluation of discussion activity, peer evaluation in a group for each students for their performance, assessment about module, and written tests as well.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1204-1212
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• 2002

Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.111-121
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• 2009

Background: Osteosarcoma is one of the most common primary malignant tumors of bone occurring mainly in children and adolescents. Although surgery combined with chemotherapy has markedly improved patient survival during the last years, the use of anticancer drugs is still associated with serious problem, such as the frequent acquisition of drug-resistant phenotypes and occurrence of "secondary malignancies". Several solid tumors display enhanced expression of matrix metalloproteinases (MMPs), and recently clinical trials have been initiated on MMP-inhibitors. On the other hand, bisphosphonates (BPs) are inhibitors of bone resorption, and widely used to treat osteoclast-mediated bone diseases. Also they appear to possess direct antitumor activity. Methods: One osteosarcoma cell line (U2OS) was treated with ibandronate (0, 0.1, 1, $10{\mu}M$) for 48 hours. Cell viabilities were determined using MTT assay, the mRNA levels of MMP-2 and MT1-MMP were detected by reverse-transcription polymerase chain reaction, the amount of MMP-2 and MT1-MMP protein were measured by Westernblot, the activities of MMP-2 were observed by Gelatin zymography, and Matrigel invasion assays were used to investigate the invasive potential of osteosarcoma cell lines before and after ibandronate treatment. Results: The invasiveness of U2OS cell line was reduced dose-dependently following 48 hour treatment of up to $10{\mu}M$ of the ibandronate at which concentration no cytotoxicity occurred. Furthermore, the gelatinolytic activities and protein and mRNA levels of MMP-2 and MT1-MMP were also suppressed by increasing ibandronate concentrations. Conclusion: Given that MMP-2 is instrumental in tumor cell invasion, it is very likely that the reduction in osteosarcoma cell invasion by ibandronate is a consequence, at least in part, of suppressed expression of both MMP-2 and MT1-MMP. Isolation of a molecule (s) responsible for the bisphosphonate inhibition of tumor cell invasion would pave the way for the development of a new generation of metastasis inhibitors.