• Clinical and Experimental Pediatrics
• /
• v.46 no.9
• /
• pp.858-864
• /
• 2003

Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.

• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1267-1272
• /
• 2009

Purpose:We examined the ability of preschool aged children to meet the American Thoracic Society (ATS) and European Resiratory Society (ERS) goals for spirometry quality and tried to find out the major factor for improving the rate of success of spiromety test in this age group. Methods:Spirometry was performed in 2-6 aged 155 children with chronic cough or suspicious asthma with the recording of maneuver quality measures of forced expiratory time, end-of-test volume, back-extrapolated volume (Vbe), and forced vital capacity (FVC), as well as flow-volume curve. The subjects were tested several times and the two best results in each subject were selected. All criteria for quality control were suggested by ATS/ERS guidelines. The criteria for starting of the test was Vbe <80 mL and Vbe/FVC <12.5%. The criteria for repeatability of the test was that second highest FVC and FEV1 are within 100 ml or 10% of the highest value, whichever is greater. For the criteria for termination of the test for preschool aged children, we evaluated the flow-volume curve Results:As getting older, the success rate of spirometry increased and rapidly increased after 3 years old. Total success rate of the test was 59.4% (2 years old - 14.3%, 3 years old - 53.7%, 4 years old - 65.1%, 5 years old - 69.7%, 6 years old- 70.8%). The percentage of failure to meet the criteria for starting the test was 6.5%, repeatability of the test was 12.3% and end of the test was 31%. There was a significant difference only in age between success group and failure group. Evaluating the quality control criteria of previous studies, the success rate increased with age. Conclusion:About 60% of preschool aged children met ATS/ERS goals for spirometry test performance and the success rate was highly correlated with age. It is clearly needed that developing more feasible and suitable criteria for quality control of spirometry test in preschool aged children.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.17 no.1
• /
• pp.1-10
• /
• 2017

Purpose: This study aimed to investigate the perception and emotional experiences in rare and intractable diseases for caregivers of pediatric patients with mitochondrial diseases in order to provide therapeutic interventions for patients, caregivers, and families. Methods: A total of 83 caregivers of pediatric patients with mitochondrial diseases were recruited from the pediatric mitochondrial disease clinics of the Gangnam Severance Hospital in South Korea. Participants completed the survey about their perception of mitochondrial disease and emotional experiences after the diagnosis, and these clinical data were analyzed accordingly. Results: Surveys from a total of 83 caregivers of patients were analyzed, and the patients' age ranged from 6 to 12 years (33%), followed by ages 1 to 6 years (30%). Children with mitochondrial diseases were between 0 and 0.5 years of age at the time of first symptom onset (43%), and the duration of illness lasted more than 10 years in most cases (42%). Prior to diagnosis of mitochondrial diseases, the amount of awareness the caregivers had was 'Not at all' for both rare and intractable diseases and mitochondrial diseases in 44 cases and 68 cases, respectively. For the caregivers' emotional experiences, the most common initial responses were 'Discouraged/despair', 'Helpless/lethargic', and 'Disconcerted'. 'Anxious', 'Committed to treatment', and 'Responsibility as family members' were the most common emotional responses from the caregivers, followed by 'Disconcerted' and 'Helpless/lethargic'. Conclusion: It is important to consider the level of perception and emotional experiences of caregivers and patients with rare and intractable mitochondrial diseases for planning treatment programs.

• Clinical and Experimental Pediatrics
• /
• v.48 no.11
• /
• pp.1187-1192
• /
• 2005

Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

• Clinical and Experimental Pediatrics
• /
• v.45 no.6
• /
• pp.783-789
• /
• 2002

Purpose : We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment. Methods : We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000. Results : The mean annual incidence was $36.1{\pm}11.1$ cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was $2.4{\pm}1.7$ years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated($400-500mg/day{\times}4-5days$, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case. Conclusion : In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1116-1120
• /
• 2005

Purpose : Although the rotavirus-related neonatal death occurred in western part of Kyeonggi Province recently, there were just a few reports about rotavirus gastroentertis in domestic since 2000. We proposed to investigate changes of epidemiology and clinical features of rotavirus gastroenteritis for the last 2 years. Methods : We selected 166 patients diagnosed as gastroenteritis from January, 2002 to July, 2003 and reviewed the admission records retrospectively such as age distribution, sex ratio, seasonal distribution, admission period, laboratory data and dehydration type in the rotavirus group(RVG) and non-RVG. Results : The percentage of patient under 3 years was 77% on RVG. The non-RVG showed even age distribution(P<0.05). In RVG, patients occurred in March frequently and 52% occurred from January to March. In non-RVG, patients occurred highly in February and July(P<0.05). The average of admission period was higher in RVG than non-RVG(P<0.05). The percentage of patient admitted for over 10 days was 8% in the RVG. In dehydration severity, the RVG showed mild(51%), moderate(44%) and severe(5%) respectively, but non-RVG showed only mild dehydration(P<0.05). The laboratory findings' did not have statistic significance between RVG and non-RVG. Conclusion : Compared to the previous studies, seasonal peak prevalence of rotavirus gastroenteritis changed from autumn to spring and patients over 3 years increased. Therefore, we suggest that there are variable serotypes of rotavirus domestically and there is a need for reinvestigation about clinical features and serotypes of rotavirus gastroenteritis.

• Korean journal of communication and information
• /
• v.16
• /
• pp.71-107
• /
• 2001

미국에서 이루어진 인터넷 중독 현상에 대한 초기 연구는 인터넷 중독을 알코올중독과 같은 개인의 정신적 질병으로 간주하는 의사들에 의해 주도되었다. 그러나 사회현상으로서 인터넷 중독에 대한 사회과학자들의 관심이 증대되면서 인터넷 중독의 원인을 밝히는 본격적인 연구가 이루어진다. 인터넷 이용과 초고속 인터넷 망 보급속도에서 세계최고 수준을 자랑하는 우리의 경우에도 인터넷 이용에 따른 많은 부정적인 현상들이 나타남으로써 사회적인 문제로 대두되고 있다. 이에 따라 인터넷 중독에 대한 일부 연구가 수행되었는데 이들 연구들은 인터넷 이용패턴과 이용동기를 개별적으로 분석하고 인터넷 중독정도를 측정하는 차원에 머물고 있다. 즉, 인터넷 중독의 원인을 분석하는 차원에 이르지 못하고 있다. 또한 대부분의 연구들이 10대 청소년을 연구대상으로 하고 있기 때문에 다른 연령층의 인터넷 이용특성을 파악하는 데 한계를 가지고 있다. 이 같은 현실 인식을 바탕으로 본 연구는 2000년에 발표된 한국전산원 통계수치에서 인터넷을 가장 많이 이용하는 집단으로 조사된 대학생들을 연구대상으로, (1) 이들의 인터넷 이용패턴과 이용동기를 밝히고 (2) 이들 변인들과 인터넷 중독과의 상호관련성을 분석하며 (3) 인터넷 중독의 정도와 중독요인을 조사하고 (4) 마지막으로 인터넷 이용이 다른 미디어 이용과 면대면 커뮤니케이션에 미치는 영향을 분석하고 있다. 본 연구의 자료는 2000년 5월 8일부터 19일까지 2주간에 걸쳐 서울시내 대학생들을 대상으로 강의시간에 설문지를 배포하고 응답자가 설문지에 답하는 방법을 통해 수집되었다. 수집된 556명의 설문지 가운데 유효한 512명의 설문지가 통계적인 방법을 통해 분석되었다. 설문지는 (1) 인터넷 이용패턴 (2) 인터넷 이용 동기 (3) 인터넷 의존도 (4) 인터넷 이용 이후 다른 미디어 이용정도 (5) 인터넷 이용 이후 면대면 커뮤니케이션 정도 (6) 인구통계학적 변인을 측정하는 질문 내용으로 구성되었다. 통계 분석 후 나타난 몇 가지 주요결과를 요약하면 아래와 같다. (1) 이용동기와 인터넷 이용과의 상호관련성 이용동기를 요인 분석한 결과, 6개의 이용동기가 나타났는데 오락이 가장 주요한 동기였으며 다음으로 교육/정보, 현실도피, 외로움, 쇼핑, 그리고 성적 만족 순으로 나타났다. 이용 동기들을 인터넷 이용시간과의 상호관련성을 통계 분석한 결과 기존 연구결과와 달리 성적 만족이 6가지 요인 가운데 가장 낮은 상호관련성을 보였다. 또한 이용동기 분석에서 두 번째 높게 나타난 교육/정보 역시 성적 만족 다음으로 낮은 상호관련성을 보여주었다. 이는 대학생들의 인터넷 이용이 10대들의 인터넷 이용형태와 상당히 다르다는 것을 보여주는 것으로 본 연구에서는 수행하지 못한 이 같은 결과가 나오게 된 이유를 밝히는 후속연구가 필요할 것으로 보인다. (2) 인터넷 이용동기와 인터넷 서비스와의 상호관련성 '오락은 게임, 토론그룹, 전자메일, 채팅과 상호관련을 가진 것으로 나타났으며, 교육/정보는 검색과 쇼핑, 현실도피는 게임과 토론그룹, 외로움은 토론그룹, 전자메일과 채팅, 쇼핑은 온라인 쇼핑과 상호관련성이 있는 것으로 분석되었다. 흥미로운 사실은 성적 만족과 관련해서 게임과 채팅은 긍정적인 상호관련을 가진 것으로 나타난 반면 전자메일 서비스 이용은 성적 만족과 부정적인 상호관련을 가진 것으로 분석되었다. 이는 대학생들이 지루하게 느끼거나 외로움을 느낄 때 전자메일을 주로 이용하지만 성적 만족을 위해 전자메일을 이용하지 않고 있다는 사실을 보여주는 것이다. (3) 인터넷 이용 이후 다른 미디어와 면대면 커뮤니케이션과의 관계 인터넷을 이용한 후 응답자들의 전통적인 미디어(텔레비전, 라디오, 신문, 잡지, 편지, 전화) 이용이 감소되었으며 친구, 가족, 이성친구와의 면대면 커뮤니케이션 역시 감소된 것으로 나타났는데 이 같은 감소가 인터넷 이용과 관련이 있는 것으로 나타났다. (4) 인터넷 중독 정도와 중독 요인 10대들을 대상으로 한 기존 연구에서 나타난 인터넷 중독 현상이 대학생 집단에서는 나타나지 않았다. 그러나 응답자의 28.5%가 중독집단으로 발전될 가능성을 가진 잠재적인 인터넷 의존자(Moderate Internet Dependent)로 조사되었다. 인터넷 중독을 설명하는 요인으로 이용동기 가운데 오락, 외로움과 현실도피가 주요 변인으로 나타났으며 인터넷 이용시간 역시 주요변인으로 분석되었다. 흥미 있는 결과는 선행연구에서 인터넷 중독과 밀접한 관련 있는 인터넷 서비스로 조사된 게임과 채팅이 주요변인으로 나타나지 않았다는 것이다. 또한 인터넷 이용동기와 이용시간과의 상호관련 조사 결과에서처럼 전자메일서비스는 인터넷 중독과 부정적인 관계가 있는 것으로 조사되었다.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.20 no.2
• /
• pp.54-61
• /
• 2016

Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

• The korean journal of orthodontics
• /
• v.34 no.1 s.102
• /
• pp.47-61
• /
• 2004

Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root Is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages $10\~15$ without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.1
• /
• pp.1-9
• /
• 2009

Purpose: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC. Methods: We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up. Results: The mean age of the patients was 12.5${\pm}$14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients. Conclusion: LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.