• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.163-172
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• 2011

Purpose : The purpose of this study was to review our recent experiences with deep neck abscesses in children and adolescents and to provide helpful information in treatment and diagnosis by comparing them with those in other available literatures. Methods : Medical records of 36 children and adolescents admitted for deep neck abscess at two hospitals from January 2000 to October 2010 were reviewed retrospectively. Results : Male to female ratio was 1.4 : 1 and the mean age was 6.5 years. Painful neck swelling and fever were the most frequent symptoms in patients under thirteen years of age whereas trismus and headache were frequent symptoms in patients over fourteen years of age. Submandibular space was the most common site of deep neck abscess in patients under thirteen years of age, whereas peritonsillar space was the most common site in patients over fourteen years of age. The results of bacterial cultures were positive in 61.5% of drained cases. Staphylococcus aureus was the most commonly identified bacteria in 6 patients (37.5%) and 5 of them were under 2 years of age. Twenty six patients received surgical drainage while the others were treated with antibiotics only. There were no statistically significant differences in the durations of admission, fever after admission, and antibiotic treatment between surgical and medical treatment groups. Conclusion : The common sites of deep neck abscess, associated symptoms, and causative organisms were different between children and adolescents. As there were no differences in durations of admission, fever, or antibiotics treatments between surgical and medical treatment groups, surgical drainage may be avoided by early recognition and suspicion. However, if there is no improvement of symptoms or size of abscesses within 48-72 hours of antibiotic treatment, surgical drainage should be considered.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.119-126
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• 2022

Objectives : The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). Methods : 43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. Results : Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R²=0.407, p<0.05). Conclusions : The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate disorders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.576-583
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• 2008

Purpose : The identification of specific behaviors conducive to overeating or inactivity is the cornerstone of obesity management. The Committee on Nutrition of the Korean Pediatric Society developed parent and self-reporting questionnaires about eating behavior and physical activity in 2006. The aim of this study was to evaluate the usefulness of the questionnaires in assessing modifiable lifestyle factors related to obesity. Methods : A retrospective chart review was performed for 177 children (6-11 years old) and 134 adolescents (12-16 years old) from 10 hospitals between May 2006 and January 2007 who had completed parent or self-reporting questionnaires. Cases were divided into normal and overweight groups at or above the age-gender-specific 85th percentile based on 2007 Korean national growth charts. Results : Compared to children, the adolescents tended to have a significantly more sedentary lifestvle and inappropriate dietary behaviors significantly (P<.05). Overweight mothers were significantly associated with overweight children and adolescents (P<.05). Being overweight was significantly associated with a family history of adult diseases for children and adolescents (P<.05). Inappropriate eating behaviors (strong appetite, eating fast, eating until they were full, binge eating, favoring greasy foods) were associated with being overweight in children and adolescents. Sedentary activity such as TV viewing and using a computer were significantly associated with overweight in children and adolescents (P<.05). Conclusion : Intervention to modify obesity-related lifestyle factors is needed before adolescence. These questionnaires are useful in identifying modifiable lifestyle factors and in individual counseling for overweight children and adolescents in pediatric clinics.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.150-159
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• 2008

Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.604-609
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• 2008

Purpose : Obesity in children and adolescence is highly correlated with adult obesity, which can provoke hypertension. Therefore, it is important to evaluate the blood pressure of obese children regularly. In this study, the results of ambulatory blood pressure monitoring (ABPM) in obese children and adolescents were evaluated. Methods : ABPM was conducted for selected patients who visited Handong University Sunlin Hospital from Feb. 1, 2006 to Dec. 1, 2007. The patients were classified into 3 groups: group 1 was normal, group 2 had normal casual blood pressure and a body mass index over the 95th percentile, and group 3 had high casual blood pressure over 120/80 mm Hg and a body mass index over the 95th percentile. Systolic and diastolic 24-hour blood pressure was measured, including both day and night. Results : There were 49 patients in the study. The results showed a significant difference for average systolic blood pressure between the three groups ($105.1{\pm}4.7$, $111.0{\pm}7.1$, $117.8{\pm}6.6mmHg$, P<0.001), but for average diastolic blood pressure only between groups 1 and 3 ($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$, P=0.001). In the daytime, only groups 1 and 3 showed a statistically significant difference for systolic and diastolic blood pressure. During the night the systolic pressure of group 3 was significantly higher than the other groups, but the diastolic pressure of group 3 was only higher than that group 1. No statistical difference was found in night dips among the groups. Conclusion : Ambulatory blood pressure monitoring in children and adolescents showed statistically higher blood pressure in obese patients with high casual blood pressure.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.992-997
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• 2008

Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.647-655
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• 2017

This study was conducted to review the mediating effects of retirement preparation in how the degree of requirements for retirement education and the degree of preparation for retirement education affects quality of life, and how the degree of participation in retirement education which is a moderating variable is moderated. The study findings show that first, in terms of the difference in quality of life across different general characteristics, those who live in a city rather than a Gun, those who had received education of graduate school or higher rather than those with an education of undergraduate university programs or lower, those who were public officers or employees of corporations rather than those who were self-employed had a higher quality of life. The group satisfied with their economic status and health status were found to be more satisfied with their quality of life. Second, a correlation analysis showed that there was a positive correlation between retirement preparation, quality of life, and degree of requirements for retirement preparation. Moreover, there was also a positive correlation between quality of life, retirement education and the degree of requirements for retirement education. There was a positive correlation between retirement education and the degree of requirements for retirement preparation. Third, participation in retirement education moderated the indirect effect that the degree of preparation for retirement education affected quality of life through the degree of retirement preparation. In other words, the degree of requirements for retirement education affects retirement preparation and affects quality of life through the indirect effects of retirement education. As such, the moderated mediating effects of retirement education on retirement preparation was found to be greater. This indicates that quality of life may also vary in accordance with the requirements for retirement education.

• Pediatric Infection and Vaccine
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• v.29 no.3
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• pp.131-140
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• 2022

Purpose: Since the coronavirus disease 2019 (COVID-19) pandemic began, new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged, and distinct epidemic waves of COVID-19 have occurred for an extended period. This study aimed to analyze the clinical and epidemiological characteristics of children with COVID-19 from the third wave to the middle of the fourth epidemic wave in Korea. Methods: We retrospectively reviewed the medical records of hospitalized patients aged ≤18 years with laboratory-confirmed COVID-19. The study periods were divided into the third wave (from November 13, 2020 to July 6, 2021) and the fourth wave (from July 7 to October 31, 2021). Results: Ninety-three patients were included in the analysis (33 in the third and 60 in the fourth waves). Compared with the third wave, the median age of patients was significantly older during the fourth wave (6.7 vs. 2.8 years, P=0.014). Household contacts was reported in 60.2% of total patients, similar in both periods (69.7 vs. 55.0%, P=0.190). Eighty-one (87.1%) had symptomatic SARS-CoV-2 infection. Among these, 10 (12.3%) had no respiratory symptoms. Anosmia or ageusia were more commonly observed in the fourth epidemic wave (10.7 vs. 34.0%, P=0.032). Most respiratory illness were upper respiratory tract infections (94.4%, 67/71), 4 had pneumonia. The median cycle threshold values (detection threshold, 40) for RNA-dependent RNA polymerase (RdRp) and envelope (E) genes of SARS-CoV-2 were 21.3 and 19.3, respectively. There was no significant difference in viral load during 2 epidemic waves. Conclusions: There were different characteristics during the two epidemic waves of COVID-19.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.191-199
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• 2016

Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.72-81
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• 2018

Purpose: This prospective study aimed to investigate the therapeutic efficacy of lamivudine in children with chronic hepatitis B virus (HBV) infection. Methods: During July 2003 through October 2015, children with chronic hepatitis B who visited our institution were included in this study. Fifty-five patients, who received first-line treatment of lamivudine (3 mg/kg, 100 mg maximum) for over three months, were enrolled. After initiating lamivudine, alanine aminotransferase (ALT), HBV-DNA, and HBV markers were followed up at 1 month, 3 months, and every 3 months, thereafter. The treatment endpoint was determined as 1) normalization of ALT, 2) HBeAg seroconversion, and 3) anti-HBe positivity for twelve consecutive months. Results: Thirty-one male (56.4%) and 24 female (43.6%) patients were included. The mean age at treatment initiation was 8.1 years. The mean duration of treatment was 23.4 months. ALT normalization was found in 98.2% (54 of 55). Anti-HBe seroconversion was found in 70.6% (36/51). Loss of HBsAg was found in 10.9% (6/55). All biochemical responses occurred under age seven. The rate of virologic response (defined as HBV-DNA <2,000 IU/mL) at six months after treatment initiation was 78.7% (37/47). At twelve months after reaching treatment endpoint, 87.2% (34/39) maintained their virologic response. Resistance to lamivudine was found in 16.4% (9/55). Conclusions: Lamivudine treatment in Korean pediatric patients with chronic hepatitis B showed better outcomes compared with other studies that implemented similar protocols in foreign populations. Further studies are needed to investigate the efficacy of newly recommended antiviral drugs on the Korean pediatric population.