• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.939-945
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• 2005

Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.719-726
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• 2002

Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.712-718
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• 2002

Purpose : Infantile colic is one of the most commonly encountered problems, characterized by excessive crying in apparently healthy young infants within the first 3 months of life. It is commonly assumed that the infant with colic has distress and possible pain. In recent investigations, it has been found that sucrose has an analgesic effect in newborn infants. The purpose of this study is to examine if sugar solution as sucrose also has an analgesic effect on infant colic. Methods : This prospective randomized, double-blind placebo controlled study examined healthy term infants aged 4 to 12 weeks with colic. A total of 40 infants were randomly assigned into two groups who visited Daedong Hospital from June 1999 to June 2001. Each group received sugar solution or sterile water. All data from parental diaries and interviews were recorded and analysed blindly. Results : The daily crying time and the colic improvement score were significantly better in sugar solution group as compared with the control(P=0.019, 0.045). No significant differences were noted between groups regarding the number of night wakenings(P=0.173). Conclusion : We conclude that sugar solution has an analgesic effect on infantile colic.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.754-763
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• 2002

Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

• Ocean and Polar Research
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• v.25 no.2
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• pp.183-200
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• 2003

In order to assess the ecological changes induced by organic pollutants of the Shihwa Lake, BPI (Benthic Pollution Index) based on the benthic faunal community was employed. It was modified from Infaunal Trophic Index (ITI), and recommended as a pollution detecting method for the environmental assessment. The BPI values were calculated from the benthos data, which were collected for three terms: in 1980, before the Shihwa Lake was built up; in 1994-1997, which the Shihwa Lake was completely isolated from the outer seawater; in 1997-1999, after inflow of the outer seawater. Since the Shihwa Dike was constructed in February 1994, the pollution intensity of the lake had been increased from the narrow and inner part of the former Gyeonggi Bay and spread fast along the coast line of the Shihwa Lake. Then, in 1996 it showed the very high BPI levels all around the Lake. This serious polluted condition had been lasted till 1997, when the inflow of the seawater was begun. In 1998, from the nearest part of the Shihwa Gate, the BPI levels gradually became low in most area of the Lake, except its inner and narrow part. These greatly lowered BPI levels mean that the seawater inflow could be assumed to affect positively in the lake. Furthermore, BPI gave the same results from the other environmental assessment based on the abundance and the species richness of macrobenthic community. It shows that BPI could be useful as an effective method to assess the marine environment and evaluate the status of environmental conditions.

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.758-762
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• 2003

Purpose : Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. Methods : We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups : those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. Results : Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were $20,000/mm^3$, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. Conclusion : These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.

• Ocean and Polar Research
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• v.36 no.1
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• pp.13-24
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• 2014

We established the first complete ice core processing method and analytical procedures for fundamental proxies, using a 40.2 m long ice core drilled on the Mt. Tsambagarav glacier in the Mongolian Altai mountains in July 2008. The whole core was first divided into two sub ice core sections and the measurements of the visual stratigraphy and electrical conductivity were performed on the surface of these sub core sections. A continuous sequence of samples was then prepared for chemical analyses (stable isotope ratios of oxygen ($^{18}O/^{16}O$) and hydrogen ($^2H/^1H$), soluble ions and trace elements). A total of 29 insoluble dust layers were identified from the measurement of visual stratigraphy. The electrical conductivity measurement (ECM) shows 11 peaks with the current more than 0.8 ${\mu}A$ Comparing the profiles of $SO_4{^{2-}}$ and $Cl^-$ concentrations to correlate with known volcanic eruptions, the first two ECM peaks appear to be linked to the eruptions (January and June 2007) of Kliuchevskoi volcano on the Kamchatka Peninsula of Russia, which supports the reliability of our ECM data. Finally, the composition of stable isotopes (${\delta}^{18}O$ and ${\delta}D$) shows a well-defined seasonal variation, suggesting that various chemical proxies may have been well preserved in the successive ice layers of Tsambagarav ice core. Our ice core processing method and analytical procedures for fundamental proxies are expected to be used for paleoclimate and paleoenvironmental studies from polar and alpine ice cores.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.855-861
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• 2007

Purpose : The most common causes of acute viral gastroenteritis in newborn period are rotavirus, astrovirus, norovirus and enteric adenovirus. This study was designed to investigate the clinical characteristics, clinical symptoms, isolation rate and distribution of these viruses in full-term neonates during neonatal period. We also studied the influence on the viral isolation rate by postnatal care place and feeding type. Methods : We evaluated 112 healthy full-term neonates who were admitted to Eulji hospital, presenting with symptoms of acute viral gastroenteritis from September 2004 to August 2005. Epidemiologic, clinical and laboratory data were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus, astrovirus and norovirus and RT-PCR for enteric adenovirus were performed in study subjects.Results : The mean age at the admission was $11.4{\pm}5.4days$, mean weight loss was $5.9{\pm}5.1%$, mean hospitalization duration was $6.3{\pm}3.4days$. Moderate and severe weight loss were expressed in 51.7% and metabolic acidosis was in 13.4%. The percent of living in postnatal care facility (PCF) was 74.1 % and the percent of mixed feeding was 64.3%. Isolation rate of virus was 33%. The most prevalent virus was rotavirus (59.5%), followed by astrovirus (29.7%) and norovirus (10.8%). There was no differences in virus isolation rate by postnatal care place and by feeding type. The rotavirus was main virus in both home group and PCF group. But astrovirus was more detected in PCF and norovirus was more detected in home (P<0.05). According to monthly distribution of virus, acute viral gastroenteritis in newborn period was concentrated in September to December. Conclusion : The isolation rate of 4 type viruses was 33% and rotavirus was the leading cause of acute gastroenteritis during neonatal period. There was no differences in clinical characteristics on each viral groups.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.299-306
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• 2008

Purpose : Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal disorder characterized by fever, splenomegaly, pancytopenia, and hemophagocytosis in the bone marrow and other tissues. In this study, we investigated the clinical manifestations and prognostic factors in patients with HLH. Methods : We retrospectively analyzed the data from 29 patients who were diagnosed whit HLH in the Severance Children's Hospital from Jan. 1996 to Feb. 2007. Results : The median age at diagnosis was 3.8 years (range 0.1-12.2). The ratio of male to female patients was 1.1:1. The 5-year overall survival rate was 55.2% with a median follow-up duration of 32 months. In a multivariate analysis, the duration of fever before admission (survival vs. non-survival, 6.5 days vs. 14 days, P=0.010), the interval from the day of fever onset to the day of initiation of etoposide (survival vs. non-survival, 10 days vs. 35 days, P=0.002) and the presence of neurologic symptoms (survival vs. non-survival, 1 case vs. 7 cases, P=0.010) were independent, poor prognostic factors of HLH. EBV infection, gender, and the level of serum ferritin had no relations to the poor prognosis of the disease. Conclusion : This study showed that the presence of neurologic symptoms and a longer duration of fever were related to a poor prognosis. Therefore, if a patient develops neurologic symptoms and the duration of fever is prolonged, a prompt diagnostic approach and aggressive treatment for HLH are necessary.

• Cartoon and Animation Studies
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• s.51
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• pp.181-201
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• 2018

The cartoon industry in Korea has continued to decline due to the contraction of published comics market and decrease in the number of comic books rental stores until the 2000s when it rapidly started to experience qualitative changes and quantitative growth due to the emergence of webtoon. The market size of webtoon industry, valued at 420 billion won in 2015, is expected to grow to 880.5 billion won by 2018. Notably, most cartoonists who draw cartoon strips are using digital devices and producing scripts in data, thereby overcoming the geographical, spatial and physical limitation of contents. As a result, a favorable environment for the creation of local ecosystems is generated. While the infrastructures of human resources are steadily growing by region, cartoon industries that are supported by the government policy have shown good performance combined with factors of creative infrastructures in local areas such as webtoon experience centers, webtoon campuses and webtoon creation centers, etc. Nevertheless, it is true that cartoon infrastructures are substantially based on a capital area which leads to an imbalanced structure of cartoon industry. To see the statistics, companies of offline cartoon business in Seoul and Gyeonggi Province make up 87%, except for distribution industry. In addition, companies of online cartoon business which are situated outside of Seoul and Gyeonggi Province form merely 7.5%. Studies and research on local webtoon are inadequate. The existing studies on local webtoon usually focus on its industrial and economic values, mentioning the word "local" only sometimes. Therefore, this study looked into the current status of local webtoon of the present time for the current state of local cartoon ecosystem, middle and long-term support from the government, and an alternative in the future. Main challenges include the expansion of opportunities to enjoy cartoon cultures, the independence of cartoon infrastructure, and the settlement of regionally specialized cartoon cultures. It means that, in order to enable the cartoon ecosystem to settle down in local areas, it is vital to utilize and link basic infrastructures. Furthermore, it is necessary to consider independence and autonomy beyond the limited support by the government. Finally, webtoon should be designated as a culture, which can be a new direction of the development of local webtoon. Furthermore, desirable models should be continuously researched and studied, which are suitable for each region and connect them with regional tourism, culture and art industry. It will allow the webtoon industry to soft land in the industry. Local webtoon, which is a growth engine of regions and main contents of the fourth industrial revolution, is expected to be a momentum for the decentralization of power and reindustrialization of regions.