• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.66-81
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• 2021

The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.297-308
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• 2021

Objective : Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. Methods : This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient's age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. Results : This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40-0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24;95% CI, 0.14-0.40; p=0.60; I2=0%) than in general patient population. Conclusion : The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

• The Journal of the Korea Contents Association
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• v.21 no.11
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• pp.389-402
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• 2021

The purpose of this study is to examine early childhood teacher's perception and current implementation toward autonomy and to provide basic data for related research. The survey was conducted with 121 public and private kindergarten teachers. The study results are as follows: First, as for teachers' perception of autonomy, the majority of the survey respondents answered that "I am very interested in the concept of autonomy and have tried to practice it." In terms of areas for which they expect to be given autonomy, "autonomy in developing and operating education plans" was most answered. Second, as for teachers' practice of autonomy, teacher autonomy was answered most for "work and operation" in the development and implementation of education plans among "institutional autonomy." In terms of communication between parents and the local community, "operation of the kindergarten website" and "operation of teachers' personal e-mail" were most answered. In addition, "participation in teacher training" was most answered for the development of teachers' expertise, and "interaction with infants" for "autonomy in educational activity." Lastly, it is expected for follow-up research to perform case studies to understand the context of the implementation of teacher autonomy.

• The Journal of the Acoustical Society of Korea
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• v.42 no.5
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• pp.460-468
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• 2023

Developmental Dysplasia of the Hip (DDH) is a pathological condition commonly occurring during the growth phase of infants. It acts as one of the factors that can disrupt an infant's growth and trigger potential complications. Therefore, it is critically important to detect and treat this condition early. The traditional diagnostic methods for DDH involve palpation techniques and diagnosis methods based on the detection of keypoints in the hip joint using X-ray or ultrasound imaging. However, there exist limitations in objectivity and productivity during keypoint detection in the hip joint. This study proposes a deep learning model-based keypoint detection method using X-ray and ultrasound imaging and analyzes the performance of keypoint detection using various deep learning models. Additionally, the study introduces and evaluates various data augmentation techniques to compensate the lack of medical data. This research demonstrated the highest keypoint detection performance when applying the residual network 152 (ResNet152) model with simple & complex augmentation techniques, with average Object Keypoint Similarity (OKS) of approximately 95.33 % and 81.21 % in X-ray and ultrasound images, respectively. These results demonstrate that the application of deep learning models to ultrasound and X-ray images to detect the keypoints in the hip joint could enhance the objectivity and productivity in DDH diagnosis.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.927-934
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• 2023

This study explored the process of how children are connected to and placed in the daycare center's interest area environment. Focusing on the process of getting to know, we tried to understand it through Deleuze's concept of connection-placement, which emphasized the power between materials and humans, to see how the familiar environment called the area of interest affects children's behavior. For this purpose, 20 children in the mixed class aged 4-5 years at B Daycare Center in Seoul were observed for a total of 2 hours each through 2 preliminary observations and 5 research observations from March to May 2023. First, the results of the study showed that infants' true interest could be found in the infant's gaze, not in the adult's gaze. Second, the space and play materials of the interest area environment are structurally arranged in accordance with the order of play types, but the boundaries become ambiguous as they are connected to children. Third, although the children's play seemed to be play without deviating from each area of interest, the space itself was a single mass in which interest was expressed. We hope that this study will help instructors in their practice of constructing an environment for areas of interest, and that we will become instructors who ask questions at every moment about what kind of traces will be left on children's thinking as the environment of space and media.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.139-144
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• 2023

Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.35 no.1
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• pp.301-324
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• 2024

In this study, we attempted to propose operational directions for each space in order to transform the newly built library in Yangpyeong-gun into a space for cultural enjoyment and creativity development for local residents. To this end, the purpose is to understand the space composition status of Yangpyeong-gun public libraries and establish an operation plan (draft) for the space to be constructed. To this end, we analyzed the names, operation status, and cases of similar spaces in other libraries, and analyzed the spatial characteristics of library cases to establish a space operation plan for the Yangpyeong-gun public library. As a result of the study, it is important to utilize spaces such as children's resource rooms to improve early reading habits for infants and children, contribute to development, and develop various senses, and small theaters should be planned with a focus on large-scale performances. Furniture and space for reading and relaxation should be provided next to Byeokmyeonga & Bookstair, and it should be operated as a communication space where small talk is possible within a certain limit. It is necessary to operate the multipurpose room by activating experiential creative activities and creative performances. It is necessary for the club room to establish an operation plan through regular communication and opinion sharing. The maker space space is a space that supports various creative activities, and the general data room is a place that provides materials on all topics and must be operated by regularly communicating with users and reflecting their opinions. Lastly, I would like to suggest that the family room should be used like a book cafe where children and parents can freely drink tea together in the same space.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1126-1133
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• 2002

Purpose : Prader-Willi syndrome(PWS) is a complex disorder affecting multisystems with characteristic clinical features. Its genetic basis is an expression defect in the paternally derived chromosome 15q11-q13. We analyzed the clinical features and genetic basis of PWS patients for early detection and treatment. Methods : We retrospectively studied 24 patients with PWS in Department of Pediatrics, Samsung Medical Center, from September 1997 to September 2001. We performed cytogenetic and molecular genetic techniques using high resolution GTG banding techniques, fluorescent in situ hybridization and methylation-specific PCR for CpG island of SNRPN gene region. Results : The average birth weight of PWS patients was $2.67{\pm}0.47kg$ and median age at diagnosis was 1.3 years. The average height and weight of PWS patients under one year at diagnostic time were located in a 3-10 percentile relatively, and a rapid weight gain was seen between two and six years. Feeding problems in infancy and neonatal hypotonia were the two most consistently positive major criteria in over 95% of the patients. In 18 of the 24 cases(75%), deletion of chromosome 15q11-q13 was demonstrated and one case among 18 had an unbalanced 14;15 translocation. In four cases without any cytogenetic abnormality, it may be considered as maternal uniparental disomy and the rest showed another findings. Conclusion : We suggest diagnostic testing for PWS in all infants/neonates with unexplained feeding problems and hypotonia. It is necessary for clinically suspicious patients to undergo an early genetic test. As the genetic basis of PWS was heterogenous and complex, further study is required.

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.241-247
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• 2007

Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.165-173
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• 2016

Objectives : Since the awareness of autism spectrum disorders(ASD) is growing, as a result, it is increasing numbers of infants and toddlers being referred to specialized clinics for a differential diagnosis and the importance of early autism spectrum disorders detection is emphasized. This study is to know the difference between ASD and intellectual disability(ID) from comparison of the demographics, clinical characters and obstetric complications. Methods : The participants are 816 toddlers who visited the developmental delay clinic(DDC) in National Health Insurance Ilsan hospital. The number of toddlers diagnosed as ASD and ID was 324 and 492. 75 toddlers out of 114 who returned to DDC were diagnosed as ID at the first visit but 7 of them had changed diagnosis to ASD at the second visit. After compared ASD with ID from the first visit, we analyzed characters of toddlers who had the changed diagnosis to ASD at the second visit. Results : As a result, the comparison between ASD and ID at the first visit shows that the boys have higher ratio, lower obstetric complication and lower language assessment score in ASD. The toddlers who had the changed diagnosis at the second visit were all boys and they had more cases of family history of developmental delay and had lower score of receptive language developmental quotient. Conclusions : These findings suggest that sex, language characteristics and obstetric complication could be useful in the early detection of ASD.