• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.36-41
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• 2019

Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There were significant differences in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.2
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• pp.459-467
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• 2021

This study examined the onset of adolescent delinquency through discrete-time survival analysis. Our analysis used data obtained from the Korean Children & Youth Panel Survey, and included 2,277 middle school students. The main analysis results are as follows. First, the hazard probability for the occurrence of delinquency was the highest at 16.6% in the second year of middle school, slightly decreased in the third year of middle school, but continued to increase as the overall grade increased. Second, adolescent psychological and emotional factors have significantly affected the onset of delinquency. Third, negative parenting methods had a significant impact on delinquency, but neglect was not significant. Fourth, having delinquent friends was an important factor affecting the status of delinquency. Fifth, among the school factors, adjustment of learning activities, adjustment of school rules, and adjustment of friendship relations influenced the status of delinquency, while the adjustment of teacher relations was not significant. As early intervention is important to prevent juvenile delinquency, education and support for establishing healthy relationships are needed.

• Clinical Pain
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• v.19 no.1
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• pp.32-35
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• 2020

Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

• The Journal of Pediatrics of Korean Medicine
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• v.37 no.1
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• pp.58-72
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• 2023

Objectives The purpose of this study is to analyze the latest clinical trends in peripheral facial nerve palsy pediatric and adolescent patients who treated in Korean medicine hospital. Methods The study was conducted based on 185 cases of pediatric and adolescent patients with peripheral facial nerve paralysis who visited Korean medicine hospital from January 2017 to June 2022. Results The mean age of onset of facial nerve paralysis in children and adolescents was 11.7 years, and the incidence rate was higher in boys than in girls. The seasonal distribution was the most common in autumn, and 91.4% were diagnosed with Bell's palsy. The recurrence rate was 7.6%. The severity was evaluated on the House-Brackmann Grading System (HBGS) scale, and the most common was Grade III. It took an average of 6.5 days from the date of onset to visit the hospital, and 75.7% visited the hospital within a week from the date of onset. Hospitalized treatment was 69.2%. The higher the HBGS grade, the more hospitalized treatment was, and the total number of treatments and the duration of treatment tended to increase. The average treatment period from the first visit date was 119.6 days. 17.8% received only Korean medicine treatment, and 69.2% took Western medicine with herbal medicine. Conclusions In this study, there was a difference in the average treatment period from previous studies according to the study period setting. Long-term studies on the recovery rate and prognosis of pediatric facial paralysis are needed.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.11-19
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• 1999

Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. MCNS most commonly appears between the ages of 2 and 10 yr. But the incidence and prognosis in adolescent MCNS are different from those found in young children; the prognosis and the response to therapy is unfavorable with increasing ages. So we compared the prevalence and the clinical manifestations of adolescent MCNS with that of childhood MCNS for management of adolescent MCNS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of the 216 cases with MCNS which were divided into children group and adolescent group by their age of onset; under 12 years(childhood) and between 12-18 years(adolescent). Results: 1) The number of childhood idiopathic nephrotic syndrome was 245 cases, and that of adolescent idiopathic nephrotic syndrome was 55 cases. 188 cases($77\%$) showed MCNS, 30 cases($12\%$) FSGS, 4 cases($1.6\%$) MSPCN in childhood idiopathic nephrotic syndrome; 28 cases($51\%$) showed MCNS, 12 cases($22\%$) FSGS in adolescent idiopathic nephrotic syndrome. 2) The mean onset age was $7.53{\pm}5.5$ years, and the male to female ratio was 3.8:1 in childhood onset and 2.5:1 in adolescent onset with male predominance. 3) Hematuria was associated with $17\%$ of childhood onset and $39.3\%$ of adolescent onset disease(P=0.005). Hypertension appeared in $0.5\%\;and\;7\%$ in each group without significant difference between the groups. 4) 24 hour urine protein, SPI, albumin, BUN, cholesterol level showed no significant difference. 5) The response of childhood onset and adolescent onset MCNS to steroid therapy showed complete remission in $11.7\%\;&\;14.7\%$, infrequent relapsing in $29.2\%\;&\;28.5\%$, frequent relapsing in $23.9\%\;&\;14.7\%$, steroid dependent in $21.8\%\;&\;28.6\%$ each. Steroid resistant showed $13.3\%\;&\;14.7\%$ with no significance. 6) Immunosuppresant therapy was performed $57\%$ in childhood onset and $65\%$ in adolescent onset. 7) Mean number of relapse and duration from onset to first relapse showed no significance between two groups. Conclusion : Our results indicate that the incidence of hematuria, the rate of steroid dependent and frequent relapsing, and the recurrence rate were higher in adolescent MCNS; showed poorer steroid responsiveness and prognosis. Our data also point to the need for a more aggressive therapy to treat and make recommendations for the adolescent population as a whole.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.92-100
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• 1997

Objective：The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method：Subjects consisted of 157 patients with Tourette’ disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results：The mean age of patients was 14.49(${\pm}7.99$) years. Patients consisted of 138 males (87.9%) and 19 females(12.1%). The sex ratio was 7：1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(${\pm}4.56$) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed；the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers (2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession；and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion：These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’ disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.

• Journal of Korean Biological Nursing Science
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• v.11 no.1
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• pp.23-31
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• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.332-334
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• 1995

Two hypertensive men with DeBakey type III dissection were admitted due to acute onset of leg ischemia.One patient had ischemia of both legs,The other patient had ischemia of the right leg.Angiograms showed occlusion of aortic bifurcation in one patient and occlusion of right common iliac artery and right renal artery in the other patient.The first patient who had ischemia of both legs was relieved by axillo-bifemoral bypass operation and the second patient with right leg ischemia by femoro-femoral bypass.The dissection of the aorta was successfully managed by conservative measures including hypotensive medication.The bypass grafts was functioning well one year later.The aortic dissection should not be overlooked as an etiology of acute onset of ischemia of the lower extremities.

• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.765-771
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• 2000

Objectives : To evaluate the pain control effect of combination treatment of Oriental Medicine on patients who suffered from thalamic pain syndrome caused by thalamic stroke. Methods : We reviewed the medical records and brain imaging data of all patients with thalamic stroke from September 1998 to August 2000 who visited to Department of Oriental Internal Medicine, National Medical Center. We evaluated clinical features of thalamic pain syndrome, including incidence, onset interval from stroke, nature, pain distribution, and assessed the pain control effect of combination treatment by Visual Analog Scale(VAS). Results : 64 cases were selected under the inclusion criteria, and 17 patients(26.5%) with thalamic pain syndrome were identified from 64 thalamic strokes. VAS proved combination treatment effective to control pain of thalamic pain syndrome. In 12 cases(70.5%), pain onset was within the first week poststroke. The patients with allodynia were 6(35.3%). In 12 cases(70.5%), the lesion was mainly located in the posterolateral areas of thalamus. Conclusion : We conclude that combination treatment of the Oriental Medicine modalities have pain control effectiveness on thalamic pain syndrome.(t=-5.47, p=0.0001)

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.6 no.11
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• pp.2800-2812
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• 2012

The purpose of this study was to examine the syllable-word boundary misalignment cost on word segmentation in Korean continuous speech. Previous studies have demonstrated the important role of syllabification in speech segmentation. The current study investigated whether the resyllabification process affects word recognition in Korean continuous speech. In Experiment I, under the misalignment condition, participants were presented with stimuli in which a word-final consonant became the onset of the next syllable. (e.g., /k/ in belsak ingan becomes the onset of the first syllable of ingan 'human'). In the alignment condition, they heard stimuli in which a word-final vowel was also the final segment of the syllable (e.g., /eo/ in heulmeo ingan is the end of both the syllable and word). The results showed that word recognition was faster and more accurate in the alignment condition. Experiment II aimed to confirm that the results of Experiment I were attributable to the resyllabification process, by comparing only the target words from each condition. The results of Experiment II supported the findings of Experiment I. Therefore, based on the current study, we confirmed that Korean, a syllable-timed language, has a misalignment cost of resyllabification.