• Microbiology and Biotechnology Letters
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• v.50 no.1
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• pp.126-134
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• 2022

Norovirus (NoV) is an important pathogen causing acute gastroenteritis worldwide. The purpose of the present study was the molecular characterization of NoV. A total of 408 stool specimens collected from hospitalized children associated with acute gastroenteritis in Chiang Rai, Thailand, 2015-2017 were investigated for the presence of NoVs by RT-PCR. NoV GII was detected in 32 samples (7.8%). Five distinct genotypes were identified, including GII.4 (13/32, 40.6%), GII.3 (11/32, 34.3%), GII.17 (4/32, 12.5%), GII.2 (2/32, 6.3%), and GII.14 (2/32, 6.3%). NoV infection occurred mostly in young children under 3 years of age (31/32, 96.9%) and showed the main peak in summer months from March to April (18/32, 56.3%). Phylogenetic analysis revealed that all 13 GII.4 strains clustered with GII.4 Sydney 2012 variant. Representative GII.3 strains were analyzed as a recombinant GII.3P[12] strain. Several amino acid differences were found in the antigenic epitopes and antibody binding sites of the VP1 capsid of the GII.3P[12]. Homology modeling of the P domain of the GII.3P[12] strain demonstrated that 10/13 amino acid differences were predicted to be located on the surface-exposed area of the capsid structure. These amino acid changes might affect the infectivity and the antigenicity of the recombinant GII.3P[12]. The prevalence of GII.4 Sydney 2012 and recombinant GII.3P[12] strains indicates the genetic diversity of circulating NoVs in Thailand, emphazing the importance of continuous surveillance to mornitor newly emerging NoV strains in the future.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.92-106
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• 1999

Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.490-497
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• 1998

This study was designed to investigate the effects of information by using cartoon on preoperative anxiety of children following tonsillectomy. The subjects were 30 children aged between 7 and 12 who were hospitalized at C university hospital for undergoing tonsillectomy from December 20, 1996 to August 14, 1997 Sixteen of them were assigned to the experimental group, while fourteen subjects to the control group. The data were collected through preoperative state anxiety, pulse rate, pain before and after giving information by using cartoon. The results were as follows : 1. Preoperative state anxiety increased in both groups (P=0.0348). No significant difference found between experimental and control group. But preopertive anxiety in experimental group was apt to increase less than that in the control group. 2. Pulse rate didn't make significant difference within and between groups. 3. Pain increased in both groups (P=0.0001). No significant difference found between experimental and control group. 4. Experimental group between the aged 7 and 9 decreased preoperative state anxiety, but experimental group between the aged 10 and 12 increased preoperative state anxiety after treatment(P=0.0298). These findings may indicate that the information by using cartoon is effective in children between the aged 7 and 12.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.148-160
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• 1990

This paper reports on the development of the Children's Separtion Rating Scale(CSRS), its initial reliability and validity, and clinical/research utility with psychiatrically hospitalized children. The CSRS appears to be a reliable and valid instrument, and useful in distinguishing children's separation reaction from their general psychopathology. It may be also useful in aiding clinicians in differential diagnosis. This study points to the need for further understanding of children's psychiatric hospitalization in relation to their separation reaction and its possible untoward effects. Findings of this pilot study support the notion that inpatient treatment programs should address the developmental needs and abilities of the various age groups and the particular deficits reflected in their psychopathology.

• Clinical and Experimental Pediatrics
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• v.64 no.8
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• pp.415-421
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• 2021

Background: Antibiotic resistance is associated with longer hospitalizations, higher treatment costs, and increased morbidity and mortality rates. Purpose: This study aimed to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Iranian children. Methods: International databases, including Web of Science, PubMed, Embase, and Scopus, and Iranian databases, including Scientific Information Database (www.sid.ir), Magiran, and Iranian Database for Medical Literature (idml.research.ac.ir), were systematically searched for articles published between January 2000 and August 2019. Sources of heterogeneity were determined using subgroup analysis and meta-regression. Results: Overall, 343 studies were identified; of them, 20 were included in the meta-analysis to estimate the pooled prevalence. The pooled prevalence of MRSA was 42% (95% confidence interval [CI], 29-55) among culture-positive cases of S. aureus, 51% (95% CI, 39-62) in hospitalized children, and 14% (95% CI, 0.05-27) in healthy children. Conclusion: The overall pooled prevalence of MRSA in children was 42%. Appropriate infection control measures and effective antibiotic therapy are needed.

• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.178-185
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• 2014

Purpose: Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods: We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results: Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively). Conclusion: Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.143-152
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• 2004

Purpose: The purpose of this study is to detect viral coproantigens in children who were hospitalized with acute diarrhea and to compare its association with clinical symptoms. Methods: Seventy-four stool samples were collected from children admitted to Ewha Mokdong Hospital from March 1996 to December 1999. The samples were frozen and analyzed for rotavirus, adenovirus, enterovirus, astrovirus, and calicivirus by enzyme immunoassay (EIA) with monoclonal antibody. 53 stool samples were collected from patients with diarrhea (diarrheal group) and 21 stool samples from patients hospitalized for reasons other than diarrhea (control group). Clinical features and laboratory findings were reviewed in both groups. Results: Among 74 stool samples, virus antigens were detected in 60 samples. Of the 60 virus-positive stool samples, 47 enterovirus, 26 rotavirus, 16 adenovirus, 11 astrovirus, and 11 calicivirus antigens were detected by EIA. Of the 60 virus-positive stool samples, 28 samples have one viral antigen, 30 samples have 2 or more viral antigens, and 2 samples showed a simultaneous infection of Salmonella group B and enterovirus. There was no relationship between the detected virus and clinical features. Conclusion: In this study, viral coproantigen and clinical symptoms were not associated. In the future, further larger scale studies are necessary.

• Child Health Nursing Research
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• v.18 no.1
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• pp.9-18
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• 2012

Purpose: This study was conducted to analyze factors affecting readmission of children with home ventilator care. Methods: To collect patient data, a retrospective chart review was done of medical records of children admitted between June 1, 2007 and May 31, 2010 at one children's hospital located in Seoul. During that period 30 children were discharged with a home ventilator. Results: Twenty-one of these children had a total of 63 readmissions during the study period, averaging 2.1 readmissions per child with a mean duration of hospitalization of 7.4 days. Children with nasogastric tubes were more frequently readmitted (t=7.232, p=.012) and duration of hospitalization was significantly longer (t=4.761, p=.038). Children who had cardio-pulmonary comorbidity were more frequently readmitted and had longer hospitalization than children without comorbidity (t=5.444, p=.027). When home ventilator assisted children were admitted via emergency room, they were hospitalized longer (t=14.686, p=<.001). Cardio-pulmonary morbidity and readmission via ER explained 38.1% of variation for readmission. Feeding method explained 15.0% of variation in length of hospitalization. Conclusion: The results suggest that health care providers must give individualized education on home ventilator care to parents with children who are at risk for readmission due to cardio-pulmonary comorbidities, nasogastric tube, or readmission via ER.

• Childhood Kidney Diseases
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• v.27 no.1
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• pp.34-39
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• 2023

Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.69-74
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• 2007

Purpose : Human coronanviruses (hCovs) including hCoV-229E and hCoV-OC43 have been known as etiologic agents of the common colds and were regarded as clinically insignificant agents. However, recent identification of hCoV-NL63 and hCoV-HKU1 in children with lower respiratory tract infections has evoked the clinical concerns about their prevalence and the clinical significance of these hCoVs in children. This study was performed to investigate the prevalence of hCoVs in children with community-acquired pneumonia. Methods : From March 2006 to January 2007, nasopharyngeal specimens collected from children hospitalized with pneumonia, were tested for the presence of common respiratory viruses (respiratory syncytial virus, influenza A, influenza B, parainfluenza viruses, and adenovirus) using multiplex reverse transcriptase polymerase chain reaction (RT-PCR). Human metapneumovirus (hMPV) infection was excluded by nested RT-PCR using primers for the F-gene. To detect the different strains of hCoVs, nested RT-PCR assays specific for hCoVNL63, hCoV-OC43, hCoV-229E, and hCoV-HKU1 were performed. Results : Out of the 217 nasopharyngeal aspirate from children aged under 15 years, respiratory syncytial virus (RSV) was detected in 32 patients, hMPV in 18, human parainfluenza virus in 10, influenza virus A in 2, and adenovirus in 6. HCoVs were detected by RT-PCR in 8 (3.7%) of the 217 patients, hCoV-229E in 1, hCoV-NL63 in 3, and hCoVOC43 in 4 patients. HCoV-HKU1 was not detected in this study population. Conclusion : Recently identified hCoV-NL63 and hCoV-HKU1 seemed to have a little clinical significance in Korean children with severe or hospitalized community-acquired pneumonia.