• Childhood Kidney Diseases
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• v.26 no.1
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• pp.46-51
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• 2022

Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.

• The Journal of Korean Society for School & Community Health Education
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• v.3
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• pp.79-110
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• 2002

The purpose of this study was to provide basic data necessary for creating a more successful health enhancement program, health education and health policy which can enhance health management abilities and enable a healthy school life by examining relations between high school students' health perception, who are in early adolescence, and their health promotion behavior. The subjects in this study were 813 students from 8 high schools on Jeju Island. The collected data were analyzed with t-test and one-way ANOVA through questionnaires by researcher on the basis of advance research. The findings of this study were as belows : 1. When general characteristics were considered, health perception was more significantly affected by those who were boys, whose family income was on a higher level, who scored better in school, whose parents were more concerned about their children's health, and who had experiences of being hospitalized. Especially, the more parents were concerned about their children's health, the higher the child's self-confidence on health(p<.05), anxiety on health(p<.05), practicality on disease prevention(p<.05), self-confidence on future health(p<.01), health care ability(p<.01), and family roles on health(p<.05). The less parents were concerned about their children's health, the higher the child's anxiety on disease(p<.01) and uncertainty on future health(p<.01). 2. When students' health promotion behavior was concerned, in the area of Eating Habits, having regular meals(72.9%), moderate consumption of meat(89.7%) and a balanced diet(64%) were common, whereas having a regular breakfast(37.4%) and eating vegetables and fruits(43.6%) were rare. In the area of Exercise, all subareas such as exercising 3 or 4 times a week(76.7%), more than one hour of exercise at a time(74.9%), a short distance walk(51.8%), exercise within one hour after meals(87%), and whether wanning up or not(88.6%) were above average. In the area of Personal Hygiene, all subareas such as drinking boiled water(57.3%), washing hands after using the bathroom(71%), brushing teeth after eating(42.4%), washing up after going out(50.3%), and washing hair and taking a frequent bath(77.2%) were rare. In the area of Control of Personal Relations, consulting personal problems with family(78.7%) had a positive response, whereas meeting someone new(59.8%), maintaining sound relations with the opposite sex(47.3%), having respect for one's opinion(51.5%), and maintaining peaceful relations with people(58.4%) had rare negative results. In the area of Stress Management, not being competitive(69.4%), releasing problems(62.4%) and sleeping soundly(66.2%) were common, whereas having your own ways to relieve stress(46.8%) and having your own dreams and hopes(58.5%) were rare. 3. When general characteristics were considered, as far as relations of health promotion behavior were concerned, the boys were significantly different in the area of Eating Habits(p<0.01) and Exercise(p<0.01), and the girls were in the area of Personal Hygiene. As family economic status was high and parents were concerned about their children's health, the entire areas of health promotion behavior were significantly different. Whether or not they were hospitalized made no significant difference in statistics. 4. When their regions were considered, it comparing city to town, there was no statistically significant difference in health perception and relations of health promotion behavior according to general characteristics. As seen in the results above, high school students' level of health perception and level of practicing health promotion behavior were generally low. In conclusion, by enhancing health perception, a plan for activating health education, which can implement positive health promotion behavior, should be made.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.834-841
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• 2008

Purpose : This study was perfomed to analyze in detail the viral etiology of acute lower respiratory tract infections (ALRI) in Cheunan, Korea by multiplex RT-PCR, including human rhinovirus (hRV) and newly identified viruses such as human metapneumovirus (hMPV) and human coronavirus (HCoV-OC43, HCoV-229E/NL63). Method : Nasopharyngeal aspirates (NPA) were collected from 863 hospitalized children with ALRI on the first day of admission at Soonchunhyang University Cheonan Hospital and analyzed by multiplex RT-PCR from December 2005 to November 2006. Results : Viral agents were detected from 474 subjects (54.9%). The identified viral pathogens were hRV 9.2%, hMPV 6.8%, HCoV-229E/NL63 1.4%, and HCoV-OC43 2.1%. Coinfections with ${\geq}2$ viruses were observed in 108 patients (22.8%). The major period of viral ALRI was the first year of life. Clinical diagnoses of viral ALRI were pneumonia (59.5%), bronchiolitis (24.7%), tracheobronchitis (11.4%), and croup (4%). The most common causes of bronchiolitis was respiratory syncytial virus B (RSV B), whereas hMPV, hRV, HCoV-229E/NL63, and HCoV-OC43 were commonly found in patients with pneumonia. The number of hMPV infections peaked between March and May 2006. HCoV-OC43 was prevalent from November to February 2006, whereas HCoV-229E and hRV were detected throughout the year. Conclusion : Although the study was confined to one year, hMPV was not detected during winter and peaked between March and April, which was not consistent with previous studies'. This present study indicates that HCoV is a less common respiratory pathogen in cases of ALRI in Korean children

• Tuberculosis and Respiratory Diseases
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• v.72 no.6
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• pp.493-500
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• 2012

Background: This study investigated the clinical characteristics and risk factors of the severity of pandemic influenza A (H1N1) 2009 infection in pediatric patients in Busan and Gyeongsangnam-do. Methods: Cases of influenza A (H1N1) 2009 in patients under the age of 18 years, confirmed by reverse transcription polymerase chain reaction, at Pusan National University Hospital and Pusan National University Yangsan Hospital from the last week of August 2009 through the last week of February 2010 were retrospectively analyzed. Results: Of the 3,777 confirmed cases of influenza A (H1N1) 2009, 2,200 (58.2%) were male and 1,577 (41.8%) were female. The average age of the patients was $8.4{\pm}4.8$ years. The total cases peaked during 44th to 46th week. Most of the patients were in the 5- to 9-year-old age group. Oseltamivir was administered to 2,959 (78.3%) of the patients. 221 patients (5.9%) were hospitalized, age an average of $6.7{\pm}4.5$ years. The average duration of hospitalization was $7.4{\pm}5.6$ days. One hundred cases (45.2%) had pneumonia. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. Children with asthma were at very high risk of hospitalization, over 20 times the non-asthmatic children (odds ratio [OR], 21.684; confidence interval [CI], 13.295~39.791). Likewise the children with neurologic deficits faced a 16 times higher risk (OR, 15.738; CI, 7.961~31.111). Ten of the patients (4.5%) were admitted to the intensive care unit, and eight (3.6%) required mechanical ventilation. Conclusion: Of the pediatric patients with pandemic influenza A (H1N1) 2009, most of the patients were in the 5- to 9-year-old age group. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. The most common complication was pneumonia. The very high risk of severe morbidity in children with asthma or neurologic disease shows the critical importance of targeted vaccine coverage, special awareness and swift care by both guardians and primary care providers.

• Child Health Nursing Research
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• v.5 no.1
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• pp.48-58
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• 1999

The purpose of this study was to determine the most accurate technique measuring the apical pulse rate, using three counting duration 15, 30 and 60 seconds, and two methods start ‘0’ and start ‘1’. The instrument used in the study was the EKG monitor, stethoscope and stopwatch. Data was analyzed by utilizing SPSSWIN program. General characteristics of the subjects were analyzed by frequency, percentile, mean, SD. The subject of this research is made up of 46 children and 20 nurses. The children were infants, & under the age of 5. They were hospitalised in PICU & NICU in 2 tertiary hospitals in seoul from Jan. 1. 1998 to Sep. 10. 1998. The measurement of starting 1 & measurement of starting ‘0’ used the T-test to find out the measurement error. Apical pulse duration of 15, 30, 60 seconds were used to find out measurement error, the measurement error depend on experience of Nurse were analyzed by using ANOVA. The result of this study are as follows. 1. When comparing the starting poin of apical pulse 0&1, starting with 1 the measurement error is less, but not statiscally significant. 2. When counting the apical pulse by 15, 30,60 sec. ; 60 seconds counting duration was more accurate, but not statistically significant. 3. The mean of measure error ; Group under 100/min, is 10.33 ; from 100 re 119/min, is 8.30 ; from 120 to 139/min, is 4.76 ; from 140 to 159/min, is 6.09 ; above 160, is 17.83. The differences of these groups are statistically significant. When 60sec were counted, under 140/min the mean of measurement error is 3.4. Also when 30 seconds were counted from 140/min to 159/min the measurement error is 7.14, above 160/min the measurement error is 16.4. That measurement mean is the smallest than the other durations. During the 15 sec. count the measurement error was the largest of them all. 4. By the experience of the nurses, the apical pulse count measurement error was discovered. Under a year experience this measurement error was the largest(11.09), 1 year to under 3 years, the error is the smallest(4.86). 3 year to under 6 years the error is 8.33, 5 years above the error is 6.11 but this is not statistical significant. Under a year experience when counting 15, 30, 60 seconds the error is the largest. The group of the nurses from a year to under 3 years, the measurement error is the smallest of all the groups. The result of the study is to determine the technique measuring the apical pulse rate, Hargest (1974), starting point ‘0’ is not proved. When the pulse rate increases the 30 sec measurement rate is accurate. Under 140/min the 60 sec measurement rate is the most accurate. Depending on the nurses experiences, there is a variable difference to the apical pulse rate measurement. Especially new nurses training courses should enforce the children’s pulse rate count and the basic vital signs.

• Journal of Dairy Science and Biotechnology
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• v.27 no.1
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• pp.1-12
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• 2009

In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.60-66
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• 1997

Even though the urinary stones are rare in children, careful observation and monitoring are necessary because the incidence has been increasing. This study is aimed to document the characteristics of urinary stones in children including the symptoms, diagnosis, with or without urinary tract infection, other urinary tract anomaly and treatment. 45 patients under the age of 15 years with urinary stones hospitalized during Jan. 1986 to Jun. 1996 at Severance Hospital were reviewed retrospectively. Patients' mean age was 6.5 years and sex ratio (male : female) was 5.4:1. The most common symptom was gross hematuria. Stones accompanied with urinary tract infection was 46.7%, and stones associated with urinary tract anomaly was 35.6%. Extracorporeal shock wave lithotripsy, percutaneous nephrolithotorny, hydration and diuretics were the treatment modality used. Urinary stone were found to be a significant cause of urinary tract obstruction in children, requiring prompt diagnosis and treatment. Although KUB, IVP, and ultrasonography were commonly used to make the diagnosis, many cases were detected only by ultrasonographic study.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.212-219
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• 2007

Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups. Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.

• Korean Parent-Child Health Journal
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• v.15 no.1
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• pp.20-32
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• 2012

Purpose: The purpose of this study was to identify clinical decision making pattern of pediatric nurses and analyze how it shows the differences in types of decision making pattern by nurses characters. Methods: A self-administered questionnaire was used to pediatric nurses of 4 general hospitals in Seoul from February 2004 to April 2004. The data of 251 nurses was analyzed by varimax rotation factor analysis, t-test, and ANOVA. Results: 6 decision making patterns were identified: Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, Nursing Model-oriented, Medical Knowledge-oriented, and Patient-Family-Nurse Collaborative. Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, and Nursing Model-oriented decision making pattern got meaningful differences in age, marital status, total number of years in nursing practice, and number of years in pediatric nursing practice. Conclusion: We expect the result of this study can be applied for promotion of understanding the decision making of nurses that occurs in pediatric nursing practice and also can be used as foundation data for development and expansion of pediatric nursing practice.

• Journal of Korean Academy of Nursing
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• v.32 no.6
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• pp.775-783
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• 2002

The purpose of this study was to provide basic data on preventive child abuse program development. Method: Data were collected on 105 high-risk families of child abuse intervention was obtained from their main child rearer who raised the child under 18 years, olds during 10 months period from May, 2000 to March 2001. Result: The results were as follows : 1. Child abuse occurred in the subject's home, in the case of mild child abuse, 'throwing an object at the child' had the highest percentage 39.1%, in severe child abuse, 'rod, stick, belt, broom beating or using a variety of objects such as' had the highest percentage 49.5%, and in very severe child abuse, 'hospitalized by belting' had the highest percentage 3.8% 2. The degree of child abuse potential showed high risk child abuse score with a mean of 213.3. The degree of beliefs in corporal punishment showed that subjects perceived corporal punishment of children positively with a mean of 32.2,. 3. With respect to the child abuse potential, there were significant correlations with the subjects' age (r=.294, p=.002), education level (r=-.442, p=.000), and family income (r=-.355, p=.000). Conclusion: From this study not only child abuse occurrence but also child abuse potential were severely increased in poor livelihood families. Therefore to the high risk group, individual preventive approach must be applied.