• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1216-1220
• /
• 2009

Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

• The KIPS Transactions:PartC
• /
• v.10C no.5
• /
• pp.625-634
• /
• 2003

More than a decade after its initial proposal, deployment of IP Multicast has been limited due to the problem of traffic control in multicast routing, multicast address allocation in global internet, reliable multicast transport techniques etc. Lately, according to increase of multicast application service such as internet broadcast, real time security information service etc., overlay multicast is developed as a new internet multicast technology. In this paper, we describe an overlay multicast protocol and propose fast join mechanism that considers switching of the tree. To find a potential parent, an existing search algorithm descends the tree from the root by one level at a time, and it causes long joining latency. Also, it is try to select the nearest node as a potential parent. However, it can't select the nearest node by the degree limit of the node. As a result, the generated tree has low efficiency. To reduce long joining latency and improve the efficiency of the tree, we propose searching two levels of the tree at a time. This method forwards joining request message to own children node. So, at ordinary times, there is no overhead to keep the tree. But the joining request came, the increasing number of searching messages will reduce a long joining latency. Also searching more nodes will be helpful to construct more efficient trees. In order to evaluate the performance of our fast join mechanism, we measure the metrics such as the search latency and the number of searched node and the number of switching by the number of members and degree limit. The simulation results show that the performance of our mechanism is superior to that of the existing mechanism.

• Progress in Medical Physics
• /
• v.22 no.4
• /
• pp.163-171
• /
• 2011

The purpose of this study was to investigate the effect of various technical parameters for the dose optimization in pediatric chest radiological examinations by evaluating effective dose and effective detective quantum efficiency (eDQE) including the scatter radiation from the object, the blur caused by the focal spot, geometric magnification and detector characteristics. For the tube voltages ranging from 40 to 90 kVp in 10 kVp increments at the FDD of 100, 110, 120, 150, 180 cm, the eDQE was evaluated at the same effective dose. The results showed that the eDQE was largest at 60 kVp when compares the eDQE at different tube voltage. Especially, the eDQE was considerably higher without the use of an anti-scatter grid on equivalent effective dose. This indicates that the reducing the scatter radiation did not compensate for the loss of absorbed effective photons in the grid. When the grid is not used the eDQE increased with increasing FDD because of the greater effective modulation transfer function (eMTF). However, most of major hospitals in Korea employed a short FDD of 100 cm with an anti-scatter grid for the chest radiological examination of a 15 month old infant. As a result, the entrance surface air kerma (ESAK) values for the hospitals of this survey exceeded the Korean DRL (diagnostic reference level) of $100{\mu}Gy$. Therefore, appropriate technical parameters should be established to perform pediatric chest examinations on children of different ages. The results of this study may serve as a baseline to establish detailed reference level of pediatric dose for different ages.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.34 no.1
• /
• pp.66-74
• /
• 2005

This survey was conducted to assess the consumer perceptions of food-related hazard in 500 housewives from all over Korea. The subjects were selected by stratified random sampling method. The survey was performed using structured questionnaire through telephone interview by skilled interviewers. The results showed that 34.6% of the respondents felt secure and were not concerned about food safety, and 65.4% were concerned about food safety. Logistic regression analysis showed that the increasing concern on food brands, food additives (such as food preservatives and artificial color), and imported foodstuffs indicated the current increasing concern on food safety. Other related factors indicating the increasing concern on food safety were education level and care for children's health. The respondents who cared about food safety expressed a high degree of concern on processed foodstuffs such as commercial boxed lunch (93.3%), imported foods (92.7%), fastfoods (89.9%), processed meat products (88.7%), dining out (85.6%), cannery and frozen foods (83.5%), and instant foods (82.0%). The lowest degree of concern was on rice. All the respondents perceived that residues of chemical substances such as pesticides and food additives, and endocrine disrupters were the most potential food risk factors, followed by food-borne pathogens, and GMOs (Genetically Modified Organisms). However, these results were not consistent with scientific judgment. Therefore, more education and information were needed for consumers' awareness of facts and myths about food safety. In addition, the results showed that consumers put lower trust in food products information such as food labels, cultivation methods (organic or not), quality labels, and the place of origin. Nevertheless, the respondents expressed their desire to overcome alienation, and recognized the importance of knowing of the origin or the producers of food. They identified that people who need to take extreme precautions on food contamination were the producers, government officials, food companies, consumers, the consumer's association, and marketers, arranged in the order of highest to lowest. They also believed that the production stage of agriculture was the most important step for improving the level of food safety Therefore, the results indicated that there is a need to introduce safety systems in the production of agricultural products, as follows: Good Agricultural Practice (GAP), Hazard Analysis and Critical Control Point (HACCP), and Traceability System (75).

• Neonatal Medicine
• /
• v.18 no.2
• /
• pp.310-319
• /
• 2011

Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.22 no.1
• /
• pp.23-27
• /
• 2018

Purpose The introduction of bone scan has been reported as a useful tool in the diagnosis, treatment, and treatment response of skeletal disease. The purpose of this study is to improve the anatomical information and tolerance of the bone by combining bone scan and pelvic X-ray without additional radiation exposure. Materials and Methods From November 2015 to August 2016, 236 patients(64 men and 172 women, average age $50.96{\pm}15.39years$) take Bone scan and Pelvis AP(Anteroposterior) X-ray scan at the National Cancer Center. The scan equipment was a gamma camera, Symbia Ecam (SIEMENS, Germany), and a digital x-ray, DRS-800 (Listem, Korea). Osirix version 3.8.1 (Osirix, USA) and Stata/SE version 14.0 (StataCorp, USA) were used for image combination and analysis. The patient was intravenously injected with $^{99m}Tc-DPD$ (740 MBq), and the scan was performed 2 to 4 hours later. Gamma camera image acquisition were Matrix size $256{\times}1024$, Zoom 1.00, and scan speed 17 cm/min. The digital X-ray was made with a collimator size of $14^{{\prime}{\prime}}{\times}17^{{\prime}{\prime}}$, 77 kVp (60 to 97 kVp) and an average of 30 mAs (20 to 48). ASIS and pubic symphysis Select virtual points then Combine three virtual points and pelvic contour lines. The acquired images were evaluated by three radiologists who worked for more than 5 years in the nuclear medicine department. Results Of the total 236 patients, 216 (91.53%) were matched. The median and range (min~max) of the age were 67 (46~81) years old in the unmatched group and 52 (22~87) years old in the matched group, The Wilcoxon rank-sum test was performed to determine whether age was different between the two groups. As a result, the age difference between the two groups was statistically significant at p < 0.0001. Of the 64 men, 60 (93.75%) were match and of the 172 women, 156 (93.75%) were match. There was no statistically significant difference according to gender(p = 0.4542). Of the 54 patients without pelvic lesions, 54 (100.00%) were match, and 162 (89.01%) of 182 patients with pelvic lesions were match. There was a statistically significant difference according to the presence of pelvic lesions. Conclusion There are many variables in the combination of bone scan and pelvic X-ray imaging, and the patient's age and pelvic lesion may have some effect on the image combination. This study is expected to be useful for the diagnosis of pelvic osteosarcoma of children without radiation exposure. It is expected that this combination of images will help to develop the nuclear medicine image.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.14 no.2
• /
• pp.161-170
• /
• 2011

Purpose: The aim of this study was to investigate the feeding patterns, use of dietary supplements, and nutrient intake of Korean toddlers. Methods: We used data for 930 toddlers who participated in the 4th Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2009. Feeding patterns and use of dietary supplements were assessed using standardized questionnaires, and nutrition intake was assessed using the 24 hr recall method. Results: In 2007~2009, 48.7% of toddlers used dietary supplements. Most parents (95.4%) initiated a regime of dietary supplements for their children following the advice of friends or relatives. Only 0.4% of parents followed the advice given by their doctors for dietary supplements use. In the survey of nutrient intake for toddlers, the prevalence of inadequate calcium intake was 53.9% for subjects aged 1 year, 55.2% for 2 years and 65.6% for subjects aged 3 years. The prevalence of inadequate iron intake was 52.0% for subjects aged 1 year, 48.7% for 2 years and 48.4% for subjects aged 3 years. In the survey performed on feeding patterns of toddlers during the infant period, mixed feeding accounted for 57.4%, breast feeding for 32.2%,and formula feeding for 10.4%. Sixty-five percent of toddlers began weaning between 4 and 6 months. Conclusions: This study indicated that a number of toddlers were at risk of inadequate calcium and iron intake. The role of professionals in counseling for qualified dietary intake and dietary supplement use is therefore necessary for Korean toddlers.

• Pediatric Infection and Vaccine
• /
• v.12 no.2
• /
• pp.178-185
• /
• 2005

Purpose : Ocular adnexal and orbital infections are broadly divided into preseptal(periorbital) and postseptal(orbital) cellulitis by orbital septum. In this study, we investigated the difference between periorbital and orbital cellulitis regarding their pathogenesis, clinical manifestations, treatments, and prognosis. Methods : We reviewed medical records of 50 cases who were hospitalized in the Severance hospital due to orbital cellulitis from May 1995 to April 2004. Results : There were 32 males and 18 females. The mean age was $3.2{\pm}3.5$ year. According to the result of orbital computerized tomography, 36 cases were periorbital cellulitis, 10 cases orbital cellulitis and 4 cases not diagnosed. The clinical manifestations of periorbital cellulitis are periorbital swelling(100%), fever(19%), orbital pain(6%), and chemosis(22%). On the other hand, those of orbital cellulitis are periorbital swelling(100%), fever(80%), orbital pain(60%), proptosis(20%), chemosis(70%) and limitation of eye movement(20%). The etiologies of periorbital cellulitis are sinusitis(14%), upper respiratory infection(8%), conjunctivitis (19%), skin wound(14%) and unknown(44%). The etiologies of orbital cellulitis are sinusitis (50%), upper respiratory infection(20%), and unknown(30%). The first line antibiotics used in the majority of cases were combinations of cefoxitin+aminoglycoside. 5 patients with orbital cellulitis taking cefoxitin+aminoglycoside had to change the medication into vancomycin or clindamycin. 3 patients with orbital cellulitis underwent operation while 1 patient developed bacterial meningitis. Conclusion : According to invasion of orbit, ocular adnexal and orbital infections are quite different in their pathogenesis, treatment and prognosis. As atypical cases may confound the diagnosis, prompt orbital computerized tomography is required for an accurate diagnosis.

• Pediatric Infection and Vaccine
• /
• v.12 no.2
• /
• pp.124-134
• /
• 2005

Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

• Pediatric Infection and Vaccine
• /
• v.23 no.1
• /
• pp.10-17
• /
• 2016

Purpose: The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease. Methods: We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed. Results: The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08). Conclusions: The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.