• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.991-997
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• 2005

Purpose : Cow's milk protein-induced enterocolitis(CMPIE) is a symptom complex of vomiting and/or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. Methods : We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. Results : CMPIE was diagnosed in 11 patients(12.8%). On admission, failure to gain weight(P=0.003), hypoalbuminemia(P=0.003), peripheral leukocytosis(P=0.015), and metabolic acidosis(P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight <10 g/day(OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia <3.5 g/dL(OR, 9.18[95% CI, 1.69-49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting(81.8%), abnormal stool test(80.0%), peripheral leukocyte count and absolute neutrophil count(ANC) increase(100.0%) (P<0.05), and enteropathy(100.0%). Conclusion : CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow : failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1021-1028
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• 2009

Purpose:Medical therapy is the initial treatment for children with Graves disease to avoid complications of other treatments. However, optimal treatment for childhood Graves disease is controversial because most patients require relatively long periods of medical therapy and relapse is common after medication discontinuation. Therefore, this study aimed to search clinical or biochemical characteristics that could be used as remission predictors in Graves disease. Methods:We retrospectively studied children diagnosed with Graves disease, treated with anti-thyroid agents, and observed for at least 3 years. Patients were categorized into remission and non-remission groups, and the groups were compared to determine the variables that were predictive of achieving remission. Results:Sixty-four patients were enrolled, of which 37 (57.8%) achieved remission and 27 (42.2%) could not achieve remission until the last visit. Normalization of thyroid-stimulating hormone-binding inhibitory immunoglobulin (TBII) after treatment was faster in the remission group than in the non-remission group (remission group, $15.5{\pm}12.07$ vs. non-remission group, $41.69{\pm}35.70$ months). Thyrotropin-releasing hormone (TRH) stimulation tests were performed in 28 patients. Only 2 (8.3%) of 26 patients who showed normal or hyper-response in TRH stimulation test relapsed. Binary logistic regression analysis identified rapid achievement of TBII normalization after treatment as a significant predictor of remission. Six percent of patients achieved remission within 3 years and 55.8% achieved it within 6 years. Conclusion:Rapid achievement of TBII normalization can be a predictor of remission in childhood Graves disease. The TRH stimulation test can be a predictor of maintenance of remission.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.1
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• pp.15-22
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• 2009

Objectives : Prevalence of postpartum depressive disorders reaches approximately 10-15% of childbearing women. This preliminary study was intended to explore the relationships between postpartum depressive disorders and family adaptability and cohesion. Methods : Childbearing women(n=24) were assessed for risk factors for postpartum depression before and after childbirth prospectively. At gestational age between 36th and 40th week, the questionnaire about various factors before childbirth, Edinburgh postnatal depression scale(EPDS), Family adaptability-cohesion evaluation scale (FACES), and Beck anxiety inventory(BAI) were assessed. After childbirth, for the diagnosis of postpartum depressive disorders, a structured diagnostic interview according to MINI International Neuropsychiatric Interview was performed, furthermore, the questionnaire about various factors after childbirth, EPDS, and BAI were assessed at 4-6 weeks postpartum. Results : Among various factors and scales, family adaptability and cohesion, mood symptom and change during pregnancy were associated with postpartum depressive disorder in comparison with non-postpartum depressive disorder subjects. In addition, low family adaptability and cohesion and mood change during pregnancy were significantly associated factors with postpartum depressive disorder using logistic regression analysis. Conclusion : The results suggest the postpartum depressive disorder could be related with prenatal low family adaptability and cohesion. This preliminary study, however, includes only a few subjects, so that further large-sized study will be needed to replicate our results.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.46-57
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• 2017

This study examined the level of job satisfaction of rescue workers in accordance with the sociodemographic and health related characteristics, as well as job-related factors. Moreover, this study aimed to know the relationship between job satisfaction and violence experience, job stress, and burn-out. A total of 1,240 rescue workers, who works in 14 fire stations across the country, were surveyed. The survey was conducted by self-administered questionnaires during the period between March 1st and April 30, 2016. As a result, the score of job satisfaction according to the sociodemographic and health related characteristics were significantly lower in the younger-aged group, unmarried group, no-regular exercise group, and poor group of subjective sleep evaluation, unhealthy group of subjective health status than their respective counterparts. From the perspective of job-related characteristics, the job satisfaction scores were significantly lower in the groups of lower rank, lower job career, lower monthly income, hard group of physical burden of work, dissatisfaction group of sense of satisfaction in work, unfit group of the job, without group of consider quitting the job than their respective counterparts. The score of job satisfaction, in accordance with violence experience, job stress, and burn-out were significantly lower in groups with higher scores of violence experience, job stress, and burn-out. In a logistic regression analysis, the adjusted odds ratio of the low-risk job satisfaction were significantly increased in the very high group than in the low group of violence experience, in middle, high and very high group than in low group of job stress, in very high group than in low group of burn-out. The results suggest that the job satisfaction of rescue workers is significantly influenced by various factors, including socio-demographic characteristics, health-related behaviors, job-related characteristics, violence experience, job stress, and burn-out.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.2
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• pp.759-764
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• 2011

This study was conducted to provide the basic data for the health management of the primary school, by finding and analyzing the factors affecting the degrees of atopic dermatitis symptom's severeness. The subjects of our study were collected 273 pupils mothers, whose children are undergoing through the atopic symptoms. The investigation process took the entire month of the November in 2006. The result of the older the pupils, the severer their symptoms(p<0.05). The longer the period(p<0.01), the more widely spread over the body, and the severer the symptoms(p<0.01). In the dietary habit, the more meat they eat, the severer the symptom(p<0.05). and in relation to the eating the food outside home, the more frequently they eat the fast-food, the severer the symptom. In the multiple logistic regression analysis, using the degrees of atopic dermatitis symptom's severeness as the dependent variables. it is discovered that the longer infection period they have and the more frequently they have the fast-food, the severer the symptom of the atopic dermatitis. The parent's love for the child, the monthly cost for the management of the infection, and the parent's feeling toward the child, can have a greate influence on the physical health, the feelings and the relation with the friends of the infected child, when the child shows the symptoms of scratching his skin. The conclusions of When all the results above are put together, the dietary habit of eating the meals mostly prepared with the meat should be corrected, and the education to form the pupil's right dietary habit, such as, putting the limit on the fast-food, must be made, in order to prevent the symptom of the atopic dermatitis from getting worse. And by the recognizing the atopic dermatitis as the family health problem, the comprehensive family health management, including the mother should be made.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.288-293
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• 2011

This study was conducted to investigate the elementary school students' consciousness of safety, activities to prevent their accidents and factors causing such accidents. For this aim, a research was conducted from Nov. 19 through Dec. 22, 2007 by means of questionnaires distributed to 800 students enrolled in the 5th and 6th grades of 4 elementary schools in a urban-rural combined city. Out of the questionnaires distributed, 785 were collected and put to analysis by using SPSS 13.0 program to determine t-test, ANOVA, logistic regression, etc. 1. The maximum scores of safety consciousness revealing relatively high level of safety consciousness. There was, however, statistically significant difference by grade, type of residence, school life and academic achievements. In detail, 5th graders featured higher level of safety consciousness and those who live in apartments, lead a pleasant life at school and get better academic scores tended to keep higher level of safety consciousness. 2. The subjects of the high scored of activities to prevent accidents, with a statistically significant difference by gender, grade and individual personality. Females, 5th graders and active students were found to be more conscious of preventive activities for accidents. 3. In general, 6th graders and active students turned out to have experienced more accidents. 4. The main factors exerting influence on occurrence of accidents on the part of elementary school students are known to be preventive actions and consciousness of traffic safety in the category of safety consciousness. The significant variable in preventive actions was preventive actions of traffic accidents, burns and intoxication by category of accidents, but individual personality by category of general characters. Sixth graders and male students experienced more accidents, without significantly significant difference, though. As a result, From the above findings, prevention of safety accidents is found to be very important for elementary school students. It is therefore suggested that schools as well as homes should continue to conduct practical education to prevent accidents with priority placed on familiarizing students with preventive activities in daily life in consideration of their personal characters.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.9
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• pp.5660-5667
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• 2014

The aim of this study was to assess the association of metabolic syndrome, metabolic syndrome score (MSS) and pulse pressure (PP) in Korean adults. The study subjects were Korean adults 20 years or older (n=5,889) who participated in the Korea National Health and Nutrition Examination Survey 2012. After adjusting for factors, such as year and gender and BMI, the mean PP increased with increasing MSS (MSS 0, $41.30{\pm}0.34mmHg$ and MSS 1, $42.16{\pm}0.31mmHg$ and MSS 2, $44.73{\pm}0.34mmHg$ and MSS, 3, $46.46{\pm}0.42mmHg$ and MSS 4, $48.62{\pm}0.58mmHg$ and MSS 5, $53.50{\pm}1.05mmHg$), and the mean PP for metabolic syndrome($47.25{\pm}0.34mmHg$) increased in comparison to Non-Metabolic syndrome ($42.77{\pm}0.19mmHg$). When logistic regression analysis was performed, the odds ratio (OR) of Hyper-PP (61> PP) for MSS 0 was 4.49 in MSS 1 (95% confidence interval[CI], 2.68-7.57) and 8.01 in MSS 2 (95% CI, 4.77-13.47) and 11.37 in MSS 3 (95% CI, 6.67-19.35) and 19.69 in MSS 4 (95% CI, 11.20-34.60) and 34.07 in MSS 5 (95% CI, 17.44-66.52), metabolic syndrome was associated with an increased Hyper-PP(OR 4.6, 95% CI, 2.0-10.4). Conclusion. These results suggest that an increase in MSS or metabolic syndrome might increase the pulse pressure.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.585-590
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• 2003

Purpose : This study is designed to determine the prevalence of cardiovascular autonomic neuropathy and its relationship to risk factors in adolescents with diabetes mellitus(DM). Methods : Ninety-two diabetic patients(80 with type 1 DM and 12 with type 2 DM), ranging from eight to 26 years of age, were studied for cardiovascular autonomic function, and the relationship to age, duration of diabetes, glycated hemoglobin(HbA1c), urinary albumin excretion, and the presence of diabetic retinopathy and abnormal nerve conduction velocities(NCV) were analysed. Autonomic function was assessed by measuring heart rate variation during valsalva manoeuvre, deep breathing and standing from a lying position(30 : 15 ratio), and postural hypotension. Results : Among patients with type 1 DM, 22.5% had early, 8.7% had definite, and 1.3% had severe autonomic dysfunction, and among patients with type 2 DM, 16.7% had early, 8.3% had definite, and 8.3% had severe autonomic dysfunction. On logistic regression analysis including both type 1 and type 2 diabetic patients, the age of the patient(OR=1.133(1.003-1.279), P<0.05) and duration of diabetes(OR=1.148(1.009-1.307), P<0.05) significantly predicted cardiovascular autonomic dysfunction while HbA1c, blood pressure, urinary albumin excretion, and presence of diabetic retinopathy and abnormal NCV did not. The valsalva ratio was borderline or abnormal in 31.5% of patients, the heart rate variation on deep breathing in 41.3%, the 30 : 15 ratio in 14.1%, and postural hypotension in 9.8% of patients. The valsalva ratio and the heart rate variation on deep breathing significantly predicted cardiovascular autonomic dysfunction, but the 30 : 15 ratio and postural hypotension did not. Conclusion : Cardiovascular autonomic dysfunction was found in 32.6% of diabetic patients and 10.8 % of patients had definite or severe involvement. The risk of cardiovascular autonomic dysfunction increased with the patient's age and the duration of DM. This study suggests that the valsalva ratio and the heart rate variation on deep breathing are the most useful tests in evaluating the cardiovascular autonomic function in children and adolescents with DM.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1127-1135
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• 2009

Purpose : To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low- birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL). Methods : In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined. Results : MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-0.99 P=0.036) for noncystic PVL were only significant independently. Conclusion : White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1140-1146
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• 2009

Purpose:The pathophysiology of magnesium, the second highest common compound in humans, is still unclear, especially in preterm babies. We accessed the association between total magnesium (tMg), ionized Mg (iMg), and gestational age (GA) and that between serum magnesium (sMg) and intraventricular hemorrhage (IVH) in preterm babies. Methods:In all, 119 inborn preterm infants admitted between July 2006 and February 2008 were divided into the IVH group (19) and the control group (100) and were prospectively analyzed. TMg, iMg, pH, total calcium (tCa), and ionized Ca (iCa) levels were determined immediately after delivery or within 3 hours after birth, and their correlation with GA were investigated. Results:TMg was not correlated with GA, tCa, iCa, and pH. IMg was correlated with tMg (r=0.288, P=0.002) and iCa (r=0.212, P=0.021); however, it was not correlated with GA and pH. Mean GA and birth weight were significantly lower (P=0.002) and smaller (P=0.030) in the IVH group. Mean sMg was higher in the IVH group ($2.5{\pm}0.9mg/dL$) than in the control group ($2.1{\pm}0.6mg/dL$) (P=0.021). SMg was a risk factor even after logistic regression analysis (OR, 2.798; 95% C.I., 1.265-6.192; P=0.011). Conclusion:In less than 37-week-old preterm babies, tMg and iMg were similar, regardless of GA. High sMg may be a risk factor for IVH in premature babies, regardless of their exposure to antenatal magnesium.