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Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

A Survey on Attitudes Toward Science and Science Teaching Among the Secondary School Science Teachers (과학(科學)과 과학교육(科學敎育)에 대한 중등과학교사(中等科學敎師)의 태도(態度) 조사연구(調査硏究))

  • Pak, Sung-Jae;Lee, Hi-Sung
    • Journal of The Korean Association For Science Education
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    • v.4 no.1
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    • pp.1-14
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    • 1984
  • The student's attitude toward science is generally influenced by their teachers. Therefore, teachers' positive attitudes toward science and science teaching play an important role to change the student's attitude toward science. The purpose of this survey is to investigate the status on attitudes toward science and science teaching among the secondary school science teachers in Korea. The attitudes were surveyed by the questionnaire which was developed by Sung-Jae Pak. The instrument is designed to use Likert type scale and is composed of two kinds of scale: one is the attitudes toward science scale (the AT scale) and the other is the attitudes toward science teaching scale (the AT Kale), which contains 24 questions respectively. Each of them has 6 sub-level areas. The six areas of attitude toward science are as follow: The goals and values, process and method of science, knowledge and the view of nature, social and cultural aspects, scientist and a career in science, the preferences and willingness. The six areas of attitude toward science teaching are as follow: The goals and values, process and method of science teaching, the content and structure, social and cultural aspects, science educator and a career in science teaching, satisfaction and willingness. From 152 teachers' responses, the tendency of total as well as each area and the contrast of their backgrounds at the level of 5% significance were analyzed by SPSS computer program. Some results and conclusion of the study are as follow: 1. The overall attitude of the measured secondary school science teachers shows a positive trend tendency. Also total positive attitude toward science teaching are slightly higher than that of science, which support the fact that the teachers are not scientists but they are directly involved in teaching of science. 2. The attitudes toward science are moderately correlated to the attitudes toward science teaching (r=0.52). 3. The areas of knowledge, nature-view and tile area of social aspects of science show a very negative tendency. Also the two areas are not correlated to some other areal at the level at 5% significance. 4. Female science teachers exhibit just a little more positive attitudes than those of male teachers in science teaching. 5. The science teachers who wanted to have a profession of scholar or educator exhibit a little more positive attitudes than others in science and total attitudes (AS+AT). 6. The more the science teachers have "intellectual delights" the more their attitudes toward science and science teaching are positive. 7. At the level of 5% significance, there are differences which college they graduated from, but there are no differences in multiple comparison at 10% level. 8. The differences in their background dose not appear in such as age; teaching career; academic career; deny the superstition; their onlook for the scientist or educator when they were freshmen; major the basic science; opinions about the U.F.O. and the origin of life. 9. The responses of certain individual statement are quite different from the overall tendencies, which strongly suggest the de1ailed analysis and deeper study. For the continuing study, it is recommendable to revile the measuring tools with the theoretical study for the better validity and reliability, and investigate the status of the attitudes toward science and science teaching among the science teachers with sufficient samples.

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Analysis of Experiments for the Rules of Material Change Unit in 9th Grade Science Textbooks and the Development of Experiments Applying Small-Scale Chemistry (9학년 과학교과서 물질변화에서의 규칙성 단원 실험 분석과 Small-Scale Chemistry를 적용한 실험 개발)

  • Ryu, Ran-Yeong;Kim, Dong-Jin;Hwang, Hyun-Sook;Park, Se-Yeol;Lee, Sang-Kwon;Park, Kuk-Tae
    • Journal of the Korean Chemical Society
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    • v.55 no.3
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    • pp.529-540
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    • 2011
  • The purpose of this study was to analyze experiments for the rules of material change unit in 9th grade science textbooks and develop experiments applying small-scale chemistry (SSC). For this study, experimental methods for the precipitation experiment, water electrolysis experiment, decomposition of hydrogen peroxide experiment presented in the 9 science textbooks were analyzed. Problems and improvements that were needed were extracted by 13 science teachers performing the experiments. Experiments applying SSC were developed based on the improvements needed. Afterwards, 19 pre-service science teachers performed both the developed SSC experiments and the science textbooks' experiments. A questionnaire about merits and demerits of the experiments applying SSC was performed. According to the results of this study, most of the 9th grade science textbooks included the lead iodide precipitation experiment, water electrolysis experiment by Hoffman voltameter, and decomposition of hydrogen peroxide experiment using catalytic manganese dioxide. Improvements were needed on the quantity of reagents, time for performing experiments, and scale of experimental apparatus. Merits of the developed experiments applying SSC which used small amount of reagents were safety, easy waste material disposal, short reaction time, and reproducible experimental results. Demerits of the experiments applying SSC were difficulty in observing, decreased achievement, and lack of skill in handling small-scale apparatus. Therefore, if the experiments developed applying SSC were to be utilized in 9th grade science experiments, it will be possible to use less reagent and be able to teach and carry out reproducible experiments at the same time. Also, the reproducible experiments based on SSC will help students under stand the scientific concepts for the rules of material change unit.

Shear bond strength of metal orthodontic brackets bonded with Self-Etching Primer (Self-etching primer를 이용하여 접착된 교정용 브라켓의 전단결합강도)

  • Ahn, Yun-Pyo;Kim, Hyo-Young;Jeon, Young-Mi;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.51-61
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    • 2003
  • The purpose of this study was to evaluate the effects of a self-etching primer on the shear bond strength of orthodontic brackets and on the failure pattern of bracket-adhesive interfaces in dry or wet condition. Brackets were bonded to extracted human teeth according to one of three experimental protocols. In the Group P, teeth were etched with $37\%$ phosphoric acid. After the Transbond XT Primer was applied onto the etched surfaces, the brackets were bonded with Transbond XT(3M, Unitek, Monrovia, Calif) and light cured for 40 seconds. In the Group SD, a self-etching primer(3M, Unitek, Monrovia, Calif) was placed on the enamel for 3 seconds and gently evaporated with air, as suggested by the manufacturer. The brackets were then bonded with Transbond XT as in the Group P In the Group SW, artificial saliva was applied to the enamel surface for 10 seconds to allow complete hydration of the surface before application self-etching primer The brackets were then bonded following the procedures of Group SD. Each group was divided into 2 sub-groups(0.5h, 24h) according to debonding time. Shear bond strengths were measured by Instron universal testing machine. After debonding, the teeth and brackets were examined under scanning electron microscope and assessed with the adhesive remnant index. The result obtained were summarized as follows ; 1. The shear bond strengths were high enough to use clinically in all testing groups, but the shear bond strengths of Group SD and SW were significantly lower than Group P(p<0.05). 2. With respect to comparison of debonding time, 24h debonding samples exhibited heigher shear bond strength than 0.5h debonding samples in Group P, SD and SW(p<0.05). 3. In the self etching primer groups(Group SD and Group SW), there was no significant difference in mean shear bond strength between under dry and wet state(p>0.05). 4. There was a greater frequency of ARI score of 0 and 1 with the Group P. On the other hand, there was a higher frequency of ARI scores of 2 and 3 with Group SD and Group SW(p<0.05).

A Review of the Systemic Analysis Method on Dental Sedation for Children (소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰)

  • An, Soyoun;Lee, Jewoo;Kim, Seungoh;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.331-339
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    • 2015
  • The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

Removal of Methyl tert-Butyl Ether (MTBE) by Modified Fenton Process for in-situ Remediation (Methyl tert-Butyl Ether(MTBE)의 in-situ Remediation을 위한 Modified Fenton Process에 관한 연구)

  • Chung, Young-Wook;Seo, Seung-Won;Kim, Min-Kyoung;Lee, Jong-Yeol;Kong, Sung-Ho
    • Journal of Soil and Groundwater Environment
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    • v.12 no.2
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    • pp.27-36
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    • 2007
  • A recent study showed that MTBE can be degraded by Fenton's Reagent (FR). The treatment of MTBE with FR, however, has a definite limitation of extremely low pH requirement (optimum pH $3{\sim}4$) that makes the process impracticable under neutral pH condition on which the ferrous ion precipitate forming salt with hydroxyl anion, which result in the diminishment of the Fenton reaction and incompatible with biological treatment. Consequently, this process using only FR is not suitable for in-situ remediation of MTBE. In order to overcome this limitation, modified Fenton process using NTA, oxalate, and acetate as chelating reagents was introduced into this study. Modified Fenton reaction, available at near neutral pH, has been researched for the purpose of obtaining high performance of oxidation efficiency with stabilized ferrous or ferric ion by chelating agent. In the MTBE degradation experiment with modified Fenton reaction, it was observed that this reaction was influenced by some factors such as concentrations of ferric ion, hydrogen peroxide, and each chelating agent and pH. Six potential chelators including oxalate, succinate, acetate, citrate, NTA, and EDTA were tested to identify an appropriate chelator. Among them, oxalate, acetate, and NTA were selected based on their remediation efficiency and biodegradability of each chelator. Using NTA, the best result was obtained, showing more than 99.9% of MTBE degradation after 30 min at pH 7; the initial concentration of hydrogen peroxide, NTA, and ferric ion were 1470 mM, 6 mM, and 2 mM, respectively. Under the same experimental condition, the removal of MTBE using oxalate and acetate were 91.3% and 75.8%, respectively. Optimum concentration of iron ion were 3 mM using oxalate which showed the greatest removal efficiency. In case of acetate, $[MTBE]_0$ decreased gradually when concentration of iron ion increased above 5 mM. In this research, it was showed that modified Fenton reaction is proper for in-situ remediation of MTBE with great efficiency and the application of chelatimg agents, such as NTA, was able to make the ferric ion stable even at near neutral pH. In consequence, the outcomes of this study clearly showed that the modified Fenton process successfully coped with the limitation of the low pH requirement. Furthermore, the introduction of low molecular weight organic acids makes the process more available since these compounds have distinguishable biodegradability and it may be able to use natural iron mineral as catalyst for in situ remediation, so as to produce hydroxyl radical without the additional injection of ferric ion.

Current Status of Children on Peritoneal Dialysis in Korea : A Cross-Sectional Multicenter Study (소아복막투석의 현황: 다기관 공동연구 결과보고)

  • Youn, Ji-Seok;Lee, Joo-Hoon;Park, Young-Seo;Yim, Hyung-Eun;Paik, Kyung-Hoon;Yoo, Kee-Hwan;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.176-188
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    • 2009
  • Purpose : Peritoneal dialysis (PD) is the major form of dialysis in use for infants and children with end-stage renal disease (ESRD). The aim of this study was to gain insight into the current status of children on PD in Korea. Methods : In May 2008, questionnaires were sent to the pediatric nephrologists via e-mail. Four centers replied and those data were reviewed. Results : A total of 103 patients were included in this study. Male to female ratio was 1.6:1. Mean age was $11.5{\pm}4.9$ years (0-19 years). Primary renal diseases diagnosed were as follows: primary glomerular disease (34%), chronic pyelonephritis-reflux nephropathy (14.6%), systemic disease (9.7%), renal hypoplasia/dysplasia (8.7%), heredofamilial disease (6.8%), vascular disease (3.9%), drug-induced nephropathy (1.0%), and unknown (12.6%). PD modalities were as follows: CAPD (42.7%), CCPD (27.2%), NIPD (11.7%), and Hybrid (18.4%). Weekly total Kt/V was $2.1{\pm}0.7$ (0.3-4.1). Results of peritoneal equilibrium test were as follows: low 36.8%, low average 31.6%, high average 19.7%, and high 11.8%. Z-score for weight was $-1.00{\pm}1.20$ (-4.54~+2.50). Z-score for height was $-1.55{\pm}1.65$ (-9.42~+1.87). Growth hormone was administered in 24.3% of patients. Anti-hypertensive drugs were administered in 64.0% of patients. Laboratory findings were as follows: hemoglobin $10.5{\pm}1.4$ g/dL, calcium $9.7{\pm}0.7$ mg/dL, phosphorus $5.4{\pm}1.4$ mg/dL, and parathyroid hormone $324.2{\pm}342.8$ pg/mL. Conclusion : Primary glomerular disease was the most common cause of ESRD. CAPD was the most prevalent PD modality. Low and low average peritoneal transport type were common. Growth disturbance were noted in many patients. Some patients had hypertension even with anti- hypertensive drugs. Calcium-phosphorus levels were maintained adequately, but many patients had secondary hyperparathyroidism.

A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

Use of herbal medicine in epileptic children (소아 간질 환자에서 한약 복용 실태)

  • Lee, Jee Yeon;Choi, Wook Sun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.415-419
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    • 2008
  • Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

The Usefulness Assessment of Verifying Daily Output by Using CHECKMATE$^{TM}$ (CHECKMATE$^{TM}$를 이용한 일일 출력 검증의 유용성 평가)

  • Cho, Han-Sang;Nam, Sang-Soo;Park, Hae-Jin;Kim, Mi-Hwa;Park, An-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.51-58
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    • 2011
  • Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

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