• Childhood Kidney Diseases
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• v.11 no.2
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• pp.229-238
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• 2007

Purpose : Since the first febrile UTI(urinary tract infection) in infants is commonly associated with vesicoureteral reflux(VUR), imaging studies such as renal ultrasonography, dimercaptosuccinic acid(DMSA) scan, and voiding cystourethrography(VCUG) are recommended. How-ever, because of the invasiveness of VCUG, it is difficult to perform in all young infants with febrile UTI. The purpose of this study is to compare the clinical and laboratory characteristics, radiologic findings between the young infant group(1 to 6month, n=121) and the old infant group(7 to 24months, n=91), and to determine the clinical and radiologic risk factors that predict the presence of VUR before the VCUG in patients with their first febrile UTI under 2 years of age. Methods : We reviewed the medical records of 211 first febrile UTI patients under 2 years of age retrospectively, and compared clinical, laboratory, and radiologic findings between the two age groups. Results : The young infant group had a male preponderance and a higher incidence of Escherichia coli in their urine culture. The incidence of acute renal parenchymal defects on DMSA scans were significantly increased in the young infant group. The incidence of VUR was 29% in patients who had a VCUG, but there were no differences in the incidence of VUR between the two age groups. Abnormal findings on DMSA scan significantly correlated with higher incidence of VUR in the young infant group. Incidence of abnormal findings DMSA scan significantly increased with high grade VUR(garde III-V ). Conclusion : In treating first febrile UTI patients under 2 years, physicians have to consider such characteristics as age less than 6 months, male preponderance, E.coli in the urine culture, and increased incidence of abnormal findings on DMSA scans which correlated well with the presence of VUR. The results of the DMSA scan might help us to predict the presence of VUR before the VCUG in first febrile UTI and help us to reduce performing invasive radio-logic studies especially in the young infant group. (J Korean Soc Pediatr Nephrol 2007;11:229-238)

• Journal of the Korean Society of Food Culture
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• v.7 no.4
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• pp.309-321
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• 1992

A study was designed to assess the current status of infant feeding and weaning practice through an retrospective survey on feeding method, a period of weaning and various kinds of weaning food. Analysing a few influential environmental factors while assessing the level of knowledge today's mothers have on infant nutrition. The results are as follows: 1. As random samples for this study, a total of 516 mothers having infants under the age of 3 were surveyed. Among them, 235 were from Seoul and 281 were from Kyongi province (Yongin, Suwon, Bupyong, Poil, Kihung, Ansan(Chungbuk)). 2. Among the infants who fell under the category of normality (Kaup index $15{\sim}18$), the infants from Seoul area amounted to 60.7%, surpassing the percentage of the infants from Kyongi province, 41.9%. The percentage of the infants belong to a group of under nutrition (Kaup index <13) was relatively higher than that of the infants in a group of overnutrition (Kaup index >20). 3. 16.1% of mother surveyed were breast-fed, 54.6% were formula-fed and 29.3% were mixed-fed. The result indicated that the percentage of breast-fed infants of high-educated, working mothers were relatively lower than those of low-educated housewives. 4. Most of the respondents knew the significance or the necessity of supplementary food in terms of weaning. 5. 98.8% of those surveyed responded that the mother's adequate knowledge on weaning was necessary. 70.1% of them replied that they wanted to get various and in-depth information in printed materials such as books or other kinds of publications. They, also showed deep interest in recipe of weaning food. 6. The average period when those surveyed began weaning of their infants was $4.3{\pm}1.8$ months. The tendency of earlier weaning in 3 months was founded among 41.1% of them. About half of the respondents, 52.3%, started weaning of their infants in $4{\sim}6$ months. In overall, 93.4% of them set on weaning in less than 6 months after babies were born. The survey, in addition, revealed an interesting fact that earlier weaning of infants was shown in the group of high-educated mothers. 7. According to the study, finishing period of weaning was $13.3{\pm}5.4$ months on average. Only 38.9% of the respondents ended weaning of their infants in 12 months, the proper period recommended by renowned experts. In general, the infants on formula-feeding finished their weaning later than those on breast-feeding (p<0.05).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.93-97
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• 2014

Purpose: Gastroesophageal reflux in infant is a physiological process. However, surgery is performed in high risk infants with severe gastroesophageal reflux disease (GERD) when medical management fails. This study focuses on efficacy and safety of Nissen fundoplication for GERD in infants under age 12 months. Methods: This study was a retrospective case analysis of 11 neonates and infants under 12 months of age who underwent Nissen fundoplication following a failure of medical treatment between June 2010 and June 2013 at Pusan National University Children's Hospital. The records were reviewed to determine the effect of fundoplication on symptoms and post-operative complications. Results: A total of 11 infants consist of four males and seven females. Mean birth weight was $2,305.5{\pm}558.6g$ (1,390-3,130 g). They had some underlying disease, which are not related with GERD such as congenital heart disease (54.5%), prematurity (45.5%), neurologic disease (18.2%), respiratory disease (18.2%), and other gastrointestinal disease. Mean body weight at surgery was $3,803.6{\pm}1,864.9g$ (1,938.7-5,668.5 g). Mean age at operation was $99.9{\pm}107.6days$ (17-276 days). Duration from operation to full enteral feeding was 10.9 days. Symptoms related GERD disappeared in all patients including one who got reoperation. One infant died of congenital heart disease unrelated to surgery. There were no complications related to fundoplication. Conclusion: Fundoplication is effective and safe treatment in the neonates and infants with severe GERD.

• 모자간호학회지
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• v.3 no.2
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• pp.153-165
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• 1993

This study presents results of surveys conducted Seoul area using structured questionnaire developed by researchers to determine the degree of recognition and practice of breast-feeding. The subjects were mothers of 255 childs 1-36 months of age who have experienced breast feeding over one month. Recognition of breastfeeding was significantly associated with "baby's health", "emotional relationship between mother and infant", "mother's health", "for economic reasons". The majority of mothers got information of breastfeeding through booklets(64.7%), from her mothers(44.7%), through T.V or Radio (45.5%), School education(41.6%) from mother in law(36.5%), and did not perceive professional advice from nurses or doctors as important. "Lack of milk" was the predominant reason for for terminating breastfeeding. Efforts for practice of breastfeeding was comparatively high because of experienced mothers of breastfeeding. Some of them were "frying to take liguid diet and nurtitional food for increasing secretion of milk", "fed on by infant-demanded schedule". Duration of breastfeeding was under on month (31.0%), 1-3 months(25.5%), 3-6 months(19.6%), 6-9 months (11.0%). Degree of recognition and practice of breastfeeding was significantly correlated with mother's educational background, location of delivary(big hopital), Rooming in, over 5 months of breastfeeding. Based on the results of this study, we suggest that effective and supportive breastfeeding program developed by nurses have to provide to mothers of infants to take an important role in breastfeeding.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.58-63
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• 2018

Purpose: We observed an association between obesity and UTI in infants and pediatric patients, which we aimed to validate in this study. Method: The medical records of 740 patients (${\leq}24$ months old) hospitalized with fever were retrospectively analyzed. The patients were subdivided into 2 groups, namely, the UTI and control (non UTI) groups. We analyzed the patient's height, weight. Obesity was defined as weight-for-length ${\geq}95^{th}$ percentile, and the association between obesity and UTI was evaluated. Results: Out of 740 patients, 253 and 487 patients were in the UTI group and the control group, respectively. A comparative analysis, based on 3 age groups (0-5 months, 6-11 months, and 12-24 months) showed higher proportion of obesity in the UTI group (26.4%) than in the control group (13.0%) in the 0-5months group. After adjusting for age and gender in the 0-5month group, the obesity group was 3.76 times likely to have an UTI (95% CI 1.419-9.98). Conclusion: Obesity and UTI show strong association, especially in infants aged 0-5 months. Febrile obese infant patients (${\leq}5$ months old) visiting medical centers should be advised urine tests for potential UTI.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.136-142
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• 2015

Purpose: Although the American Academy of Pediatrics provides clinical guidelines for urinary tract infection (UTI) infants, guidelines are not appropriate for neonates and infants less than 2 months of age due to insufficient data. The aim of this study was to evaluate the characteristics of neonates and young infants less than 2 months old (group 1) with UTI compared to older infants from 2 to 12 months old (group 2). Methods: We reviewed UTI patients aged 0 to 12 months admitted to the pediatric department in the last 5 years. Clinical characteristics such as age, sex, fever duration, recurrence, progression to acute pyelonephritis (APN), malformations like hydronephrosis and vesicoureteral reflux (VUR), and laboratory results were compared between group 1 and group 2. Results: 615 patients were included in this study. Group 1 had 94 cases and group 2 had 521 cases. Escherichia coli was the most commonly isolated pathogen in urine cultures. Fever duration was shorter in group 1 (vs.) 2 ($1.91{\pm}1.43$ days vs. $3.42{\pm}2.40$ days, P<0.05). As compared to group 2, group 1 had a higher proportion of patients with antenatal hydronephrosis and hydronephrosis found after admission (10.6% vs. 3.6% and 75.5% vs. 55.9%, P<0.05). There were differences between two groups in white blood cell (WBC) count (Group 1: $13,694{\pm}5,315/{\mu}L$, Group 2: $15,271{\pm}6,130/{\mu}L$, P<0.05) and C-reactive protein (Group 1: $32.02{\pm}35.17mg/L$, Group 2: $46.51{\pm}46.63mg/L$, P<0.05). Conclusion: Compared to older infants, UTI in neonates and young infants shows milder clinical manifestations except higher rates of hydronephrosis but outcome is alike.

• Korean Parent-Child Health Journal
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• v.8 no.2
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• pp.123-136
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• 2005

This research is to compare the infant's temperament and parenting stress perceived by premature infants' mother and full-term infants' mother. It aims at establishing the healthy relationship between mothers and infants. It investigates the basic data of nursing intervention program to help the mother of premature infant. The period of data collection was from May 1, 2005 to May 30, 2005, and the subjects were total 123 mothers: 44 mothers of premature infants and 79 mothers of full-term infants under 6 months who visited general hospitals, individual pediatrics, and health center located in G city. "What My Baby Is Like(WBL)" developed by Pridham, Chang, and Chiu(1994) and translated by Bang Kyeong Sook(1999) was used as a measuring instrument of infants' temperament, and Parenting Stress Index (PSI) developed by Abidin(1990) and revised and complemented by Kim Dong Hee(1997) was used as a measuring instrument of parenting stress. Collected Data were analyzed through $X^2$-test, t-test, Pearson's correlation with SPSS 12.0 window program. The results are as follows: 1. There was a significant difference in the infant's temperament perceived by premature infants' mothers and full-term infants' mothers (t=-4.08, p=.00). In subcategory, there were significant difference between premature infants' mother and full-term infants' mother in geniality(t=-3.62, p=.00), adaptation(t=-3.43, p=.00) and reaction(t=-2.01, p=.05). 2. There was a significant difference in parenting stress between premature infants' mother and full-term infants' mother(t=6.57, p=.00). The parenting stress of premature infants mothers appeared to be higher than full-term infants' mothers. They showed the higher stress in the mother-child relationship area(t=6.27, p=.00) and child area(t=7.38, p=.00) among 3 areas of parenting stress. 3. There were negative correlation between infants' temperament and parenting stress. As mothers perceived the infant's temperament negatively, the parenting stress. Especially, the negative correlation of infants' temperament and parenting stress of premature infants' mothers(r=-.44) was stronger than that of full-term infants' mothers(r=-37). From the research, as mothers of premature infants receive more stress, their stress can cause the serious problem to the relationship of the mother and the infant. Therefore, the nursing intervention should be carried out in order to change the negative perception of mothers towards their infants into the positive perception reduce the parenting stress.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.100-104
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• 2005

Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.285-290
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• 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.278-286
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• 2006

Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.