• Kidney Research and Clinical Practice
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• 제36권3호
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• pp.257-263
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• 2017

Background Rituximab (RTX) can be used as a rescue therapy for steroid-dependent nephrotic syndrome (SDNS). However, the efficacy and safety of long-term, repeated use of RTX are not established. This study was conducted to assess the efficacy and safety of long-term, repeated RTX treatment in children. Methods Eighteen consecutive child patients with SDNS who were treated with three or more cycles of RTX for one year or longer were recruited, and their medical records were retrospectively reviewed. Results The patients were followed for $4.7{\pm}1.9years$ and received $5.2{\pm}2.3cycles$ of RTX over $2.8{\pm}1.1years$. Approximately 70% of the additional RTX cycles were administered due to recovery of B-cells without relapse. The relapse rate decreased from $3.4{\pm}2.0per$ year initially to $0.4{\pm}0.8per$ year at the third year after RTX treatment. Approximately 10% of the RTX infusions were accompanied by mild infusion reactions. Eight patients showed sustained remission without any oral medication after the last cycle of RTX, while 10 patients had one or more episodes of relapse after the last cycle of RTX. The relapse rate in the latter group decreased from $2.8{\pm}1.5per$ year before RTX treatment to $1.3{\pm}0.8per$ year after cessation of RTX treatment. No significant differences in clinical parameters were found between the two groups. Conclusion This retrospective study showed that pre-emptive and long-term, repeated RTX treatment is relatively effective and safe in children with SDNS. However, well-designed prospective studies are needed to confirm these findings.

• 대한지역사회영양학회지
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• 제25권6호
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• pp.451-463
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• 2020

Objectives: The purpose of this study was to develop and evaluate booklets and video clips to prevent children from picky eating. Methods: Based on a survey conducted on food preferences of preschool children aged 2 to 5 years, 14 kinds of less preferred vegetables were selected. Accordingly, educational videos, activity books, and teaching-learning guides were produced for preschool children using the 'food bridge' theory, and the educational materials were named "Friendly vegetables". Educational materials were distributed to childcare institutions, and their effectiveness was investigated for preschool children who were instructed on these materials once every 30 days from March to November, 2019. The children were examined for changes in their knowledge of names, colors, taste/texture, methods of cultivation, and preferences for vegetables before and after the instructional course. Results: The awareness of vegetables increased significantly in younger children and the picky eating group. When the assessment was carried out in terms of vegetable knowledge, it was observed that the younger the age or the pickier the in eating food, the more effective the education is compared to the counter part. The preference for vegetables also increased after the instruction compared to the pre-instruction period, but significant changes were seen only in the 2~3 year age group for boys and girls. Also, only the picky group of girls showed changes in preference. The children's average interest in the education materials was 3.85 points out of 5 points. Conclusions: Through this study, we have developed educational materials for standalone use in childcare facilities and confirmed that they have a significant effect on improving awareness and preferences related to vegetables. In summary, the younger the age or the pickier the child in eating food, the more effective the education. It is believed that additional education on mealtime guidance is needed which can alter the eating behavior of preschool children and improve their diet. It is proposed to widen the scope of use of the materials by collecting diverse opinions from child care teachers.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.489-499
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• 2022

Purpose: The survival rate of pediatric patients undergoing liver transplantation has increased considerably. Despite this, the period after transplantation is still complex and poses several challenges to the recipient's family, which is responsible for care management. Recently, more attention has been paid to the impact of this complex procedure on the quality of life of caregivers. Hence, this study is aimed at assessing the quality of life of caregivers of patients who have undergone liver transplantation and the aspects that influence it. Methods: This was an observational and cross-sectional study. From November 2020 to January 2021, short-form-36 questionnaires and additional questions were given to the main caregivers of children and adolescents who underwent pediatric liver transplantation. Results: Thirty-eight questionnaires were completed and the results revealed a lower quality of life in comparison to Brazilian standards, primarily in the mental domains (41.8±14.1 vs. 51.1±2.8; p<0.001). It did not show a significant association with socioeconomic or transplant-related factors, but it did show a negative impact on parents' perception of the child's health. Parents who reported worse health status for their children had a lower mental quality of life (44.1±13.8 vs. 33.3±12.6; p<0.05). Conclusion: The caregivers of transplanted children have a lower quality of life than those of the local population. Psychological assistance should be routinely provided to parents for long-term follow-up to mitigate potential negative effects on the transplanted child's care.

• Pediatric Infection and Vaccine
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• 제28권3호
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• pp.160-167
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• 2021

비장티푸스 살모넬라균에 의한 화농성 척추염은 면역이 정상인 소아청소년에서는 매우 드문 질환으로, 주로 면역저하자나 낫적혈구병과 같은 혈색소병을 가진 환자들이 이 질환의 위험군으로 알려져 있다. 본 증례는 발열과 우상복부 통증으로 내원한 정상 면역을 가진 건강한 13세 청소년에서 대변 배양 검사를 통하여 비장티푸스 살모넬라균을 확인하고, 지속된 발열에 대하여 추가 영상 검사를 통하여 화농성 척추염이 합병되었음을 확인한 증례로, 불명열의 검사로 배양 검사의 중요성을 인식하게 하고, 일반적이지 않은 살모넬라증의 임상경과를 보이는 경우에는 장외 국소감염의 합병증에 대하여 철저하게 조사하는 것이 중요함을 보여준다.

• 한국심리학회지:법
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• 제11권2호
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• pp.117-134
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• 2020

본 연구는 냉담-무정서 특질의 하위요인인 냉담성, 부주의/무신경, 감정표현결여와 부모양육행동, 사회경제적 지위가 소년범죄에 미치는 영향을 살펴보고자 했다. 이를 위해 2016년 7월부터 2017년 3월까지 서울 소재 보호관찰소에서 만 15~17세의 소년법 위반 청소년 103명, 2018년 7월에 수도권 소재 고등학교 1, 2학년 123명의 자기보고식 자료를 수집하였다. 먼저 범죄 유무에 따라 주요 변인의 차이를 살펴본 결과, 범죄 집단이 일반 집단에 비해 냉담-무정서 특질의 부주의/무신경이 더 높았고, 사회경제적 지위가 더 낮았다. 또한, 두 집단 모두에서 냉담-무정서 특질 중 유일하게 부주의/무신경이 부모의 수용, 일상생활 모니터링과 유의미한 부적 상관을 나타냈다. 마지막으로, 부주의/무신경과 가정의 경제 수준이 소년범죄를 유의미하게 예측하였다. 이러한 결과는 냉담-무정서 특질이 높은 청소년은 범죄 유무와 상관없이 부모의 긍정적인 양육행동을 적게 지각함을 보여주며, 부주의/무신경과 가정의 경제 수준이 소년범죄의 발생에 기여하는 잠재적 요인임을 시사한다.

• Human Ecology Research
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• 제61권3호
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• pp.429-443
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• 2023

The purpose of this study was to investigate whether internal control, autonomous motivation of middle school students, and perceived parental pressure on academic performance affect academic procrastination, while verifying the moderating roles of autonomous motivation and parental pressure on academic performance. The participants were a total of 371 middle school students. Academic procrastination, internal control, autonomous motivation, and parental pressure on academic performance were measured using the Procrastination Inventory (Aitken, 1982) revised by Jeon and Park (2014), the Internal-External Control Scale (Ko, 2014), the Academic Self-Regulation Questionnaire (Ryan & Connell, 1989) revised by Kim (2002), and the Scale of Kang (2003), respectively. The collected data was analyzed using SPSS 26.0 and a Process Macro Model 2 (multiple additional modulation effect). The results of the study are summarized as follows. First, middle school students' internal control, autonomous motivation, and perceived parental pressure on academic performance directly affected the students's academic procrastination. Second, the moderating role of parental pressure on academic performance was significant. On the other hand, the moderating role of autonomous motivation was not significant. In conclusion, the results of this study suggest that in order to reduce and prevent academic procrastination it is important to improve internal control by helping middle school students become confident enough to believe that they have the ability to change their behavior and achieve their aims. At the same time, parents need to be interested in the process rather than only the academic performance of their children and support their autonomy.

• Clinical and Experimental Pediatrics
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• 제59권12호
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• pp.483-489
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• 2016

Purpose: We investigated the number of test takers of the Korean-Developmental Screening Test (K-DST) in a single children's hospital within a year, according to age, referral rate, and follow-up percentage. Methods: For this study, 4,062 children who visited and received K-DST at Woorisoa Children's Hospital between January and December 2015 were enrolled. Seven test sets were used according to the Korean National Health Screening Program for infants and children in the following age groups: 4 to 6, 9 to 12, 18 to 24, 30 to 36, 42 to 48, 54 to 60, and 66 to 71 months. The results of the K-DST were categorized into 4 groups as follows: further evaluation (<-2 standard deviation [-2SD]), follow-up test (-2SD to -1SD), peer level (-1SD to 1SD), and high level (>1SD). Results: The test participants' population and follow-up population were concentrated before the age of 24 months (2,532, 62.3%). The children most commonly referred for further evaluation were those in the 30- to 41-month age group. A mismatch was found between the results of the K-DST and the additional questions. Most of the infants and children with suspicious developmental delays showed catch-up development in their follow-up tests (43 of 55, 78.2%). Conclusion: The use of K-DST should be encouraged, especially among children aged over 24 months. Multiple-choice question format for the additional questions is recommended to avoid confusion. We suggest a nationwide study to evaluate and revise the K-DST.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권1호
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• pp.61-69
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• 2022

Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권1호
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• pp.23-33
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• 2023

Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life. Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/ behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges. Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity. Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

• Hip & pelvis
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• 제35권2호
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• pp.73-87
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• 2023

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.