• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.193-198
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• 2014

Purpose: This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope. Methods: To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF). Results: HRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P =0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P =0.015) and normalized HF (61.18 ms vs. 43.19 ms, P =0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P =0.022) and LF/HF ratio (0.76 vs. 1.89, P =0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents. Conclusion: The results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.558-563
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• 2000

The lasers have been used in dentistry for more than 30 years and the application of lasers for drilling dental hard tissue has been investigated since the early developement of lasers. Recently, the Er:YAG laser was invented for hard tissue ablation. The Er:YAG laser, having a wavelength of 2.94um, is highly absorbed in both water and hydroxiapatite, leading to a very effective material for hard tissue removal by bursting off the solid tissue component that is, enamel and dentin are removed by the Er :YAG laser by water vaporization and microexplosion, without any melting of inorganic tissues. Therefore, the Er:YAG laser produced round craters with well defined margins and the surrounding tissues had no cracks and no charring. When used for cavity preparation, pulpal damage should not occur if hear buildup is minimized by careful selection of exposure parameters and by use of a water spray. The present study demonstrated that the Er:YAG laser cut the tooth substance adequately for composite resin restoration, without having undesirable side effects such as harmful effects on the pulp, discoloration or cracking etc. Also, the child patients were well cooperative during laser treatment mainly because of little noise, lesser vibration and minimal pain compared to conventional means of cavity preparation.

• Journal of Haehwa Medicine
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• v.8 no.1
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• pp.865-878
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• 1999

With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.2
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• pp.352-360
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• 1997

It has been reported that There is a relatively high incidence of congenital cleft lip and palate among congenital anomalies. Children with the cleft lip and palate confront various problems ranging from feeding difficulties as infants to frequent ear infections, compromised speech, aberrant dentofacial development, malocclusion and esthetic impairment with its unfavorable effects on the psychosocial adaptation of the individual. Management of these patients is a process that starts in infancy and continues on into adulthood. Through a team approach, professionals from various fields convene to assess the needs of the child and to assist the parents in dealing with the situation. A pediatric dentist, one of the team, must advise the parents the way of feeding or make an obturator for normal feeding and weight gain of infants with cleft lip and/or palate. An obturator can aid nursing, stimulate orofacial development, help develop the palatal shelves, prevent tongue distortions, prevent nasal septum irritation, decrease chance of ear infections, expand collaped maxillary segments, constrict the expanded anterior part of the maxilla, reposition the premaxilla, and help the parents psychologically. Three cases of infants with cleft lip and palate were managed with the obturator at the Dept. of Pediatric Dentistry, Kyung Hee University. In all cases, infants showed normal feeding and weight gaining after the insertion of the obturator.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.225-233
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• 1998

The purpose of this study was to determine the thickness of the cortical bone at the mandibular angle in children and adolescents. The subjects were composed of 153 subjects who were 3 to 17 years of age that had not been history of bone disease or metabolic disease and no dental caries or tooth loss on mandibular molars. The subjects were divided into three age groups, group I (preschool children) was 3 to 5 years of age and grouop II (school children) was 6 to 11 years of age and group III (adolescence) was 12 to 17 years of age. Panoramic radiographs of these patients were collected and measurements of the thickness of the cortical bone were obtained at the mandibular angle. The average thickness of the cortical bone in the group I was 1.01$\pm$0.18 mm in boys and 1.07$\pm$0.22 mm in girls. In the group II was 1.23$\pm$0.18 mm in boys and 1.32$\pm$0.18 mm in girls. In the group III was 1.60$\pm$0.23 mm in boys and 1.58$\pm$0.20 mm in girls. Statistical analyses did not reveal any significant difference between the right or left side of the mandible but difference was exist between the same age groups by sex, especially in group II (p<0.01), except in group III. The greater thickness of cortical bone in the older age group was shown to be statistically significant. The correlation coefficient between age and the thickness of the cortical bone at the mandibular angle showed a high value of r=0.76.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.645-650
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• 2004

Calcifying odontogenic cyst(COC) is a rare developmental odontogenic cyst, which shows diverse classification and terminology. Cystic epithelial lining of COC is composed of basal cell layer of columnar cells and overlying layer of stellate reticulum. In the epithelium, ghost cells that might induce adjacent mesenchymal tissue to develop dental organ are shown characteristically. In spite of low rate of recurrence, we have to get a histopathological examination so that odontogenic lesions may recur without fully curettage of lining epithelium. 7-year-old male child came pediatric dentistry in wonkwang university dental hospital in order to check the delayed eruption of left maxillary central incisor. Radiographic examination revealed a well-defined radiopaque mass, overlapping impacted left central and lateral incisor crown. Enucleated mass was tooth-like features and also had epithelium lining. Results of histopathologic procedure, we saw the lots of ghost cell and proliferating hard dental tissues. Also we saw the cystic epithelium cells. It revealed diagnosis of the COC associated complex odontoma. For this reason one should consider of COC when patients present odontoma-like lesion with impacted tooth.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.428-436
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• 1997

Objectives : The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. Methods : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. Results : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged form 10.8% to 28.8% by area. Conclusions : Invalid diagnosis of cases might overestimate the prevalence of child-hood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.1
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• pp.48-54
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• 2015

Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed. Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated. Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period. Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.17-25
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• 2018

Purpose: Blood culture is an essential diagnostic tool and requires clear indications, proper techniques, and quality control. We aimed to investigate whether blood cultures in children are appropriate for indications, are performed correctly, and receive proper quality control. Methods: We conducted an online survey targeting pediatric infectious diseases (ID) specialists working in general hospitals and neonatologists (Neo) working at hospitals operating a neonatal intensive care unit in Korea. Results: Approximately 81.1% (30/37) of pediatric ID specialists and 72.2% (52/72) of Neo responded to the survey. Some of the respondents (33.3% of ID and 59.6% of Neo) performed blood culture as a regular test irrespective of the indication. Approximately 40% of ID and 65.4% of Neo ordered only one set of blood culture in patients suspected with bacteremia. The most commonly used disinfectant for skin preparation was povidone-iodine, while the skin preparation method varied by institution. Approximately two-thirds of the institutions were monitoring the blood culture contamination rate, whereas relatively few provided staff with feedback on that rate. In addition, less than half of the institutions were providing regular staff training on blood culture (40% of ID and 28.8% of Neo). Conclusions: The indication and methods of blood culture for children varied according to institution, and few hospitals exert effort in improving the quality of blood culture. Institutions have to strive constantly toward improvement of blood culture quality and evidence-based recommendations for pediatric blood cultures should be standardized.