• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.94-101
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• 2024

Purpose: Coronavirus disease 2019 (COVID-19) has posed a significant burden to infant and toddler's care globally, while the disease severity is generally mild in this age group. In this study, we aimed to assess epidemiological and clinical aspects of COVID-19 in infants and toddlers in Seoul, South Korea. Methods: We used Seoul Metropolitan Government's epidemiological investigation database to describe the epidemiological and clinical characteristics of COVID-19 in infants and toddlers, between March 2020 to December 2021. Results: A total of 5,025 infants and toddlers aged <5 years was diagnosed between the observed period. 2,720 (54.1%) had symptoms, and fever was the most common symptom in 1,941 (74.1%). Of the diagnosed cases, 96.4% did not have underlying diseases. In a district level, extended opening of childcare facility was associated with increased risk of COVID-19 in infants and toddlers. Conclusions: An efficient monitoring system, resembling routine clinical care, is crucial, considering the low rates of severe progression and fatality among infants and toddlers. Moreover, a well-grounded intervention based on scientific evidence, rather than unconditional closures, is necessary to establish a suitable childcare policy that ensures safety from infectious diseases while not overlooking the developmental aspects of social skills.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.187-193
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• 2024

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.55-84
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• 2015

The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.268-272
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• 2006

Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.122-129
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• 2005

Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

• The Korean Society of Law and Medicine
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• v.22 no.3
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• pp.57-95
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• 2021

Korea's period for preservation of embryos is up to five years (the Bioethics Act). However, the study reviewed domestic and foreign laws and drew issues due to the recent demand that the development of related science and technology and the period limitation limit the rights of consent holder for embryo production. the first issue is that preserved embryos are intended for pregnancy, and it is important to ensure that the autonomy of the consent holder is protected through careful consideration based on information such as scientific evidence. the second is that regulations regarding the obligation to manage embryonic preservation institutions are needed. the third is to create a social atmosphere in which embryo creation, preservation, and disposal take place in a minimum range, considering the special status of embryos. based on this issue, the first of the proposals for rational improvement of the regulation and system about embryo preservation is the introduction of an environment in which sufficient explanation and appropriate consent can be exercised and to extend the reasons for the extension of the period, rather than specifying the specific period in law. the second is that institutionalization is necessary considering not only the obligation to manage preservation institutions but also the overall site, such as concerns that may arise as a result. lastly, we propose the introduction of a management method considering the future use of embryos, such as transfer to provide research purposes and donation of pregnancy purposes by others. this process should be a method of sufficient social discussion and consensus, as well as a general consideration of the family relationship with the born child.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.455-459
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• 2012

Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

• Journal of forensic and investigative science
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• v.2 no.1
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• pp.32-51
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• 2007

Serial violent crimes have occurred more frequently. Additional attention is paid to relevant areas in which discussions has also increased. This study analyzed Young-cheol Yoo, serial killer case. Two of Yoo's crimes were studied for modus operandi. The cases selected were the premeditated break-in homicide of upper-class elderly people and the impulsive homicide of the Hwanghak-Dong street vendor. Crime motives, targets, times, places, means and methods were analyzed. Profiling techniques in Young-cheol Yoo cases were evaluated and the problems discovered during investigation were discussed. The followings are the findings of the analysis of the serial killer Yoo cases. Yoo exhibited a hatred toward the rich, the elderly, and women as well as a fear of diseases and death. Yoo's crime targets were the elderly residing in wealthy houses, street vendors and prostitutes. The numbers of victims were: 3 men and 5 women victims in 4 homicide cases involving the elderly residents in wealthy houses; one man in 1 street vendor homicide case 11 women in 11 prostitute homicide cases, so total 20 persons were murdered in 16 cases. The time of the crimes were between 10 am and noon in the homicide cases of the elderly and very late at night or early in the morning in the prostitute homicide cases. Means and methods facilitated include the use of a knife as a threat and a hammer made by Yoo to strike the head and face of victims. In the homicide cases involving the elderly, he attempted to disguise the crime scene as a burglary or committed arson to destroy the evidence; in the prostitute homicide cases, bodies were mutilated and buried in secret. 1) Generally each serial killer case has different characteristics, motives, and purposes; while some serial killer cases involve similar methods, others use different methods. Unlike other crimes, serial killers' characteristics and tastes are very different, so it is difficult to explain serial killings based on a specific model. It is important to accurately capture modus operandi of each serial killing and for detectives to familiarize themselves with them. The process of tracing and use of imagination which follows a serial killer's psychology and thought must be used to find out what kind of thoughts pushed the killer to commit the crime. In order to investigate and research difficult subjects such as serial killing, various methods, skills, and relevant knowledge should be studied, and institutional endeavors should go hand in hand with individual efforts.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.91-98
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• 2007

Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.47-52
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• 1999

Purpose : The purpose of this study was aimed to evaluate the BOLD(blood oxygen level dependent) contrast fMRI(functional MR imaging) in the occipital lobe and to compare with the metabolic changes based on H MRS (MR spectroscopy) and MRSI (MR spectroscopic imaging) before and after visual stimulation Materials and Methods : Healthy human volunteers (eight males and two females with 24-30 year age) participated in this study. All of the BOLD fMRI were acquired on a 1.5T MR with EPI during supervised visual stimulation in the occipital lobe. The red flicker with 8Hz was used for visual stimulation. After imaging acquisition, the MR images were transferred into unix workstation and processed with acquired from the same location based on the activation map. MRSI (magnetic resonance spectroscopic imaging) was also acquired to analyze the lactate changes before and after stimulation. Results : The activation maps were successfully produced by BOLD effect due to visual stimulation. NAA (N-acetyle aspartate)/Cr (creatine) ratio varied only from $1.79{\pm}0.28{\;}to{\;}1.88{\pm}0.20$ in activation area before and after stimulation. However, the signal intensity of lactate was elevated $9.48{\pm}4.38$ times higher than before activation. Lactate metabolite images were consistent with the activation maps. Conclusion : The BOLD contrast fMRI is enough sensitive to detect the activated area in human brain during the visual stimulation. Lactate metabolite map presents the evidence of lactate elevation on the same area of activation.