• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.996-1002
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• 2003

Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.207-214
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• 2009

Purpose: Childhood obesity can be complicated by hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and diabetes mellitus. The aim of this study was to evaluate the prevalence of obesity and metabolic complications of children and adolescents based on the degree of obesity. Methods: We analyzed the records of 8,880 students who received student health examinations between May 2006 and October 2008 at the Eulji General Hospital. The prevalence of obesity was evaluated by the body mass index and obesity index. A total of 1,076 obese students had blood tests. We analyzed aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting glucose, total cholesterol, and blood pressure according to the degree of obesity. Results: According to the body mass index, the overall prevalence of obesity was 7.2% (7.8% of male and 6.5% of female students). Based on the obesity index, 12.3% of students (mild: 6.3%, moderate: 5.0%, and severe: 1.0%) were obese. The prevalence of hypercholesterolemia, ALT elevation, and hypertension were increased as a function of the degree of obesity (p<0.05), but hyperglycemia showed no significant differences (p=0.298). The overall prevalence of ALT elevation was 17.7% (mild obese group, 10.4%; moderate obese group, 20.5%; and severe obese group, 46.8%). The prevalence of hypercholesterolemia, hypertension, and hyperglycemia were significantly higher in the elevated ALT group (24.7%, 42.6%, and 5.2%, respectively) compared to the normal ALT group (11.1%, 29.8%, and 2.0%, respectively; p<0.05). Conclusion: Hypercholesterolemia, liver function test abnormalities, and hypertension were associated with the degree of obesity. We should focus our attention on managing obese children and adolescents to prevent metabolic complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.344-356
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• 2005

There are normal inhabitants doing medically useful functions in the body. There are many kinds of bacteria performing specific functions in the oral cavity. Two strains of lactic acid bacteria were isolated from inhabitants of caries-free children's oral cavity, which inhibited the formation of artificial plaque by Streptococcus mutans and the production of volatile sulfur compounds by anaerobic bacteria. The isolates were identified by the test using API 50 CHL medium kit and 16S rDNA partial sequencing. 1. Two isolates were Gram-positive bacilli and produced hydrogen peroxide. 2. When Streptococcus mutans was cultured in the media, the mean weight of formed artificial plaque on the orthodontic wires was $124.4{\pm}30.4\;mg$, whereas being reduced to $5.2{\pm}2.0mg$ and $10.6{\pm}6.6mg$ in the media cultured with Streptococcus mutans and each isolate, respectively (p<0.05) 3. The number of viable cells of Streptococcus mutans was $3.4{\times}10^9$ per ml in the cultured solution, whereas those of Streptococcus mutans in the combined culture with each of isolates were $4.6{\times}10^8\;and\;2.4{\times}10^8$ per ml. 4. The optical density was 1.286 in the supernatant of Fusobacterium nucleatum after vortexing for 30minutes, whereas in the supernatant of combined Fusobacterium nucleatum and each isolate, they were reduced to 0.628 and 0.497, which the percentages of coaggregation between them were 29.4% and 57.8%, respectively 5. The optical density of Fusobacterium nucleatum precipitate was 1.794 in the culture media containing cysteine and $FeSO_4$, being reduced to 1.144 and 0.915 in the coaggregated precipitates of Fusobacterium nucleatum and each isolate. The optical density of Porphyromonas gingivalis precipitate was 1.932 in the culture media, being reduced to 1.170 and 1.266 in the coaggregated precipitates of Porphyromonas gingivalis and each isolate. 6. When two isolates were tested with API 50 CHL medium kit, those were identified Lactobaciallius salivarius and Lactobaciallius delbrueckii subsp. lactis. 7. The similarity values of 16S rDNA sequence between each of isolates and Lactobaciallius salivarius subsp. salicinius were 99.60% and 99.73%, respectively, meaning that isolates were Lactobaciallius salivarius subsp. salicinius. These results indicated that two strains isolated from caries-free children's saliva, which inhibited the formation of artificial plaque and the production of volatile sulfur compounds, were identified as Lactobaciallius salivarius subsp. salicinius.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Journal of Radiation Protection and Research
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• v.40 no.2
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• pp.118-123
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• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.376-381
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• 2002

The purpose of this study was to analyse the color of natural deciduous teeth in Korean children and to compare with that of composite resin specimens. The subjects were 148 children (80 boys and 68 girls) with good general condition and normal teeth color, aged between 3 and 6 years. The color of middle third of maxillary central incisor in deciduous teeth was examined with shade guide and then measured by means of the colorimeter CV300 which can be measured by CIELAB system. The data were analyzed statistically by SPSS program. The results were summerized as follows; 1. Over 90% of the color for the deciduous anterior teeth was in A1, A2, B1, B2 and P shade. 2. The means of deciduous teeth color were $L^*=58.72,\;a^*=-1.18,\;b^*=-0.63$ by colorimeter CV300. 3. $L^*,\;a^*\;and\;b^*$ prices for A1, A2, B1, B2, P were $L^*=52.52,\;a^*=-1.90,\;b^*=1.18$ in A1 specimen, $L^*=54.90,\;a^*=-1.87,\;b^*=1.60$ in A2 specimen, $L^*=59.80,\;a^*=-2.70,\;b^*=-0.63$ in B1 specimen, $L^*=56.90,\;a^*=-1.70,\;b^*=1.63$ in B2 specimen, $L^*=52.93,\;a^*=-2.33,\;b^*=1.10$ in P specimen. The means of B1 color specimen were most similar to those of deciduous teeth color. The A1 color values were similar to the P color values. 4. The standard deviation of $L^*,\;a^*$ was small among colors, but that of $b^*$, in the yellowish color, was large.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.245-253
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• 2003

Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

• (The)Study of the Eastern Classic
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• no.48
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• pp.253-287
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• 2012

This research aimed to discuss the necessity of education and evil through perspective of Sunja and Hannah Arendt. In case of Sunja, it was reviewed by his opinion about Sunja as the central figure. As for Arendt, it was researched with "Eichmann in Jerusalem" as the central figure which she wrote participating in the trial process of Eichmann who was a war criminal of Nazi. Sunja thought evil as the nature of people and understood that they all are originally selfish, envious, and seeking desire. Therefore, Sunja thought it is important to properly seek human desire. He claimed Haw Seong Gi Wi(化性起僞, changing evil human nature into goodness through manner) which changes human nature from evil to goodness. A teacher who leads evil into goodness is surely needed in the process of Haw Seong Gi Wi. At the same time, in the dimension of educational content it put stress on the role of Ye(禮, manner) which lets them realize discernment so that they properly seek human desire and Ak(樂, harmony) which harmoniously controls human emotion, and key point on education regarding Ye and Ak. As for Arendt, however, she recognized evil as normal one. Even though he thought that conforming the order of superior authority was the best value and then took evil of killing many Jews in thoughtlessness, Eichmann maintained that he did not take evil but only conformed the order. This way, people could take evil in thoughtlessness in totalitarianism, and it makes circumstance that they could not take goodness. Therefore they could take evil in thoughtlessness and experience the radical evil and the banality of evil. Accordingly, political praxis which guarantees people's plurality as the words and praxis is needed. It is named natality because the truth that they are born in this world is a starting point, and makes the essence of education. In this process, teachers have to be a representative of this generation for children as new social members, and be able to keep children's newness. Sunja and Arendt have the same equality and difference in that they referred to the necessity of education to overcome human evil. It is the same quality that goodness could recover the function of community and the practice of education is considered important in the goal of education and the dimension of directivity. It is different in methodical characteristic of education that Arendt, however, suggests praxis as the way that they express themselves in totalitarianism while Sunja thought that continuous practice piling up virtue for goodness is important.

• Sleep Medicine and Psychophysiology
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• v.27 no.2
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• pp.67-76
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• 2020

Objectives: Brain maturation involves brain lateralization and asymmetry to achieve efficient information processing and cognitive controls. This study elucidates normal brain maturation change during the gap between ages 6-9 and age 14-17 using resting EEG. Methods: An EEG dataset was acquired from open source MIPDB (Multimodal Resource for Studying Information Processing in the Developing Brain). Ages 6-9 (n = 24) and ages 14-17 (n = 26) were selected for analysis, and subjects with psychiatric illness or EEG with severe noise were excluded. Finally, ages 6-9 (n = 14) and ages 14-17 (n = 11) were subjected to EEG analysis using EEGlab. A 120-sec length of resting EEG when eyes were closed was secured for analysis. Brain topography was compartmentalized into nine regions, best fitted with brain anatomical structure. Results: Absolute power of the delta band and theta band in ages 6-9 was greater than that of ages 14-17 in the whole brain, and, also is relative power of delta band in frontal compartment, which is same line with previous studies. The relative power of the beta band of ages 14-17 was greater than that of ages 6-9 in the whole brain. In asymmetry evaluation, relative power of the theta band in ages 14-17 showed greater power in the left than right frontal compartment; the opposite finding was noted in the parietal compartment. For the alpha band, a strong relative power distribution in the left parietal compartment was observed in ages 14-17. Absolute and relative power of the alpha band is distributed with hemispheric left lateralization in ages 14-17. Conclusion: During the gap period between ages 6-9 and ages 14-17, brain work becomes more complicated and sophisticated, and alpha band and beta band plays important roles in brain maturation in typically developing children.

• Clinical and Experimental Pediatrics
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• v.48 no.4
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• pp.406-410
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• 2005

Purpose : Anticonvulsants have a number of side effects and some of them may be attributed to a disturbance of serum trace metal homeostasis. Although they are minor building components in tissues, they play important functional roles in the peripheral and central nervous system. We measured serum copper and zinc levels in epileptic children who were treated with anticonvulsants to know the effects of anticonvulsants on serum copper and zinc levels. Methods : Serum copper and zinc levels were determined in 64 epileptic patients receiving anticonvulsant therapy in Chungnam National University Hospital, and in 20 normal controls. Sixty-four epileptic patients were divided into three groups : 16 patients who were treated with valproic acid monotherapy; 26 patients who were treated with valproic acid in addition to other anticonvulsants; and 22 patients who were treated with anticonvulsants except for valporic acid. Results : All patients receiving anticonvulsants had significantly lower serum copper levels($80.21{\pm}19.42{\mu}g/dL$) in comparison to the normal controls($102.12{\pm}32.8{\mu}g/dL$). Serum zinc levels in patients receiving anticonvulsants($79.78{\pm}21.88{\mu}g/dL$) were not statistically different from those of controls ($85.26{\pm}29.81{\mu}g/dL$). There were no significant difference of serum copper and zinc levels among the three groups. Conclusion : In this study, we clearly showed that anticonvulsants decreased serum copper levels. Although we did not observe any clinical findings related to copper deficiency, we should pay attention to potent copper deficiency in patients with anticonvulsant treatment.