• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1249-1259
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• 2009

Purpose:From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. Methods:Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. Results:Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. Conclusion:The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.29-34
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• 2019

Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.

• Journal of Nutrition and Health
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• v.53 no.6
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• pp.596-612
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• 2020

Purpose: This study was conducted to evaluate the dietary behaviors of preschool children using the nutrition quotient for preschoolers (NQ-P) and investigate factors that influence NQ-P in preschool children. Methods: Subjects were 214 parents with children aged 3-5 years residing in Busan and Gyeongnam, Korea. The survey was conducted from March to April, 2019 using a questionnaire that included demographic characteristics, the NQ-P questions, and health consciousness. All data was statistically analyzed by the SPSS program (Ver 25.0) and the statistical differences in variables were evaluated by the chi-square test, Fisher's exact test, t-test, one-way ANOVA, and Tukey's multiple comparison test. Results: The mean score of NQ-P of the total subjects was 58.28, which was within the medium-low grade. The mean score of 'balance' was 60.08, 'moderation' was 47.64, and 'environment' was 67.83. The analysis of related-factors influencing NQ-P scores showed that there was a significant difference according to the frequency of dining out. The scores of the NQ-P (p < 0.05), moderation (p < 0.001), and environment (p < 0.05) were significantly higher in the 1-2 times per week group compare to 3-4 times and 5-6 times per week group. The scores of NQ-P (p < 0.01), environment (p < 0.01) were significantly higher in the high group of parents' health consciousness compared to the those with low health consciousness. Conclusion: According to the results of the evaluation by NQ-P, the dietary behaviors of preschool children residing in Busan and Gyeongnam need to be improved and monitored. For improving their eating behavior and nutritional health status, preschool children and their parents need proper nutrition education programs.

• Science of Emotion and Sensibility
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• v.24 no.4
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• pp.139-148
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• 2021

This study aimed to verify how a multisensory storytelling-based activity-based intervention affects social interaction in children with cerebral palsy. As a quasi-experimental investigation, this study used a single-blind, two-group pre-post test design. This study comprised 24 children aged 7 to 8 y who had been diagnosed with spastic cerebral palsy and were classified as having GMFCS stages I to III. Twelve children were randomly assigned to experimental and control groups, with neither the children nor their guardians knowing which group they were placed in. The group program comprised 16 sessions of 60 min each, twice a week for eight weeks. The experimental group engaged in an activity-centered intervention centered on multisensory storytelling, whereas the control group engaged in structured physical activity. The activities were assessed using the peer relations skills scale to determine the extent to which social interaction had changed prior to and during the child's intervention. The SPSS 25.0 for Windows (IBM Corp, USA) application was used to analyze the data, and the significance level (α) for statistical verification was set to 0.05. Furthermore, the Wilcoxon Signed-Rank and Mann-Whitney U tests were used to assess the differences in social interaction between the experimental and control groups. Significant differences were observed in the total of the peer relationship skill scale and cooperation and empathy areas of the subtest in the intragroup change of the peer relationship skill scale between the experimental and control groups. However, the experimental group demonstrated a significant difference in the initiative area, whereas the control group demonstrated no significant difference. A significant difference was observed in the amount of change between the two groups in the initiative area and total of the subtest of peer relationship skills but no significant difference in the collaboration and empathy areas. We gave a multisensory storytelling-based activity-based intervention based on multisensory storytelling to children with cerebral palsy and saw a significant improvement in peer relationship skills. It may be proposed as an effective intervention strategy for children with cerebral palsy who struggle with social contact.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.1
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• pp.39-49
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• 2020

Objective : The aim of this study was to investigate the care burden and life quality in family caregivers of community-dwelling patients using home mechanical ventilator(HMV) in Yeognam region. Methods : Survey performed to family caregivers of the patients using HMV in Yeognam region, Korea. The questionnaire is composed with patient care and the burden on caring. Korean version of Short Form Zarit Burden Interview(K-ZBI-12) and 3-Level version of EuroQol-5 Dimension applying Korean weight(KEQ-5D-3L) were also investigated. Statistical significance was accepted for p<.05. Results : A total 98 out of 150 questionnaires were analyzed. The K-ZBI-12(33.08±10.34) had a correlation with KEQ-5D-3L(0.71±0.25) negatively(p=.038). Patients' age, duration of HMV, financial burden and professional caregivers' care time had correlations with K-ZBI-12 positively(p<.05). KEQ-5D-3L correlated duration of HMV negatively(p=.017). Invasive ventilator group had lower KEQ-5D-3L than the non-invasive ventilator group(p=.008). K-ZBI-12 was lower in more than one caregiver care of patients than in one(p=.001). Conclusion : This study revealed high care burden and low quality of life in family caregivers of the patients with HMV in Yeongnam region, Korea. Efforts are needed to continually identify the needs of patients and their families, and the socioeconomic support and medical services associated with HMV.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.929-934
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• 2005

Purpose : This study describes how often complementary and alternative medical(CAM) therapies, what patterns of CAM therapies utilization, what types of CAM therapies and why CAM therapies are used in children and adolescent with chronic disease. Methods : We interviewed and filled out questionnaires with parents of patients suffering from asthma, atopic dermatitis, congenital myopathy, epilepsy and so on from Mar 2004 to Aug 2004. Results : Two hundred fifty two parents answered questionnaires; 160 cases(63.5 percent) had used CAM therapies. Utilization of CAM therapies according to each chronic disease was as follows : congenital myopathy(100 percent), atopic dermatitis(91.1 percent), asthma(72.5 percent), chronic diarrhea (50.0 percent), epilepsy(17.1 percent) etc. Types of CAM therapy were as follows : dietary supplement (31.1 percent), herb medicine(23.4 percent), massage(14.2 percent), acupuncture(4.6 percent) etc. Sixty four(40.0 percent) case underwent more than two types of CAM therapies simultaneously. One hundred thirty three(83.1 percent) case were asked through non-medical prescription. Ninety nine(61.9 percent) case were recognized positive effect of CAM therapies. Parents' and childrens' ages were influential factors in CAM therapies utilization : the older the parents and the younger the children, the higher the utilization. Conclusion : Although patients receive treatment with western medicine, many of them not only undergo CAM therapies, especially more than two types, but also recognize the positive effects of CAM therapies. As a result, we suggest that it is easy to use of CAM therapies, and the positive effects of CAM therapies are prominent, domestically. Therefore, medical approach and study about the effectiveness and side effects of CAM therapies is necessary to avoid the imprudent use of such therapies.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.159-166
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• 2009

Purpose : Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies in children on a weaning diet. We investigated weaning practices in infants and children, as well as their mothers' knowledge about weaning. Methods : We investigated 129 children with IDA and 166 without IDA (aged 6-36 months) who had visited 10 university hospitals between March 2006 and July 2007. We investigated the hematologic values of both groups. A questionnaire on weaning was answered by the mothers of these children. Results : The hematologic values in the IDA group showed a significant difference from those in the comparison group (P<0.05). Children who were solely breastfed until 6 months of age were 85%, 34% (P<0.05), and weaning was started by 6.3, 6.4 months, respectively (P>0.05). Rice gruel, boiled rice, and fruit juice accounted for approximately 80% of the starting foods in both groups (P>0.05). Only 40% of the children in the IDA group had a balanced diet within a month, versus 38% in the comparison group. In response to questions about the necessity of iron-fortified foods for breast-fed infants, less than 50% of mothers in both groups answered correctly. In the IDA group, 42% showed serum ferritin less than 10 ng/mL, while 92% showed serum MCV less than 72 fL. Conclusion : In conclusion, collection of information on history should be thorough for feeding and selective examinations for IDA in high-risk groups. Considering the adaptation period, we suggest beginning children on a weaning diet at 45 months. In addition, we need to educate mothers on weaning practice, especially on the necessity of iron-fortified foods for breast-fed infants.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1140-1146
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• 2009

Purpose:The pathophysiology of magnesium, the second highest common compound in humans, is still unclear, especially in preterm babies. We accessed the association between total magnesium (tMg), ionized Mg (iMg), and gestational age (GA) and that between serum magnesium (sMg) and intraventricular hemorrhage (IVH) in preterm babies. Methods:In all, 119 inborn preterm infants admitted between July 2006 and February 2008 were divided into the IVH group (19) and the control group (100) and were prospectively analyzed. TMg, iMg, pH, total calcium (tCa), and ionized Ca (iCa) levels were determined immediately after delivery or within 3 hours after birth, and their correlation with GA were investigated. Results:TMg was not correlated with GA, tCa, iCa, and pH. IMg was correlated with tMg (r=0.288, P=0.002) and iCa (r=0.212, P=0.021); however, it was not correlated with GA and pH. Mean GA and birth weight were significantly lower (P=0.002) and smaller (P=0.030) in the IVH group. Mean sMg was higher in the IVH group ($2.5{\pm}0.9mg/dL$) than in the control group ($2.1{\pm}0.6mg/dL$) (P=0.021). SMg was a risk factor even after logistic regression analysis (OR, 2.798; 95% C.I., 1.265-6.192; P=0.011). Conclusion:In less than 37-week-old preterm babies, tMg and iMg were similar, regardless of GA. High sMg may be a risk factor for IVH in premature babies, regardless of their exposure to antenatal magnesium.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.165-171
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• 2016

Purpose: Human parechovirus (HPeV) is an increasingly recognized pathogenic cause of central nervous system (CNS) infection in neonates. However, HPeV infections have not been studied in older children. This study determined the prevalence and clinical features of HPeV CNS infection in children in Korea. Methods: Reverse transcription polymerase chain reaction assays were performed using HPeV-specific, 5' untranslated, region-targeted primers to detect HPeV in cerebrospinal fluid (CSF) samples from children presenting with fever or neurologic symptoms from January 1, 2013, to July 31, 2014. HPeV genotyping was performed by sequencing the viral protein 3/1 region. Clinical and laboratory data were retrospectively abstracted from medical records and compared with those of enterovirus (EV)-positive patients from the same period. Results: Of 102 CSF samples, six (5.9%) were positive for HPeV; two of 21 EV-positive samples were co-infected with HPeV. All samples were genotype HPeV3. Two HPeV-positive patients were <3 months of age and four others were over 1 year old. While HPeV-positive infants under 1 year of age presented with sepsis-like illness without definite neurologic abnormalities, HPeV-positive children over 1 year of age presented with fever and neurologic symptoms such as seizures, loss of consciousness, and gait disturbance. The CSF findings of HPeV-positive patients were mostly within the normal range, whereas most (73.7%) EV-positive patients had pleocytosis. Conclusions: Although HPeV is typically associated with disease in young infants, the results of this study suggest that HPeV is an emerging pathogen of CNS infection with neurologic symptoms in older childhood.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1559-1570
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• 2002

Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.