• Title/Summary/Keyword: An Hyang

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An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

Analysis of Aminoglycoside Antibiotics in Meat and Cell Culture Medium Coupled with Direct Injection of an Ion-pairing Reagent (이온쌍 시약 직접 주입법을 활용한 육류 및 세포배양액 내 아미노글리코사이드계 항생제 분석)

  • Kyung-Ho Park;Song-Yi Gu;Geon-Woo Park;Jong-Jib Kim;Jong-soo Lee;Sang-Gu Kim;Sang-Yun Lee;Hyang Sook Chun
    • Journal of Food Hygiene and Safety
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    • v.38 no.5
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    • pp.319-331
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    • 2023
  • Aminoglycoside antibiotics, also known as aminoglycosides (AGs), are veterinary drugs effective against a wide range of gram-negative and gram-positive bacteria. Owing to their recent use in cultured meats, it has become essential to establish an analytical method for safety management. AGs are highly polar compounds, and ion-pair reagents (IPRs) are used to ensure component separation. Owing to the high possibility of potential mechanical problems resulting from IPR addition to the mobile phase, an analytical method in which IPRs are added directly to the vial was explored. In this study, methods for analyzing 10 AGs via liquid chromatography-tandem mass spectrometry (LC-MS/MS) with the addition of two IPRs were validated for selectivity, detection limit, quantitation limit, recovery, and precision. The detection limit was 0.0001-0.0038 mg/kg, the quantification limit was 0.004-0.011 mg/kg, and the linearity (R2) within the concentration range of 0.01-0.5 mg/kg was over 0.99. Recovery and precision (expressed as relative standard deviation) evaluated in the two matrices (beef and cell culture media) ranged from 70.7% to 120.6% and 0.2% to 24.7%, respectively. The validated AG analytical method was then applied to 15 meats prepared from chicken, beef, and pork, and 6 culture media and additives used in cultured meat. No AGs were detected in any of the 15 meats distributed in Korea; however, streptomycin and dihydrostreptomycin were detected at levels ranging from 695.85 to 1152.71 mg/kg and 6.35 to 11.11 mg/kg, respectively, in the culture media additives. The LC-MS/MS method coupled with direct addition of IPRs to the vial can provide useful basic data for AG analysis and safety evaluation of meats as well as culture media and additives for cultured meats.

An integrated Method of New Casuistry and Specified Principlism as Nursing Ethics Methodology (새로운 간호윤리학 방법론;통합된 사례방법론)

  • Um, Young-Rhan
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.51-64
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    • 1997
  • The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

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The Effect of Brand Extension of Private Label on Consumer Attitude - a focus on the moderating effect of the perceived fit difference between parent brands and an extended brand - (PL의 브랜드확장이 소비자태도에 미치는 영향에 관한 연구 : 모브랜드 적합도 인식 차이의 조절효과를 중심으로)

  • Kim, Jong-Keun;Kim, Hyang-Mi;Lee, Jong-Ho
    • Journal of Distribution Research
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    • v.16 no.4
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    • pp.1-27
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    • 2011
  • Introduction: Sales of private labels(PU have been growing m recent years. Globally, PLs have already achieved 20% share, although between 25 and 50% share in most of the European markets(AC. Nielson, 2005). These products are aimed to have comparable quality and prices as national brand(NB) products and have been continuously eroding manufacturer's national brand market share. Stores have also started introducing premium PLs that are of higher-quality and more reasonably priced compared to NBs. Worldwide, many retailers already have a multiple-tier private label architecture. Consumers as a consequence are now able to have a more diverse brand choice in store than ever before. Since premium PLs are priced higher than regular PLs and even, in some cases, above NBs, stores can expect to generate higher profits. Brand extensions and private label have been extensively studied in the marketing field. However, less attention has been paid to the private label extension. Therefore, this research focuses on private label extension using the Multi-Attribute Attitude Model(Fishbein and Ajzen, 1975). Especially there are few studies that consider the hierarchical effect of the PL's two parent brands: store brand and the original PL. We assume that the attitude toward each of the two parent brands affects the attitude towards the extended PL. The influence from each parent brand toward extended PL will vary according to the perceived fit between each parent brand and the extended PL. This research focuses on how these two parent brands act as reference points to one another in the consumers' choice consideration. Specifically we seek to understand how store image and attitude towards original PL affect consumer perceptions of extended premium PL. How consumers perceive extended premium PLs could provide strategic suggestions for retailer managers with specific suggestions on whether it is more effective: to position extended premium PL similarly or dissimilarly to original PL especially on the quality dimension and congruency with store image. There is an extensive body of research on branding and brand extensions (e.g. Aaker and Keller, 1990) and more recently on PLs(e.g. Kumar and Steenkamp, 2007). However there are no studies to date that look at the upgrading and influence of original PLs and attitude towards store on the premium PL extension. This research wishes to make a contribution to this gap using the perceived fit difference between parent brands and extended premium PL as the context. In order to meet the above objectives, we investigate which factors heighten consumers' positive attitude toward premium PL extension. Research Model and Hypotheses: When considering the attitude towards the premium PL extension, we expect four factors to have an influence: attitude towards store; attitude towards original PL; perceived congruity between the store image and the premium PL; perceived similarity between the original PL and the premium PL. We expect that all these factors have an influence on consumer attitude towards premium PL extension. Figure 1 gives the research model and hypotheses. Method: Data were collected by an intercept survey conducted on consumers at discount stores. 403 survey responses were attained (total 59.8% female, across all age ranges). Respondents were asked to respond to a series of Questions measured on 7 point likert-type scales. The survey consisted of Questions that measured: the trust towards store and the original PL; the satisfaction towards store and the original PL; the attitudes towards store, the original PL, and the extended premium PL; the perceived similarity of the original PL and the extended premium PL; the perceived congruity between the store image and the extended premium PL. Product images with specific explanations of the features of premium PL, regular PL and NB we reused as the stimuli for the Question response. We developed scales to measure the research constructs. Cronbach's alphaw as measured each construct with the reliability for all constructs exceeding the .70 standard(Nunnally, 1978). Results: To test the hypotheses, path analysis was conducted using LISREL 8.30. The path analysis for verification of the model produced satisfactory results. The validity index shows acceptable results(${\chi}^2=427.00$(P=0.00), GFI= .90, AGFI= .87, NFI= .91, RMSEA= .062, RMR= .047). With the increasing retailer use of premium PLBs, the intention of this research was to examine how consumers use original PL and store image as reference points as to the attitude towards premium PL extension. Results(see table 1 & 2) show that the attitude of each parent brand (attitudes toward store and original pL) influences the attitude towards extended PL and their perceived fit moderates these influences. Attitude toward the extended PL was influenced by the relative level of perceived fit. Discussion of results and future direction: These results suggest that the future strategy for the PL extension needs to consider that positive parent brand attitude is more strongly associated with the attitude toward PL extensions. Specifically, to improve attitude towards PL extension, building and maintaining positive attitude towards original PL is necessary. Positioning premium PL congruently to store image is also important for positive attitude. In order to improve this research, the following alternatives should also be considered. To improve the research model's predictive power, more diverse products should be included in study. Other attributes of product should also be included such as design, brand name since we only considered trust and satisfaction as factors to build consumer attitudes.

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Transference of Trust from Retailers to Private Label Products and their Manufacturers (유통업체에 대한 신뢰가 Private Label 제품과 제조업체에 대한 신뢰로 전이되는 현상에 관한 연구)

  • Kim, Hyang-Mi;Kim, Jae-Wook;Lee, Jong-Ho
    • Journal of Distribution Research
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    • v.14 no.2
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    • pp.67-95
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    • 2009
  • The purpose of this study is to empirically examine the transference of trust process, an important factor to consumer's purchase decision-making. Even though several researchers have discussed the trust transference process, there is no research related to this concept. Specifically we have focused on the transference of trust from the retailer to low involvement private label (PL) products. PL products were chosen as transference of trust occurs under ambiguity due to lack of information about the product and their manufacturer. PL products provide relatively less information than national brand (NB) products. In addition, retailers have been rapidly expanding their PL product categories. To identify the theoretical and empirical limitations of prior studies, we discuss several theories explaining the transference of trust: 'Balance theory' and 'availability heuristic' in transference of cognitive trust; 'affective transference' and 'affect as information' in transference of affective trust. An empirical test was performed. A self completion questionnaire was developed and administered to a convenience sample of PL users. 206 usable questionnaire were received. The results show that the transference of trust plays a mediating role linking the retailer to the manufacturer and to the product. Although our model, which included the transference process of trust as a mediating effect, did not improve the competitive model, the coefficients of the respective paths were found to be better. This study confirms the transference of cognitive trust from the retailer to both the manufacturer and the product, but not for affective trust. We offer the explanation that PL products may tend to have affective trust resulting from brand familiarity but not to their PL manufacturers.

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Effect of Pine (Pinus densiflora) Needle Extracts on Synthesis of Collagen in Osteoblastic MC3T3-E1 Cells (적송잎 추출물이 조골세포의 collagen 합성에 미치는 영향)

  • Jeon, Min-Hee;Kim, Young-Kyoung;Park, Yong-Soo;Hwang, Hyun-Jung;Kim, Sung-Gu;Lee, Sang-Hyeon;Choi, In-Soon;Kim, Mi-Hyang
    • Journal of Life Science
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    • v.20 no.4
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    • pp.607-613
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    • 2010
  • Osteoporosis is a disease involving a decrease in bone mineral density and an increased risk of fractures. The MC3T3-E1 pre-osteoblastic cell line is a well-accepted model of osteogenesis in vitro. Pine needles have long been used as a traditional health-promoting medicinal food in Korea. In this study, MTT assay, the alkaline phosphatase (ALP) activity and collagen synthesis of osteoblast cells were investigated to determine the effects of pine needle extracts on cell proliferation and differentiation. Pine needle extracts were prepared using hexane, ethanol and water. The effects of the pine needle extracts were examined by comparing the results with those of commercial agents, such as proanthocyanidin. The MC3T3-E1 cells exposed to proanthocyanidin showed increased proliferation in a concentration-dependent manner. The cells exposed to the hexane extract showed a similar increase in proliferation to that observed with proanthocyanidin. The hexane extract showed the highest ALP activity. Moreover, a supplement of pine needle extracts induced collagen synthesis in MC3T3-E1 cells. The pine needle extract produced the highest level of collagen synthesis at concentrations of $10{\sim}50\;{\mu}g/ml$. These results indicate that pine needle extracts have an anabolic effect on bone by promoting osteoblastic differentiation, and may be used in the treatment of common metabolic bone diseases.

Purification of Complement System-Activating Polysaccharide from Hot Water Extract of Young Stems of Cinnamomum cassia Blume (계지(桂枝) 열수추출물로부터 보체계 활성화 다당의 정제)

  • Kweon, Mee-Hyang;An, Hyun-Jung;Shin, Kwang-Soon;Na, Gyeong-Su;Sung, Ha-Chin;Yang, Han-Chul
    • Korean Journal of Food Science and Technology
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    • v.29 no.1
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    • pp.1-8
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    • 1997
  • A complement system-activating (anti-complementary) polysaccharide was purified from the hot water extract of young stems of Cinnamomum cassia Blume. Crude polysaccharide fraction (CC-1) was prepared from the hot water extract of the young stems followed by methanol-reflux, precipitation with ethanol, dialysis, and lyophilization. The anti-complementary activity of CC-1 was decreased greatly by periodate oxidation, but was not changed by pronase digestion. These suggest that carbohydrate moiety may be related to the activation of complement system. According to its ionic strength CC-1 was fractionated first using cetavlon to give 4 fractions, CC-2, 3, 4 and 5. Among them CC-2 fraction was found to retain the highest activity and yield. CC-2 was separated to an unabsorbed neutral sugar portion (CC-2-I) and seven absorbed acidic sugar fractions $(CC-2-II{\rightarrow}CC-2-VIII)$ on DEAE-Toyopearl 650C (Cl-). CC-2-III showing higher anti-complementary activity and yield than those of other fractions, was further purified on the gel permeation of Sephadex G-100 and Sepharose CL-6B to CC-2-IIIa-3. CC-2-IIIa-3 was determined to have a homogeneity hy GPC (Sepharose CL-6B) and HPLC. Gel chromatography using standard dextrans gave a value of $2.4{\times}10^5$ for the molecular weight. The purified polysaccharide, CC-2-IIIa-3 consisted of arabinose, xylose, glucose, galactose, galacturonic acid and glucuronic acid in a molar ratio of 5.56 : 3.77 : 1.87 : 1.00 : 5.12 : 3.13 and contained no nitrogen.

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The effect of rearing, health and nutrition intervention services on grandparents-grandchildren families in a rural Korean area (농촌 조손가정의 양육, 건강 및 영양중재서비스의 효과)

  • Cho, Young-Hyang;Park, Yoon-Chang
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.274-286
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    • 2010
  • Objectives: The purpose of this study was to examine the effects of the rearing, health and nutrition services through intervention in GP-GC (grandparents-grandchildren) families. Methods: A structured questionnaire was administered in January 2008 and January 2009 to 55(70) grandparents of GP-GC families who received intervention services also GP-GC families that did not receive services. The study area was the city of Chunnam Province, South Korea. The intervention services were provided by electronic voucher one day per week. The questionnaire assessed the general characteristics of the grandparents, childcare stress and burden, health status (ADL, IADL, depression, subjective health status and fall index) and mini nutritional assessment(MNA). The data were analyzed using SPSS software and an F-test, Chi-squared test and t-test. Results: The stress of grandparents resulting from childcare was high, but depression in grandparents perceived by grandchildren was significantly lower in served GP-GC families than in non-served GP-GC families. Differences in scores of affection (t=2.12, df=116, p<.05), automatics (t=2.92, df=116, p<.01), realistic(t=2.24, df=116, p<.05), and level of depression(t=2.90, df=116, p<.01) were significant. Incidences of acute disease, IADL cognitive fuction and depression of grandparents were slightly higher. Intervention services for GP-GC families had an impact on the childcare attitude and health status of grandparents. The intervention services of nutrition for grandparents were not promoted, but the scoring for subjective nutrition status were statistically higher for the served group (t=18.230, p<.0001). Conclusions: This study found that intervention programs of childcare services and health and nutrition management are effective for grandparents of GP-GC families. Intervention services for GP-GC family should establish the political issue.

Usefulness of Escherichia coli-expressed Recombinant VP6 Proteins of Group A Rotavirus in Serodiagosis of Rotavirus Infection (대장균에서 발현된 A군 로타바이러스 VP6 단백질을 이용한 로타바이러스 감염의 혈청학적 진단의 유용성)

  • Seo, Ji-Hyun;Kim, So-Young;Park, Ji-Sook;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Kim, Won-Yong;Kang, Hyung-Lyun;Baik, Seung-Chul;Lee, Woo-Kon;Cho, Myung-Je;Rhee, Kwang-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.134-145
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    • 2010
  • Purpose: The serologic diagnosis of rotaviral infections is not commonly used in clinical practice, but is used in seroepidemiologic studies. In this study, the usefulness of Escherichia coli-expressed recombinant VP6 proteins of group A rotavirus in the serodiagnosis of rotavirus infections by ELISA was evaluated. Methods: The recombinant VP6 proteins of group A rotavirus expressed in E. coli Rosetta II strain were purified and identified. One hundred sera from 22 children (4 healthy neonates, 13 healthy children, and 5 immunocompromised children) who had serial sera samples prior to and after rotavirus infections were provided by the Gyeongsang National University Hospital, a member of the National Biobank of Korea. IgG, IgA, and IgM antibodies against rVP6 were analyzed by ELISA in all of the patients and Western blot analysis in 4 neonates. Results: ELISA tests using rVP6 proteins of group A rotavirus as antigen revealed that IgG, IgA, and IgM antibodies increased after rotaviral infections in most neonates and healthy children. IgG antibodies also increased after rotaviral infections in most immunocompromised children without an adequate increase in IgM or IgA antibodies. Western blot analysis in four neonates revealed very early IgM antibody responses, even in the sera with low optical densities in ELISA tests. Conclusion: Our study showed that ELISA using rVP6 as an antigen is a valid diagnostic tool for seroepidemiologic studies of rotavirus infections and Western blot analysis is a sensitive test in detecting IgG, IgA, and and IgM antibodies in patients with rotavirus infections.

A Review of Endoscopic Removal Methods in 127 Cases of the Esophageal Foreign Bodies (소아 식도 이물의 내시경적 적출방법 변화에 대한 고찰)

  • Kim, Jum Su;Yang, Jung Soo;Jung, Hae Sung;Lee, Min Hye;Park, Chan-Hoo;Choi, Myoung Bum;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.459-465
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    • 2002
  • Purpose : The aim of this study was to evaluate the latest tendency of esophageal foreign body's extraction and to obtain a consensus from recent trends of indications and techniques of flexible endoscopy of esophageal FB in children. Methods : We retrospectively reviewed medical records of 127 cases with foreign bodies in esophagus at Dept. of Pediatrics and Otorhinolaryngology, Gyeongsang National University Hospital (GNUH) from Jun, 1987 to July, 2001. They were divided into two groups by the kinds of endoscopy : flexible endoscope(66 cases) or rigid endoscope(61 cases). Rigid endoscopy was performed under general anesthesia at Dept. of Otorhinolaryngology but flexible endoscopy was performed without general anesthesia or sedative drugs(midazolam or diazepam). Results : An annual number of cases of two groups were similar from 1991 to 1998. But from 1999, flexible endoscopy was performed actively. Asymptomatic cases were frequently observed in flexible endoscopy(28 cases/66 cases) but swallowing difficulties were frequently observed in the rigid endoscopy group(25 cases/61 cases). Other symptoms were vomiting, irritability, chest discomfort and abdominal pain. The total number of cases with underlying disease(esophageal stenosis, cerebral palsy) was 8. The total number of cases with complications (erosion, ulcer, bleeding, perforation) was 11. The above cases were not correlated between the two groups. In 55 cases(83.3%) of the flexible endoscopic group and 53 cases(86.8%) of the rigid endoscopic group, foreign bodies in the esophagus were removed within 24 hours. Conclusion : We could not find any benefit in rigid endoscopic technique. Flexible endoscopic FB removal can be performed safely and effectively in children by an experienced endoscopist.