• 컴퓨터교육학회논문지
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• 제22권3호
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• pp.123-133
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• 2019

본 연구는 스마트교육의 한 요소인 스마트 기기를 활용하여 축적된 데이터를 기초로 유아의 개별 맞춤학습을 위한 스마트교육환경을 구축하는데 목적을 두고 있다. 이를 위해 유치원 만5세 학급에서 자유선택활동 운영을 위한 개선 방안을 제안하고, 유아 스스로 놀이 계획을 세우고 평가하는 자유선택활동 운영시스템을 구현하였다. 본 연구 참여한 유아들은 놀이계획, 놀이수행 및 수행평가등 전체 활동시간을 스스로가 적극적이며 즐겁게 참여하였다. 그 결과 유아는 스마트기기를 통한 자신의 흥미영역에 대한 활동선택에 기존교육환경보다 적극적으로 참여하는 것을 확인할 수 있었다. 본 연구에서 제안된 자유선택활동 운영시스템을 이용한 교사는 분석된 자료를 활용하여 스마트기기를 이용한 개별유아의 흥미분야와 학습수준 및 교실의 각 영역별 이용형태를 혼자서 쉽게 파악할 수 있었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.460-469
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• 2019

Purpose: The ${\beta}3-adrenergic$ receptor (ADRB3) is expressed in visceral adipose tissue and has been speculated to contribute to lipolysis, energy metabolism, and regulation of the metabolic rate. In this study, we aimed to investigate the association of polymorphism of the ADRB3 gene with the sex of children with obesity and related pathologies. Methods: ADRB3 gene trp64arg genotyping was conducted in 441 children aged 6-18 years. Among these subjects, 264 were obese (103 boys; 161 girls) and 179 were of normal weight (81 boys; 98 girls). In the obese group, fasting lipids, glucose and insulin levels, and blood pressure were measured. Metabolic syndrome (MS) was defined according to the modified World Health Organization criteria adapted for children. Results: The frequency of trp64arg genotype was similar in obese and normal weight children. In obese children, serum lipid, glucose, and insulin levels; homeostasis model assessment of insulin resistance (HOMA-IR) scores; and MS were not different between arg allele carriers (trp64arg) and noncarriers (trp64trp). In 264 obese children, genetic analysis results revealed that the arg allele carriers were significantly higher in girls than in boys (p=0.001). In the normal weight group, no statistically significant difference was found between genotypes of boys and girls (p=0.771). Conclusion: Trp64arg polymorphism of the ADRB3 gene was not associated with obesity and MS in Turkish children and adolescents. Although no relationships were observed between the genotypes and lipids, glucose/insulin levels, or HOMA-IR, the presence of trp64arg variant was frequent in obese girls, which can lead to weight gain as well as difficulty in losing weight in women.

• Nutrition Research and Practice
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• 제13권5호
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• pp.410-414
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• 2019

BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.187-196
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• 2021

Purpose: The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children. Methods: In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment. Results: It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls (p<0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups. Conclusion: Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels.

• 여성건강간호학회지
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• 제26권4호
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• pp.285-299
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• 2020

Purpose: This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). Methods: We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Results: Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. Conclusion: RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers' attitudes.

• Journal of Nutrition and Health
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• 제55권6호
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• pp.630-641
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• 2022

Purpose: In this study, we assessed the intake of nutrients and food groups and analyzed the nutrition quotient of obese children in South Korea. The hypothesis was that dietary quality and nutrient intake are related to the body mass index (BMI) of obese children. Methods: The participants included 48 children (20 boys and 28 girls). Based on the guidelines for the age-for-body mass index provided by the Korean National Growth Charts for children and adolescents, the participants were divided into 3 groups: overweight, BMI ≥ 85th percentile; obese, BMI ≥ 95th percentile; severely obese, BMI ≥ 99th percentile. Results: The energy distribution showed that the carbohydrate ratio was significantly higher in the overweight group (p < 0.01), whereas the fat ratio was significantly higher in the obese and severely obese groups (p < 0.05). Thus, in the overweight and obese groups, the percent body fat was negatively associated with the carbohydrate ratio (p < 0.05) but was positively associated with the fat ratio (p < 0.05). The Dietary Reference Intakes (DRI) data revealed that the intake levels of protein, vitamin B₁, vitamin B₁₂, and sodium were higher in all groups. Intakes of fiber, calcium, potassium, and magnesium were insufficient in all groups, and the DRI percent for protein was significantly higher in the obese and severely obese groups than in the overweight group. No significant differences were obtained in food group patterns or Nutrition Quotient (NQ) scores among the 3 groups. According to the evaluation results by food record and NQ, a significant difference was obtained in the dietary quality of obese children. Conclusion: We conclude that a higher intake of fat enhances weight gain. Based on the study results, we propose that the guidelines should consider the energy distribution of carbohydrate and fat intake to prevent and control obesity among Korean children.

• Korean Journal of Radiology
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• 제22권3호
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• pp.395-404
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• 2021

Objective: To compare the utility of computed tomography perfusion (CTP) and three different 4-point scoring systems in computed tomography angiography (CTA) in confirming brain death (BD) in patients with and without skull defects. Materials and Methods: Ninety-two patients clinically diagnosed as BD using CTA and/or CTP for confirmation were retrospectively reviewed. For the final analysis, 86 patients were included in this study. Images were re-evaluated by three radiologists according to the 4-point scoring systems that consider the vessel opacification on 1) the venous phase for both M4 segments of the middle cerebral arteries (MCAs-M4) and internal cerebral veins (ICVs) (A60-V60), 2) the arterial phase for the MCA-M4 and venous phase for the ICVs (A20-V60), 3) the venous phase for the ICVs and superior petrosal veins (ICV-SPV). The CTP images were independently reviewed. The presence of an open skull defect and stasis filling was noted. Results: Sensitivities of the ICV-SPV, A20-V60, A60-V60 scoring systems, and CTP in the diagnosis of BD were 89.5%, 82.6%, 67.4%, and 93.3%, respectively. The sensitivity of A20-V60 scoring was higher than that of A60-V60 in BD patients (p < 0.001). CTP was found to be the most sensitive method (86.5%) in patients with open skull defect (p = 0.019). Interobserver agreement was excellent in the diagnosis of BD, in assessing A20-V60, A60-V60, ICV-SPV, CTP, and good in stasis filling (κ: 0.84, 0.83, 0.83, 0.83, and 0.67, respectively). Conclusion: The sensitivity of CTA confirming brain death differs between various proposed 4-point scoring systems. Although the ICV-SPV is the most sensitive, evaluation of the SPV is challenging. Adding CTP to the routine BD CTA protocol, especially in cases with open skull defect, could increase sensitivity as a useful adjunct.

• Hip & pelvis
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• 제35권2호
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• pp.73-87
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• 2023

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권3호
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• pp.176-185
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• 2024

Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.119-128
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• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.