• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권1호
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• pp.48-54
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• 2015

Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed. Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated. Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period. Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

• 한국산학기술학회논문지
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• 제15권3호
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• pp.1375-1381
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• 2014

본 연구는 창의성과 많은 관련을 가진다고 알려진 개인내적 변인인 아동의 개방적 성격과 대표적인 양육변인인 어머니의 양육태도가 창의성에 미치는 영향을 탐구하고, 이 변인들이 창의성을 매개하여 아동의 안녕감에 미치는 영향을 알아보고자 하였다. 248명의 초등학교 저학년 아동을 대상으로 분석 결과, 아동의 경험에 대한 개방성은 창의성을 부분 매개하여 주관적 안녕감에 영향을 미치는 것으로 드러났다. 하지만 어머니의 긍정적 양육태도는 창의성을 매개하지 않고 직접 안녕감에 영향을 주었다. 본 연구는 개방성 성격이 적응에 미치는 영향을 창의성을 통해 이해할 수 있다는 점을 시사하였으며, 창의성을 증진시키는 특별한 양육방식은 존재하지 않는다는 일부 선행연구의 결과를 지지하는 것으로 해석되었다.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.75-80
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• 2017

Purpose: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. Methods: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. Results: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the $mean{\pm}standard$ deviation (SD) age at infection was $13.3{\pm}3.9$ years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was $13.1{\pm}3.9$ years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. Conclusions: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.

• Perspectives in Nursing Science
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• 제12권2호
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• pp.71-81
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• 2015

Purpose: This study aimed to describe pediatric nurses' knowledge and attitude towards management of children's postoperative pain. Methods: In this cross-sectional descriptive study, the participants were 220 pediatric nurses who worked at a general hospital in Seoul. The survey questionnaires used to assess the nurses' knowledge and attitude regarding children's postoperative pain were developed for this study. Results: The average score for knowledge was 67.7 out of 100. The mean score for attitude was 72.5 out of 100. The factor related to the knowledge level was education for pain management. Moreover, age, working department, position, working experience, education level, and number of children were associated with the attitude. Conclusion: The findings of this study suggested the need for a systematic education program for pain management of children in the postoperative condition.

• Child Health Nursing Research
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• 제8권2호
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• pp.174-182
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• 2002

The purpose of this study was to investigate the experiences of accident and visiting emergency center, and the experiences of education about emergency care for parents. The subjects of this study were 117 mothers whose children are attending 9 different nursery schools or kindergartens. The instrument used in this study was developed by researchers and validated by nursing professor, first aid doctor and the president of nursery school, and consisted of 'most important thing in child rearing' ,'experiences of accident and visiting emergency center', 'type of trauma' and 'need for parent education program' the result of this study were as followed ; 1.There were 70.09％ of the experience of visiting emergency center among the subjects. The cause of visiting emergency center were high fever and convulsion(42.86％), and trauma by accident(28.04％) 2. The most common type of the indoor accident were fall down and slipping(76.92％), the common type of trauma were contusion (76.92％), abrasion(47.01％), laceration(29.06％), dislocation or fracture(12.82％), burn(10.26％), piercing(8.55％). 3.47.01％ of subjects had the experience of education about emergency care for parents. They were educated by child rearing journals (32.72％), small books which were published by hospitals or community health center (25.45％), mass media(21.8％), parent seminar (12.72％), nursery school or kindergarten (5.45％). In conclusion, the need of emergency care for children was strongly found. Therefore, on the basis of above results, the parent education program which fits their cognitive level and their health care needs So, it must be directed on the further study of parents' knowledge about emergency care for children. To enhance the effectiveness of program and accomplish the children's health promotion, advanced instructional media and demonstration must be included.

• Human Ecology Research
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• 제54권1호
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• pp.83-95
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• 2016

This study explored the processes of parental divorce and adaptation in single-parent families as well as examined how the experience of living in family welfare facilities influences the adaptation process of such families. The research question to achieve the study objective was, "What is the adaption process for a singlefather family, and what influence does living in a single-father family welfare facility have on that process?" Data collection was conducted between June 2013 and April 2014 that included an in-depth interview process and continuous participatory observations on 14 children residing in the facility. The study results were as follows. The theme in a two-parent family period was 'changes in reduction of family: serious conflicts between parents.' Children directly witnessed intense conflicts between parents and experienced anxiety from situations that involved verbal and physical violence during the two-parent family period. The experience of children prior to entering the facility was represented by "loss and confusion experienced." The theme for children of singlefather family in entering a facility was "selecting a realistic alternative." Children's daily activities consisted of being with friends of a similar age, which allowed them to play and support each other in building social skills. The facility departure theme for the children was "hope for a new life."

• Neonatal Medicine
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• 제28권3호
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• pp.116-123
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• 2021

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

• Advances in pediatric surgery
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• 제17권2호
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• pp.133-138
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• 2011

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

• 가정과삶의질연구
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• 제11권2호
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• pp.134-146
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• 1993

The purpose of this study was to collect the datas about the child care arrangement and the needs of day care programs of teaching mothers with preschool children and to develop the more desirable day care programs for them. The objects were 255 teaching mothers with preschool children. The results were as follows: 1) Teaching mothers who didn't use the day care center tended to put their children in the care of the paternal or maternal grandmothers, Major contributions of those baby-sitters were to protect the children and make everyday life training (44.0%) 2) The first reason for the mothers who used the day care center was that they had no other hands for their children(43.7%) and next reason was that the concerns for their children's socialization(35.4%) 3) Teaching mothers did not want the day care service during the vacation except 20% of them. 4) Teaching mothers absolutely wanted the day care service center especially inside their jobsite(61.0%) than any other type of day care programs and also wanted supporting by the government(66.5%) About the choice criterions of the day care center nutrition health and safety were suggested as the most important factor. They also prefered the experience with other peers and the programs focusing on the emotional development of the children.

• Clinical and Experimental Pediatrics
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• 제53권6호
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• pp.705-710
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• 2010

Purpose: To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit. Methods: A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007. Results: The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were $37^{+2}$ weeks and $2.5{\pm}0.7kg$, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age. Conclusion: Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.