• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.40-50
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• 2016

Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.377-386
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• 2019

Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (${\leq}8$ hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.

• Korean Architects
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• s.568
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• pp.72-85
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• 2016

• Korean Journal of Child Studies
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• v.28 no.6
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• pp.201-215
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• 2007

This study examined cortisol patterning in 160 children(79 boys, 81 girls; aged 4-5) attending twelve childcare centers in Seoul and Kyunggi Province. Saliva samples for the assay of cortisol were collected twice a day at 10 : 30 am and 3 : 30 pm. Saliva samples were collected again within a week after the first collection. Data were analyzed with descriptive statistics and multiple regression analysis. The cortisol level of the afternoon showed neither increase nor decrease compared to morning. Regression analysis indicated that time children spent at childcare centers accounted for increased afternoon cortisol levels; that is, higher levels of afternoon cortisol were associated with more hours per day at childcare centers.

• Korean Journal of Childcare and Education
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• v.10 no.3
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• pp.159-177
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• 2014

The purpose of this study was to examine the influential factors on parenting guilt of mothers who use a day-care center. To achieve these research goals, the present study 1) analysed the differences in the mother's parenting guilt as the socio-demographic variables of the mother and child, and 2) examined the relative effect size of influences on the mother's parenting guilt with their parenting efficacy, satisfaction on the day-care center, emotional and informational support from teachers, and mother's active interaction with day-care teachers. The participants of the study were 350 mothers whose infants and toddlers were attending day-care centers in Gwangju and Jeollanamdo. The results of this study are as follows. First, the mothers with infants who were younger than 3 years old reported more parenting guilt than the mothers with toddlers. Second, the mothers whose children were the first child reported more parenting guilt than the mothers with children who were the second or the third child. Third, the emotional support from the day-care teacher was the most influential factor on the mother's parenting guilt. This study suggests that the mutual cooperation between mother and day-care teacher are very important to reduce the mother's parenting guilt.

• Korean Journal of Childcare and Education
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• v.12 no.3
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• pp.211-238
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• 2016

This study examines indicators and factors for identification of ASD(Autism Spectrum Disorder) characteristics of infants and toddlers and early screening of children with ASD by day care teachers. Focus group interviews were conducted with 11 teachers by a semi-structured questionnaire developed by the authors. The findings are: 1) key problems and indicators of behavioral characteristics of children with ASD included problems with social communication and interactions, restricted and unusual interests, outstanding ability in specific areas, insistence on sameness and ritualized patterns, problems with language development and communication, sensory abnormalities; 2) counseling with parents of children with ASD revealed a lack of recognition of parents, negative expressions of emotions and resistance, and difficulties in referral to and association with experts; 3) needs for ASD in the child care field included visiting by experts, provision of test scales, training of child care teachers and parents, and building cooperative systems; and 4) demands of development and execution of a Korean-style scale for early screening of children with ASD.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.9-15
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• 2010

Purpose : This study was performed to investigate the prevalence of Staphylococcus aureus (S. aureus) nasal carriage in Korean children attending day care centers. Methods : During September and October 2009, a survey for nasal carriage of S. aureus and methicillin-resistant S. aureus (MRSA) was conducted among children attending day care centers located in Seoul with questionnaire survey for evaluation of risk factors of acquisition of MRSA was obtained from their guardians. A culture of the anterior nares swabs using enrichment broth was executed for isolating S. aureus and oxacillin susceptibility was assessed by the disk diffusion method. Results : Out of the 428 children enrolled whose mean age was 55 months old, 163 (38.1%) were colonized with S. aureus. Of the 163 isolates, 40 (24.5%) were MRSA. The nasal carriage rate of S. aureus showed an increasing trend with increase of age. Based on the answer to the questionnaire, 9.2% and 3.6% of children had a recent history of hospitalization and surgery, respectively, and approximately 40% of children had a history of prescription of antibiotics within 1 year prior to enrollment. Of the 428 subjects, 40 (9.3%) were MRSA nasal carriers. Conclusion : S. aureus and MRSA carriage rate of children attending day care center in Korea was 38.1% and 9.3%, respectively. Continued surveillance for nasal carriage rate of S. aureus and MRSA (especially community-associated MRSA) is mandatory.

• Korean Journal of Human Ecology
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• v.13 no.5
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• pp.711-721
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• 2004

This study is about the influences of the type of after school care and the degree of mothers' affection and monitoring toward their children on the psychological well being of children with working mother. For this research 437 children attending an elementary school with working parent were chosen. The major finding were as follows: First, the results of the findings on whether there were differences in the psychological well being of these children depending on the form of after school care showed that there were significant differences between loneliness and self-perceives competence felt by children. Second, the results of the findings on whether there were differences in the psychological well being of these children depending on the mother's affection and monitoring showed that there were significant differences between loneliness and self-perceives competence felt by children. Third, Multiple regression analysis shows, no matter what type of care a child gets, a mother's affection is the most effective variable which influence toward a child's psychological well being.

• Korean Journal of Child Studies
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• v.13 no.2
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• pp.217-228
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• 1992

The purpose of this study is to examine the effects of early full-time nonparental care during infancy/toddlerhood on children's socioemotional behaviors during the preschool period. Subjects for this study were 105 three- to five-year-olds from middle-class families in the U. S. A. Children were assigned to one of three groups according to their early care history. Children's social interactions with peers and caregivers during indoor free-play sessions in day care centers were observed for 20 minutes. The head teachers rated the children's social and emotional behaviors on two questionnaires. Mothers completed the Attachment Q-sort for attachment assessment for the preschoolers. In addition, mothers were asked to fill out a questionnaire on their parenting practices. Children who had received full-time nonparental care during infancy and/or toddlerhood were rated by their teachers as being more intellectually competent than children who did not receive full-time nonparental care during first three years of life. They were, however, rated by teachers and were observed by the researcher as being more aggressive than children with no full-time nonparental care. These children were observed to engage in less wandering/onlooking behaviors than children who had not had any full-time nonparental care. Children's attachment security scores and dependency scores did not differ as a function of early nonparental care histories. When the effects of early care patterns, sex of child, and current attachment security to mothers on aggressive behaviors of the preschoolers were examined by a hierarchical regression model, then any "pure" effects of nonparental care and of attachment security on child aggression were minimal after controlling for family background, child care center quality, and maternal childrearing practices. Strong buffering factors for the preschool children (family characteristics, parenting styles, and high quality nonparental care) mediated a possible risk factor of early nonparental care and promoted optimal outcomes for the children.