• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.189-196
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• 2018

Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.233-239
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• 2018

Purpose: Viral gastroenteritis is a common disease in infants and children. Seizures can be associated with viral gastroenteritis as benign convulsions with mild gastroenteritis (CwG). After the development of the rotavirus vaccination, norovirus has become inreasingly significant in children. We retrospectively analyzed the clinical features in a pediatric population presenting with seizures and confirmed enteral viral infections, especially norovirus infections. Methods: We retrospectively reviewed the medical records of pediatric patients aged <15 years admitted due to convulsions and gastroenteritis to the Department of Pediatrics of Myongji Hospital between July 2014 and June 2016. Results: A total of 46 patients (24 male and 22 female) were included. Norovirus was detected in 21 (45.7%) patients, adenovirus in three (6.5%), rotavirus in two (4.3%), astrovirus in one (2.2%), and none of agents were detected in 19 (41.3%) patients. Patients in the norovirus gastroenteritis (NGE) group had a higher incidence of diarrhea than that among in the non-norovirus gastroenteritis (NNGE) group (61.9% vs 28.0%; P<0.05). Twelve patients experienced status epilepticus, including five (23.8%) in the NGE group and seven (33.0%) in the NNGE group (P=0.837). Seizures were effectively terminated by intravenous benzodiazepines in 8 (66.7%) of 12 patients. Additional long-acting antiepileptic drugs such as fosphenytoin or levetiracetam were required in three (25%) of 12 patients. Conclusion: Patients with CwG with and without noroviurs infection did not differ in terms of clinical features. However, status epilepticus was not uncommon among patients with CwG by definition.

• Phonetics and Speech Sciences
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• v.13 no.2
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• pp.77-90
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• 2021

This study is to develop a Korean version of nonword intervention by modifying and supplementing a Rapid syllable transition treatment (ReST) and to determine its effect by applying it to children with CAS. Ultimately, the purpose of this study is to investigate whether nonword interventions are effective for nonword production ability and generalization of real words. Single-subject research using the ABA design was performed for a child aged five years and six months with diagnostic features of CAS. The nonwords used in the interventions were made suitable for the individual child. The intervention was provided in one-hour sessions, twice a week for six weeks. In all cases, performance of the treated three-syllable nonwords improved, and untreated three-syllable words, four-syllable words, and nonwords showed a generalization effect. However, the generalization of treatment effects to words was smaller than for nonwords. The nonword intervention was effective in improving the subject's speech motor programming skills. As a result, transition errors due to impaired speech motor programming were greatly reduced, and the ability to produce untreated nonwords was greatly increased. However, there was a limit to the full improvement of strongly habitable word errors, which would be expected if a more intensive and repetitive intervention schedule was provided.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.81-96
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• 2011

Purpose : The purpose of this study was to analyse early childhood teachers' perspectives and actual conditions of earthquakes and tsunami safety education. Methods : A total of 119 teachers were recruited from kindergarten and child-care center located in J city, all of whom gave consent to take part in these research. The data have been collected for 45 days from May to July in 2011. The data was analyzed by SPSS (version 17.0) and chi-square test. Results : The results of this study are summarized as follow. 1. 97.5% of the subjects considered earthquakes and tsunami safety education necessary, however, only 34.6% of them were given the education related to earthquakes and tsunami. 2. 63.9% of the early childhood teachers provided children in the kindergarten or childhood center with earthquakes and tsunami safety education, however, 30.3% of them were found to be without any experiences of earthquakes and tsunami safety education. 3. 68.5% of the teachers were informed earthquakes and tsunami safety knowledge. 4. 35.0% of respondents answered that the single session of earthquake and tsunami education was not efficient, thus expecting to receive continuing education. Conclusions : The study suggested that more teachers necessarily provide earthquake and tsunami safety education to reduce children's mortality rate in earthquakes and tsunami. The education program should be developed and systematized to improve teacher's knowledge. Moreover, the program should be continuously provided to teachers and children in the kindergarten or childhood center.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.248-253
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• 2013

Purpose: The aim of this study was to compare the efficacy and safety of band ligation and injection sclerotherapy in the endoscopic treatment of children with variceal bleeding. Methods: The study population included 55 children, all of whom were treated at the time of endoscopic diagnosis of esophageal varices at Asan Medical Center, Seoul, Korea, between January 1994 and January 2011. The primary outcomes included initial success rates and duration of hemostasis after endoscopic management (band ligation vs. injectionsclerotherapy). Results: The mean age was $6.7{\pm}5.2$ years and the mean follow-up time was $5.4{\pm}3.7$ years. The most common cause of esophageal varices was biliary atresia. Of 55 children with acute variceal bleeding, 39 had band ligation and 16 had injection sclerotherapy. No differences between groups were observed in terms of the size, location, and presence of red color sign. The success rates of band ligation and sclerotherapy in the control of acute bleeding episodes were 89.7% and 87.5%. The mean duration of hemostasis after endoscopic intervention was $13.2{\pm}25.1$ months. After one year, 19 of 39 patients (48.7%) treated with band ligation and 7 of 16 patients (43.8%) with injection sclerotherapy had experienced rebleeding episodes. Complications after the procedures were observed in 10.3% and 18.8% of children treated with band ligation and injection sclerotherapy. Conclusion: The results of our current study suggest that band ligation and injection sclerotherapy are equally efficient treatments for the control of acute variceal bleeding and prevention of rebleeding.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.3
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• pp.178-185
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• 2017

Purpose: To evaluate the outcomes of a hybrid prophylactic strategy to prevent cytomegalovirus (CMV) disease in pediatric liver transplantation (LT) patients. Methods: CMV DNAemia was regularly monitored by quantitative nucleic acid amplification test (QNAT) and was quantified in all children. CMV infection and disease were defined according to the International Consensus Guidelines. The hybrid strategy against CMV infection consisted of universal 3-week prophylaxis and preemptive treatment of intravenous ganciclovir regardless of the recipient's serostatus. Results: A total of 143 children who underwent living donor LT were managed using the hybrid strategy. The overall incidence of CMV infection by QNAT was 48.3% (n=69/143). The highest CMV DNAemia positivity was observed in 49.2% (n=60/122) of children in the D+/R+ group, followed by 46.7% (n=7/15) in the D+/R- group. CMV disease was noted in 26.1% (n=18/69) patients. Forty-three (62.3%) children had undergone preemptive therapy consisting of intravenous ganciclovir. No symptomatic patients developed tissue-invasive disease, resulting in no CMV-associated mortality. Conclusion: The incidence of CMV infection was high in pediatric LT patients despite the hybrid strategy. However, tissue-invasive disease in pediatric LT did not occur.

• The Journal of the Korea Contents Association
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• v.16 no.8
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• pp.706-716
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• 2016

Because of efficient space utilization and fast key search times, B-trees have been widely accepted for the use of indexes in HDD-based DBMSs. However, when the B-ree is stored in flash memory, its costly operations of node updates may impair the performance of a DBMS. This is because the random updates in B-tree's leaf nodes could tremendously enlarge I/O costs for the garbage collecting actions of flash storage. To solve the problem, we make all the parents of leaf nodes the virtual nodes, which are not stored physically. Rather than, those nodes are dynamically generated and buffered by referring to their child nodes, at their access times during key searching. By performing node updates and tree reconstruction within a single flash block, our proposed B-tree can reduce the I/O costs for garbage collection and update operations in flash. Moreover, our scheme provides the better performance of key searches, compared with earlier flash-based B-trees. Through a mathematical performance model, we verify the performance advantages of the proposed flash B-tree.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.103-110
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• 1970

It is important to point out that the percental mortality rate of the multiple pregnancy is almost twice of the single pregnancy due mainly to their prematurity and the mothers of twins will also be suffered from the plural births to nurse and take care of them. We therefore studied the incidence, the sex ratio, the types of deliveries, the complications and the percental mortality rate of the twin deliveries in order to promote the development of our field of maternal and child nursing. We selected our materials from the 112 patients who had been admitted and delivered twins in the department of OB. & Gyn. of the S.N.U. Hospital from Jan. 1962 to Dec. 1969. The abstructed results of this study were as follows. 1. The incidence of twins among 7, 731 births was 1:69 2. The occurrence of twins from elder multigravida was 4 to 6 times higher than younger primigravida mothers under 35 years of age. 3. The generational length of 45.5% of all twins was under 38 weeks and the mean birth weight of 1st and 2nd twins were 2, 354.7gm and 2, 215.8gm respectively. 4. The sex ratio of twins was 99 males and 124 females. 5. Presentation of twins: 59 cases (52.69%) were in both vertex. 37 cases (33.03%) in vertex plus breech. 15 cases (13.39%) in both breech and one case (0.89%) in transverse presentation. 6. For the types of deliveries Spontaneous deliveries were in 90 babies (40.6%) Breech extraction in 60 babies (26.3%) Vacuum used in 33 babies (15.0%) Cesarean section in 33 babies (9.8%) Forceps in 9 babies (4.2%) and others such as version and destructive measures in 9 babies (4.1%) 7. Intervals between the 1st and 2nd delivery were analyzed and 93% of 2nd twins were delivered within minutes after 1st delivery. 8. The main complications of twin deliveries were totemic (45.5%), second was postmarital hemorrhage (19.6%) and third was hydrations (7.1%) 9. The mean percental mortality of 1st and 2nd twins was 12.52% and 16.96% respectively of which main cause of death were their prematurity.

• Korean Journal of Health Education and Promotion
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• v.24 no.4
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• pp.65-85
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• 2007

Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

• Korean Journal of Acupuncture
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• v.29 no.2
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• pp.200-215
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• 2012

Objectives : The purpose of this study is to investigate the differences of pulse wave parameter between the non delivery group (single women with no childbirth experience) and the delivery group (married women who gave birth(s) in delivery). Methods : Sixty one healthy (non delivery) nulliparous women and fifty three delivery women participated in this study. We used 3 dimensional pulse analyser(3D MAC, DAEYOMEDI co., Korea), which measures radial pulse waveform non-invasively by way of tonometry method at 5 different applied pressure levels. From 114 subjects enrolled, pulse wave parameters were measured on the six locations of Chon, Kwan and Cheok of each hands. Results : Delivery group's pulse showed larger values in the following pulse wave parameters (Energy, Ap, RAI, As, Aw, h1, h2, h4, h4/h1, t, t1, t2, t4, Wm, Wm/t). Non delivery group's pulse indicated larger values in the pulse wave parameters such as Energy of left Chon, difference pulse energy between left and right hand, Ad, h5, h5/h1, t5. Conclusions : According to the analysis result, delivery group's pulse has bigger values in most part of pulse wave parameters, especially in Kwan and Cheok which correspond to Liver, Kidney, and Myeong-mun. We interpret these results that delivery women are more mature and stable in reproductive organs than non delivery group, as they have experienced delivery(deliveries) and child-caring through married life.