• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.236-243
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• 2017

Purpose: Studies on the efficacy of infliximab (IFX) in a large population of pediatric patients with Crohn's disease (CD) are limited, and prognostic factors are not well-known. The aim of this study was to evaluate outcomes of IFX in pediatric patients with CD and to identify factors associated with poor prognosis. Methods: We retrospectively analyzed medical data of 594 pediatric patients with CD between 1987 and 2013 in a tertiary center. Of these, 156 children treated with IFX were enrolled and were followed up for at least a year with intact data. Outcomes of induction and maintenance, classified as failure or clinical response, were evaluated on the tenth and 54th week of IFX therapy. Results: We treated 156 pediatric patients with CD with IFX, and the median duration of IFX therapy was 47 months. For IFX induction therapy, 134 (85.9%) patients experienced clinical response on the 10th week. Among the 134 patients who showed response to induction, 111 (82.8%) patients maintained the clinical response on the 54th week. In multivariate analysis, low hematocrit (p=0.046) at the time of IFX initiation was associated with the failure of IFX induction. For IFX maintenance therapy, longer duration from the initial diagnosis to IFX therapy (p=0.017) was associated with maintenance failure on the 54th week. Conclusion: We have shown the acceptable outcomes of IFX in a large cohort of pediatric CD patients in Korea. Hematocrit and early introduction of IFX may be prognostic factors for the outcomes of IFX.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.244-251
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• 2017

Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed $2.1{\pm}0.3$ times and $2.9{\pm}0.4$ times, respectively. After disimpaction, the frequency of defecation increased from $2.2{\pm}0.3$ per week to once a day ($1.1{\pm}0.1$ per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

• Journal of Life Science
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• v.18 no.4
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• pp.572-579
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• 2008

Genome research in economic animals has progressed rapidly in recent years, transforming from primitive genome maps to quantitative/qualitative trait maps that are indispensable to gene discovery. These advances have been benefited from the result of animal genome sequencing projects and functional genomics that are being extensively applied in livestock animal research following the development of large expressed sequences tags (ESTs). Genome sequencing efforts will provide information to QTL study by larger scale single nucleotide polymorphisms (SNPs) association study. Comparative genomics which is applying the information from human genome research as well as rodents model has contributed to important discoveries in economic animal genome research. These efforts will speed up much denser QTL maps development for phenotypic traits which are not easy to measure and to be identified by quantitative genetics [20] and lead to development of convincing markers associated with economically important trait, which will be eventually applied to livestock industry. In addition to practical application, animal genome research will enrich the understanding of human physiology in terms of genome biology.

• Allergy, Asthma & Respiratory Disease
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• v.6 no.6
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• pp.315-321
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• 2018

Purpose: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. Methods: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. Results: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was $12.7{\pm}3.2$ years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). Conclusion: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.

• Clinical and Experimental Pediatrics
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• v.64 no.7
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• pp.364-369
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• 2021

Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.492-499
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• 2021

Purpose: Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. Methods: Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. Results: IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p=0.006). Conclusion: The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.

• The Journal of Industrial Distribution & Business
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• v.12 no.11
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• pp.33-50
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• 2021

Purpose: In South Korea, two kinds of mandatory insurance, Fierce Liability Insurance and Outdoor Advertising Liability Insurance sells as of February 2021 according to relevant codes. This study analyzed third party liability and personal living liability insurance in terms of various risks not corporation side but personal side arising from normal living and life. Research design, data and methodology: Some cases of drone accident hit man and fierce dog accident were taken into analysis to verify blame ratio and insurance claim money. The former case is that on the way down the elevator, the dog, American pit bull terrier rushed in and bit the lower part of the knee against the visitor. The latter case is that while flying in the sky as usual, the drone suddenly crashed, fell, and hit the head of a young child while walking on the street. Further previous studies such as third party liabilities, liability insurance, mandatory insurance were deeply analyzed. Results: Based on some case studies and previous studies, the author suggested valuable comments in turn realization of insurer as provider, exhaustive creation and operation of mandatory insurance, realization of insured as demanded, and arrangements of laws and systems in special consideration of amendment of companion animal and exhaustive execution of mandatory insurance by the government. Conclusions: This study was about third party liability, personal living liability insurance and expansion of mandatory insurance caused by relevant laws by the government. In this study the author verified what issues were observed from two cases drone accident and fierce dog accident and then suggested some valuable comment as above both systemic plans and practical plans. First of all, the individual should get Comprehensive Property Insurance(CPI) that covers the risks of his/her own property arising from the everyday life. And then the individual should further buy Personal Living Liability Insurance(PLLI) in order to prepare 'accidents that may happen when, where, or how' and overcome the said accidents. Moreover, the individual should take a look every single insurance contract whether he/she has a special terms and conditions of Personal Living Liability Insurance(PLLI) or not.

• The Journal of Korean Association of Computer Education
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• v.22 no.3
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• pp.123-133
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• 2019

The purpose of this study is to establish Smart Education Environment for children's personalized learning based on the data are accumulated by Smart Device which is one of element on Smart Education. In this study, we propose the operational improvement plan for the free choice activity in the 5-year-old kindergarten and also implement the Free Choice Activity(FCA) management system for children to select and to evaluate the play plans for themselves. Children participating in this study have fun the whole time for the process of self-planning, the playing activities and the self-assessment of playing. As a result, it is confirmed that children participate actively in decision-making of interesting areas through the smart device than the traditional education environment before. A single teacher using FCA management system with smart device in this study can get useful information without difficulty of individual child's interests, learning and the statistics of children in the classroom.

• Clinical and Experimental Pediatrics
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• v.62 no.9
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• pp.353-359
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• 2019

Background: Researchers have shown that eosinophil peroxidase (EPO) is a relatively accurate marker of eosinophilia and eosinophil activity. However, its use as a marker of eosinophilic inflammation in nasal secretions is limited because the diagnostic cutoff values of EPO for use as a one-time test for allergic diseases such as allergic rhinitis have not been established. Purpose: To identify the correlation between nasal eosinophil count and EPO in children and adolescents with rhinitis. Methods: We recruited patients <18 years of age with rhinitis for more than 2 weeks or more than 2 episodes a year whose nasal eosinophil and EPO were measured at a single allergy clinic. The eosinophil percentage was calculated by dividing the eosinophil count by the number of total cells under light microscopy at ${\times}1,000$ magnification. EPO and protein were measured from nasal secretions. We retrospectively analyzed the correlation between nasal eosinophils and protein-corrected EPO (EPO/protein) value. Results: Of the 67 patients enrolled, 41 were male (61.2%); the mean age was $8.2{\pm}4.0years$. The median nasal eosinophil count was 1 and percentage was 1%. The median protein-corrected EPO value was $12.5ng/{\mu}g$ (range, $0-31ng/{\mu}g$). There was a statistically significant correlation between eosinophil count and percentage (P<0.001). However, the eosinophil percentage and EPO did not correlate. The eosinophil count and EPO had a statistically significant correlation (P=0.01). The EPO cutoff value examined for nasal eosinophil counts of 2, 5, 10, and 20 was $17.57ng/{\mu}g$ regardless of the reference count. The largest area under the curve value was obtained when the receiver operating characteristic curve was drawn using the eosinophil count of 2. Conclusion: Nasal eosinophil count was significantly associated with protein-corrected EPO.

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.173-178
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• 2019

Purpose: To determine whether Lactobacillus reuteri DSM 17938 plays a role in absorption of iron preparations given to children with iron deficiency anemia (IDA). Methods: We performed a quasi-experimental study involving pre- and postintervention tests using a control group in North Sulawesi province, Indonesia, between July and September 2017. We conducted a single-blind controlled trial that included primary school children who were diagnosed with IDA based on reticulocyte hemoglobin equivalent (Ret-He) levels <27.8 pg/L. Results: A total of 66 children were randomized into 2 groups. Thirty-four children received iron preparations with the addition of L. reuteri DSM 17938 (group 1), whereas the other 32 received iron preparations alone (group 2). The baseline Ret-He levels before intervention were similar in both groups. After 14 days of intervention, mean Ret-He level in group 1 changed from $24.43{\pm}1.64$ to $28.21{\pm}1.72pg/L$ (P=0.000). Mean Ret-He level in group 2 changed from $24.31{\pm}1.42$ to $27.03{\pm}2.14pg/L$ (P=0.000). Statistical analysis showed a significant increase in Ret-He levels in both groups; Ret-He levels were significantly higher in the experimental group than in the control group (P<0.05). Conclusion: Children with IDA receiving iron preparations with L. reuteri DSM 17938 for 14 days show higher Ret-He levels than those receiving iron preparations alone.