• Childhood Kidney Diseases
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• v.4 no.2
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• pp.92-101
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• 2000

Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.61-71
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• 2018

Purpose: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. Methods: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. Results: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0-2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). Conclusions: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.269-278
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• 2002

Objective s: Chromosome aneuploidy is associated with recurrent abortion and congenital anomaly and genetic diseases occur repeatedly in the specific families. Preimplantation genetic diagnosis (PGD) can prevent aneuploidy or genetic disease by selecting normal embryos before implantation and is an alternative to prenatal diagnosis. The aim of this study is to assess the outcome of PGD cycles by using FISH or PCR, and to determine the clinical usefulness and values in patients with risk of chromosomal aneuploidy or genetic disease. Materials and Methods: From 1995 to Apr. 2001, a total of 108 PGD cycles in 65 patients with poor reproductive outcome were analyzed. The indications of PGD were translocation (n=49), inversion (n=2), aneuploidy screening (n=7), Duchenne muscular dystrophy (n=5) and spinal muscular atrophy (n=2). PGD was applied due to the history of recurrent abortion, previous birth of affected child or risk of aneuploidy related to sex chromosome aneuploidy or old age. Blastomere biopsy was performed in 6$\sim$10 cell stage embryo after IVF with ICSI. In the single blastomere, chromosome aneuploidy was diagnosed by using FISH and PCR was performed for the diagnosis of exon deletion in DMD or SMA. Results: The FISH or PCR amplification was successful in 94.3% of biopsied blastomeres. The rate of transferable balanced emb ryos was 24.0% in the chromosome translocation and inversion, 57.1% for the DMD and SMA, and 28.8% for the aneuploidy screening. Overall hCG positive rate per transfer was 17.8% (18/101) and clinical pregnancy rate was 13.9% (14/101) (11 term pregnancy, 3 abortion, and 4 biochemical pregnancy). The clinical pregnancy rate of translocation and inversion was 12.9% (11/85) and abortion rate was 27.3% (3/11). In the DMD and SMA, the clinical pregnancy rate was 33.3% (3/9) and all delivered at term. The PGD results were confirmed by amniocentesis and were correct. When the embryos developed to compaction or morula, the pregnancy rate was higher (32%) than that of the cases without compaction (7.2%, p<0.01). Conclusions: PGD by using FISH or PCR is useful to get n ormal pregnancy by reducing spontaneous abortion associated with chromosome aneuploidy in the patients with structural chromosome aberration or risk of aneuploidy and can prevent genetic disease prior to implantation.

• Korean Journal of Childcare and Education
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• v.10 no.6
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• pp.223-241
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• 2014

The objective of this study was to plan a direction for the connection of the area of inquiry in daily life between infants and young children in Korea based on the analysis of the early learning standards for infants aged 0~2, and young children aged 3~4/5 in 17 different states in America. The problem of the study is as follows: What is the content area of cognitive development, science and mathematics of early learning standards regarding age? The data used in this study was collected from a total of 17 states in America in which 12 states classify infants and young children as aged 0~2 and 3~4/5 respectively and 5 states do not classify the age groups. The results obtained from the analysis of the given issues are as follows. First, in the case of the five states that showed the group aged 0~4/5, the contents related to the area of inquiry in daily life of the early learning standards were included in the mathematics and science and a part of these contents were also included in cognitive developments. In the case of the 12 states that classified the groups aged 0~2 and 3~4/5 respectively, the group aged 0~2 included cognitive developments and the group aged 3~4/5 includes mathematics and science. Second, the contents related to the area of inquiry in daily life of the early learning standards in the five states that showed the single group aged 0~4/5 include the contents in order of scientific idea, biology, physics, and the earth and space. In the 12 states that classify different age groups. Third, in the case of the states that separate age groups, the group aged 0~2 include the contents of number and operation, geometry and space while the group aged 3~4/5 include the contents of number and operations, geometry and space, and measurement. The implications of this study was that it is necessary to take into account the linking between development and characteristics of the subjects.

• Korean Journal of Social Welfare
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• v.53
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• pp.129-153
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• 2003

This study examines the socio-economic impacts of recent welfare reform in the United States. Based on the neo-conservative critique to the traditional public assistance system for low-income families, the 1996 welfare reform has given greater emphases on reducing welfare dependency and increasing work effort and self-sufficiency among welfare recipients. In particular, the welfare reform legislation instituted 60-month lifetime limits on cash assistance, expanded mandatory work requirements, and placed financial penalties for noncompliance. With the well-timed economic boom in the second half of the 1990s, the welfare reform seems to achieve considerable progress; welfare caseload has declined sharply to reach less than 50% of its 1994 peak, single mothers' labor force participation has increased substantially, and child poverty has decreased. In spite of these good signals, the welfare reform also has several potential problems. Many welfare leavers participate in the labor market, but not all (or most) of them. The economic well being of working welfare leavers did not increased significantly, because earnings increase was canceled out by parallel decrease in welfare benefits. Furthermore, most of working welfare leavers are employed in jobs with poor employment stability and low wages, making them highly vulnerable to frequent layoff, long-time joblessness, persistent poverty, and welfare recidivism. Another serious problem of the welfare reform is that a substantial number of welfare recipients are faced with extreme difficulties in finding jobs, because they have severe barriers to employment. The new welfare system with 5-year time limit can severely threaten the livelihoods of these people. The welfare reform presupposes that welfare recipients can achieve self-reliance by increasing their labor market activities. However, empirical evidences suggest that many people are unable to respond to the new, work-oriented welfare strategy. It may be a very difficult task to achieve both objectives of the welfare reform((1) providing adequate income security for low-income families and (2) promoting self-sufficiency) at the same time, because sometimes they are conflicting each other. With this in mind, a possible solution can be to distinguish welfare recipients into "(Very)-Hard-to-Employ" group and "(Relatively)-Ready-to-Work" group, based on elaborate examinations of a wide range of personal conditions. For the former group, the primary objective of welfare policies should be the first one(providing income security). For the "Ready-to-Work" group, follow-up services to promote job retention and advancement, as well as skill-training and job-search services, are very important. The U. S. experiences of the welfare reform provide some useful implications for newly developing Korean public assistance policies for the able-bodied low-income population.

• Korea journal of population studies
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• v.30 no.2
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• pp.71-95
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• 2007

This paper attempts to identify the principle of family succession and family patterns of yangban in the late Chosun period through an analysis of male adaptation cases found in family registration records. The primary source of analysis is the family registration documents of Uiseong Kim's from the late 17th century to the early 20th century. As a result, it is found that there is a substantial change in the patterns of family from the early and mid Chosun period to the late Chosun period. The change is the strengthening of the principle of patriarchy succession through male adoption. Looking at the data as a whole, the average number of household members is increased and the membership of kinship also expanded. In contrast to the family patterns of the early Chosun period, not only the patterns of Uiseong Kim's family are predominately immediate family or collateral family but also the majority is extended family in the 18th and 19th centuries. The male adoption cases recorded in Uiseong Kim's family registration documents take up 33.8% of the male adoption cases in the entire family registration documents. This goes to show that the strengthening of the principle of primogeniture succession at a time when child mortality rate is very high resulted in the increase of male adoption. In conclusion, the late Chosun society was a society where the seat of primogeniture was much more important than immediate hereditary members in the family succession.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.11-24
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• 1976

This study was a part of large scale of a prospective study on attitudes of professional students in medicine, nursing and teaching toward population related issues in Korea. The study was first conducted in May 1974 and then in May 1975 for the 1974 class cohot using a questionaire consisted of attitude scales and other items developed by Lee. The purpose of stuay was twohold, namely, to determine the difference in students among specializations on one hand and between the first and second years in the 1974 class cohot regarding tile subject matter. A one-way analysis of variance was used for attitude scale, and absolute and relative frequency were computed for the analysis of non-attitude scale items by employing Fishers' Ratio and Duncan's multiple range test at 5% level and chi square test at 5% level as significance tests. The hypothesis 'students in health profession are more likely to have positive attitudes toward population related issues progressively as class year advances than students in teaching profession' was tested and the following results were obtained: 1) Nursing students were more likely to display favarable attitudes toward family planning than medical or teaching students although the class cohot showed slightly negative improvement in the second year. Medical and teaching students apperaed to have slightly improved attitudes in the second year. 2) Respondents in general perceived national family planning program as a means of population control and this tendency was more true among nursing students as the class year advances than two other professional groups of students. Students in teaching profession appeared to perceive it more as a means to improve individual family welfare while health students were likely to see as to improve maternal and child health. This tendency was progressively improved as the class year advanced. 3) The majority of students regardless of their respective specializations believed that family planning program should be directed toward the improvement of individual family welfare. No progressive changes in the class cohot were observed. 4) About the plan to use contraceptives in future, no singnificant differences were observes among different specializations nor in different class years. However, the majority was confirmed to have a plan to use contracepives in future. An increasing proportion of the undecided category was observed, as class year advanced among health students. 5) Students in health profession were found to be more favorable about 'more leisure opportunities' as motive for limiting number of children whereas education students indicated the reasons as 'facilitate ambitions' and 'economic base' The progressive changes toward positive direction in both groups were observed as the class years advanced. 6) Attitudes toward induced abortions of the health students were observed to be positively related to class years while an inverse relationship was found in teaching students who showed much less favor in the subject matter than health students. This phenomenon may be due to the different exposure to learning environments unique to respective specializations. 7) Health students were found to have more favorable attitudes toward population education in general than the teaching students. The teaching students appeared to have changed more to the negative direction when they became the second year while no such development was observed in health students. The teaching students seemed to hold a very conservative position with regard to sex education in schools. 8) About the equality of sexes, the nursing group was found to be most favorable while the reverse was true in the teaching group. A change in the negative direction as the class year advanced was found in the teaching group. 9) About questions related to fertility values-the 10 percent of respondents regardless of specialization indicated that they would maintain their single status in future, however no change was observed in the second year. The desired number of children was found to be two by the majority of students in nursing, medicine and teaching in order of high proportion. No changes in a different class year were observed. The childless marriage was seen by nursing students as a problem more than other students, but a slight change in positive direction was found when the nursing students became the second year. In summing, as data supported in the above, students in health profession demonstrated more favorable attitudes toward population related issues than the teaching students and this tendency became more apparent in the second year. It was noticed that health students were more conscious about the health aspect of population and family planning program while the teaching students gave more attention to the socioeconomic aspect. The sex variable seemed to have operated in the item related to the equality of sexes. In conclusion, as data presented in the above, the hypothesis of this study was accepted except in the few items. It should be noted that the limitation of this study is the short duration of the observation in measuring the possible attitude changes. It should include curriculum analysis for the respective specializations in order to indentify the area of curriculum impact on students in future study.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.71-78
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• 2017

Purpose: The aim of this study was to identify the pathogens of blood stream infection (BSI) in children with hemato-oncologic disorders, to analyze susceptibility patterns of microorganisms to guide empirical antimicrobial therapy, and to compare temporal trends of the pathogen and antimicrobial susceptibility with those of previous studies. Methods: We retrospectively analyzed the medical records of children with hemato-oncologic disorders whose blood culture grew pathogens at the Seoul National University Children's Hospital between 2011 and 2015. Results: A total of 167 patients developed 221 episodes of bacteremia. Among 229 pathogens, gram-negative bacteria (GNB) accounted for 69.0% (64.0% in 2002 to 2005, 63.4% in 2006 to 2010); gram-positive bacteria (GPB) accounted for 28.8% (31.3% in 2002 to 2005, 34.6% in 2006 to 2010); and fungus accounted for 2.2%. Among GNB, Klebsiella species (53.2%, 84/158) and Escherichia coli (19.6%, 31/158) were common. Staphylococcus aureus (48.5%, 32/66) and viridans streptococci (21.2%, 14/66) were frequently isolated among GPB. The susceptibilities of oxacillin and vancomycin in GPB were 54.8% and 96.9% (51.5% and 95.5% in 2002 to 2005; 34.1% and 90.5% in 2006 to 2010), respectively, whereas in GNB, the susceptibilities of cefotaxime, piperacillin/tazobactam, and imipenem were 73.2%, 77.2%, and 92.6% (75.9%, 82.8%, and 93.4% in 2002 to 2005; 62.8%, 82.9%, 93.8% and in 2006 to 2010), respectively. There were no significant differences in the proportion of etiologic agents or the antimicrobial susceptibilities between the current study and that of the previous two studies from 2002 to 2010. Overall fatality rate was 13.1%. Conclusions: GNB predominated in BSI among children with hemato-oncologic disorders. The etiology of bacteremia and antimicrobial susceptibility were comparable to those of the previous studies. Thus, piperacillin/tazobactam can be used as the initial empirical antimicrobial agent in febrile neutropenia.

• Journal of the Korean Society of Radiology
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• v.15 no.5
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• pp.629-636
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• 2021

The purpose of this study was to identify the effects of mammo pad made of different kinds of materials on the reduced inconvenience and compression pains of patients to examine plausible interchangeability of existing pads made of single kind of material, and to examine the changes in pains of patients taking mammography and various factors therein. The high-hardness and highly-elastic mammo pressure pads, capable of replacing existing mammo pad of "H" company, were manufactured, and the display quality of mammography obtained from respective mammo pad were compared to each other to appraise the availability of manufactured mammo pad. In addition, 200 patients, who came to a general hospital in Seoul, were selected as subjects for the survey employing a questionnaire which was distributed to the subjects from December 2018 to March 2020 to identify the factors involved with the mammo pad of patients while taking mammography. The results of mammography obtained from both of the existing and newly manufactured mammo pad revealed appropriate display qualities fell within the range of clinical criteria. Besides, the factors associated with changing compression pains of patients taking mammography were analyzed wherefrom the general factors in the following order of age, height, and BMI index appeared, while the experiential and female factors appeared as in the following order: presence of menstruation, experience of child-birth, experience of breast feeding, menopause, grade of breast, shape of breast, and experience of mammography. In conclusion, the following factors comprising the age, experience of breast feeding, experience of mammography, and menopause rendered approximately 54% of power of explaining the degree of changing pains during mammography. Regarding the changes in compression pains while taking mammography, the increasing experience of mammography of patients rendered approximately 0.26 times more at the intermediate range of compression pains and approximately 0.14 times more at the range of severe pains.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.32-41
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• 2019

Purpose: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. Methods: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. Results: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. Conclusions: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.