• Childhood Kidney Diseases
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• v.2 no.2
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• pp.152-160
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• 1998

Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically. Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed. Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{\pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$\%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50\%$, each. 4) Resolution rates in relation to the age at diagnosis were $100\%$ for below 1 mo, $48\%$ between 1 mo to 1 yr, $56\%$ between 1 to 6 yr, and $13\%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93\%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32\%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up. Conclusion: The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.41-50
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• 2007

Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.17-22
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• 2000

Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.143-149
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• 2008

Purpose: To estimate the long-term therapeutic efficacy and safety of adefovir dipivoxil in children and adolescents with chronic hepatitis B who have developed lamivudine resistance. Methods: Sixteen patients (12 boys and 4 girls; ages 4.3~20.9 years; mean age 14.2 years) with chronic hepatitis B infection resistant to lamivudine therapy received adefovir (0.3 mg/kg/day, maximal dose 10 mg) orally for at least 9 months between March 2004 and April 2008. Each patient was followed up for a mean period of 27 months (range 9~49 months) until April 2008 at Kyungpook National University Hospital in Korea. Therapeutic responses to adefovir were evaluated at 12, 24, 36, and 48 months from the initiation of therapy using the Kaplan-Meier method. Response measurements included ALT normalization, HBV DNA negativization, 2 $log_{10}$ IU/mL decrement of HBeAg titer, HBeAg loss, and HBeAg/Ab seroconversion rate. Results: Three (18.8%) of the 16 patients treated with adefovir showed HBeAg/Ab seroconversion. Kaplan-Meier estimates of cumulative ALT normalization were 12.5% (12 months), 43.8% (24 months), 63.5% (36 months), and 92.7% (48 months), respectively. Cumulative HBV DNA negativization was 6.7%, 30.0%, 45.6%, and 78.2% at 12, 24, 36, and 48 months, respectively. Cumulative 2 $log_{10}$ copies/mL decrement of HBeAg titer was 12.5%, 43.8%, 56.3%, and 86.9% at 12, 24, 36, and 48 months, respectively. Cumulative HBeAg loss and HBeAg/Ab seroconversion were 6.7% (12 months) and 22.2% (24 months), respectively. Conclusion: The long-term therapeutic efficacy of adefovir dipivoxil was favorable in children and adolescents with chronic hepatitis B who had developed lamivudine resistance. The long-term use of adefovir should be safe in children.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.2
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• pp.49-71
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• 2000

The purpose of this study was to serve as a basis for school health care of better quality, by making a comparative analysis of the health care satisfaction and attitude of elementary school students in consideration of their general characteristics and the presence or absence of nurse teacher. The subjects in this study were 919 selected six graders in 16 elementary schools in the city of Tongduchun, Koyang and Euijungbu, Yangju-kun and Yeunchun-kun. A survey was conducted with questionnaire designed for measurement of health care satisfaction and attitude. As a result of analyzing the data collected from June 1 through 15, 2000, the conclusions were as follows. 1) As for the general characteristics of the students investigated, the subjects included 513 boys(55.8%) and 406 girls(44.2%). The schools where 390(42.4%) students attended were located in municipal area, and the schools where 529(57.6%) students attended were located in kun area. 608(66.2%) students had a nurse teacher at their schools, while 311(33.8%) students had no nurse teacher. 498(54.2%) had an experience to use the health room this year, but 421(45.8%) had no such an experience. Their mean school life satisfaction was scored $3.42{\pm}.71$, above the average. And their health condition was rated $3.81{\pm}.87$, which implied they tended to be in good health. 2) The mean satisfaction at the health room operation was scored $3.33{\pm}.71$, above the medium level. What they were most satisfied with($4.02{\pm}1.08$) was, among the health room facilities, that there were beds. But they expressed the least satisfaction($2.83{\pm}1.17$) at the location of health room. The presence or absence of nurse teacher made a significant difference to their satisfactionat health room operation, because the students in schools with nurse teacher showed greater satisfaction($3.42{\pm}.72$) than the others in schools with no nurse teacher did($3.15{\pm}.66$). 3) Concerning their attitude to use the health room in case of disease or accident occurrence, a lot of students in schools with a nurse teacher, who had ever suffered from indigestion, headache or traumatic injury, used the health room. In schools with no nurse teacher, there was a tendency to talk to their class teachers(p<.001). The recognition of the necessity for health counseling was generally on a medium level. The counselor whom they wanted to discuss health problem with was family or friend in the largest cases. Few students discussed with class teachers in case there was a nurse teacher in school. Instead, some of them discussed with friend, family or nurse teacher, and there was a significant difference between them(p<.001). 4) The mean satisfaction at health, sanitation and environmental management was rated $3.20{\pm}.90$, above the average. The classroom lighting gave them the best satisfaction with $3.67{\pm}1.07$, but the satisfaction at toilet cleanness and disinfection was not good with $2.83{\pm}1.19$. By the presence or absence of nurse teacher, those who had a nurse teacher expressed better satisfaction at water supply facilities including hot water than the others who had no nurse teacher did(p<.001). But no significant difference was observed in the other items. 5) The health education satisfaction was rated $3.19{\pm}.99$, which was on a medium level. By item, the mean satisfaction level was $3.36{\pm}1.19$ at nurse teacher's explanation about treatment, $3.13{\pm}1.15$ at the frequency of health education, and $3.08{\pm}1.16$ at the explanation on the cause of disease. By the presence or absence of nurse teacher, the students with nurse teacher showed significantly better satisfaction at every factor0(p<.001). 6) Regarding health education attitude, their recognition of the need for school health education was scored $3.89{\pm}.96$. Those who had a nurse teacher felt it more necessary($3.96{\pm}.92$), yet the others who had no nurse teacher felt its necessity a little less($3.74{\pm}1.01$). The most preferred thing for them to learn in health education was first aid, followed by sex education, obesity prevention, safety accident prevention in school and outdoors, smoking-related health, good use of leisure time, and environmental pollution cause in the order named. According to the presence or absence of nurse teacher, there was a significant difference in sex education(p<.01), but no significant disparities were found in the other factors. The most preferred person who would offer health education was a lecturer from the outside(45.8%) and nurse teacher(45.4%). Their preference for class teacher as a person in charge of health education was just 8.8%. But the presence or absence of nurse teacher didn't produce any differences to their preference for a person in charge of health education.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.341-346
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• 1999

Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

• Journal of The Korean Association For Science Education
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• v.24 no.6
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• pp.1118-1130
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• 2004

This article aims to (a) investigate children's images of a scientist's life style by comparing children's drawings about a scientist's schedule with those about a company employee's schedule in a weekday and on Sunday; and (b) examine the usefulness of 'Drawing A Scientist's Schedule (DASS)' test as a new instrument of learners' conceptions of a scientist and his/her work. To do those, thirty sixth- grade children participated in this study. The children, 15 boys and 15 girls, were selected from a classroom of an elementary school located in Gongju city. The children's drawings were analyzed in conjunction with individual interviews. The interviews facilitated the clarification of any ambiguous attributes of the drawings by questioning after their completion. Several significant conclusions can be drawn from this work: First, the children conceived that a scientist has more mandatory time, and less necessary and leisure time than does a company employee. Interestingly, many children thought that a scientist has similar life style on Sunday to that in a weekday, unlike a company employee. Second, in case of necessary time use in a weekday and on Sunday, the difference between a scientist and a company employee results from their sleeping time. Also, the children showed more various conceptions of a scientist's sleeping time than those of a company employee's sleeping time. Third, in case of mandatory time use, the children conceived that a scientist spends more time for his/her occupational work and less time for his/her housework activities than does a company employee. Fourth, the children's drawings showed that there is difference between a scientist's and a company employee's leisure time use and activities. Finally, the DASS test indicated its possibility and usefulness as an instrument for investigating learners' images on a scientist and his/her work. The instrument exhibited several distinctive children's conceptions that is difficult in identifying by using the DAST, a popular instrument.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.2
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• pp.63-73
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• 2015

Objective : To report the effects of a specific intervention, the Interactive Metronome$^{(R)}$ (IM), on timing, attention and motor function of a children with ADHD. Methods : The study is case reports about two boys with ADHD. One boy who is born 2008 is attending general elementary school as a first year student (case 1), and another boy who is born 2001 is attending general elementary school as a second year student (case 2). For each case subject, IM training was provided during 3 weeks, from January 2015 to Febrary 2015. Evaluations were performed pre- and post-intervention in order to exam timing, attention and motor skills. The measurements uses in this study are Long Form Assessment (LFA) for the timing, RehaCom screening module for the attention, and Bruininks-Oseretsky Test of Morot Proficiency, second version (BOT-2) for the motor function. Results : The timing function was improved in both cases since both showed reduced response time for all motor tasks of LFA. In terms of attention, case 1 showed improvement of visual attention division, neglect and response Inhibition, and case 2 showed improvement of sustained attention. Lastly, in the BOT-2, case 1 showed improved the percentile rank of short (from 42%ile to 96%ile), and case 2 also showed similar improvement (from 21%ile to 66%ile). Conclusion : This study provides positive evidence that the Interactive Metronome$^{(R)}$ training has positive power to facilitate several body functions such as timing, attention and motor control of children with ADHD, through two case studies.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.42-50
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• 2003

Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.356-363
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• 2009

Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.