Self-Symptom Checker for COVID-19 Control and Symptom Management / 보건행정학회지

Background@#Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. @*Methods@#SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. @*Results@#From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. @*Conclusion@#By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.

Allergen sensitization trajectories in children with respiratory and allergic diseases

Purpose@#There is a lack of a report about the trajectories of allergen sensitization, although it is important to understand the change of allergen sensitization to manage allergic disease. This study aimed to analyze the change and trajectories of allergen sensitization in children with respiratory and allergic diseases. @*Methods@#From 2006 to 2020, children with respiratory and allergic diseases or screened for allergic sensitization were evaluated. We visualized the alterations and the trajectories of allergen sensitization using stacked area graphs, box plots, and Sankey diagrams. @*Results@#A total of 2,804 subjects were included, and allergic rhino-conjunctivitis was diagnosed in 1,931 children (68.9%). The mean age for the first test was 4.1 years, and that for the second test was 6.5 years. Children sensitized to class 1 food allergen before age 5 showed sensitizations more for other allergens and at a younger age after age 5 than children who were not. The atopic tendency continued once it had been obtained before the early school age in the persistence or the new development of sensitization. @*Conclusion@#Allergen sensitization has changed over time and has shown different patterns according to age. Its trajectory has taken a wide variety of courses in children with respiratory and allergic diseases until the early school age. These changes reflect the allergic diseases and socio-environmental characteristics of children and adolescents.

Acute viral gastroenteritis in children hospitalized in Iksan, Korea during December 2010-June 2011 / 소아과

PURPOSE: Viral etiology is common in cases of children with acute diarrhea, and antibiotic therapy is usually not required. Therefore, it is important to determine the distribution of common viruses among children hospitalized with acute diarrhea. METHODS: We included 186 children who suffered from acute diarrhea and were hospitalized at the Wonkwang University Hospital Pediatric ward from December 1, 2010 to June 30, 2011 in this study. Stool samples were collected and multiplex reverse transcriptase polymerase chain reaction (multiplex RT-PCR) was used to simultaneously determine the viral etiology such as rotavirus, norovirus, astrovirus, or adenovirus. RESULTS: Causative viruses were detected in 72 of the 186 cases (38.7%). The mean age of the virus-positive cases was 1 year and 9 months (range, 1 month to 11 years). Rotavirus was detected in 50/186 (26.9%); norovirus, in 18/186 (9.7%); and astrovirus, in 3/186 cases (1.6%). Adenovirus was not detected in any of the cases. Proportions of norovirus genogroups I and II were 21.1% and 78.9%, respectively. Four of the 51 rotavirus-positive cases (7.8%) had received rotavirus vaccination at least once. The mean duration of diarrhea was 2.8 days (range, 1 to 10 days) and vomiting occurred in 39 of the 72 cases (54.2%). CONCLUSION: Viral etiology was confirmed in about one-third of the children with acute diarrhea, and the most common viral agent was rotavirus, followed by norovirus.

Fulminant Clinical Course on Listeria Sepsis in Preterm and Late Preterm Neonates / 대한주산의학회잡지

Listeria monocytogenes is a facultative anaerobic, gram-positive bacillus. Listeria is commonly found in processed and prepared foods and listeriosis is associated with high morbidity and mortality. This bacterium is an important cause of severe infection in neonates and pregnant women. Pregnant women are at high risk for listeriosis, but symptoms are non-specific and diagnosis is difficult. Neonatal Listeriosis is generally a severe and fatal disease. There are two forms of the disease in the neonate, early- and late-onset, suggesting different modes of transmission. Generally, early detection and empirical treatment of listeriosis help to improve survival and prognosis. We explained two cases of L. monocytogenes sepsis with culture-proven in preterm and late preterm newborns from asymptomatic mothers. These neonates had fulminant clinical course even if standard antibiotics treatments were administrated.

A Case of Acute Myopericarditis Associated With Mycoplasma Pneumoniae Infection in a Child

Mycoplasma pneumoniae (M. pneumoniae) primarily causes respiratory tract infections in persons aged 5-20 years. Tracheobronchitis and bronchopneumonia are the most commonly recognized clinical symptoms associated with M. pneumoniae infection. Complications of this infection are unusual; in particular, cardiac involvement is very rare and is generally accompanied by pneumonia. Nonrespiratory illness can therefore involve direct invasion by M. pneumoniae or autoimmune mechanisms, as suggested by the frequency of cross reaction between human antigens and M. pneumoniae. Herein, we report a case of severe acute myopericarditis with pneumonia caused by M. pneumoniae in a healthy young child who presented with fever, lethargy, oliguria and dyspnea. She survived with aggressive therapy including clarithromycin, intravenous immunoglobulin, inotropics, and diuretics. The patient was discharged on the 19th day after admission and followed up 1 month thereafter at the outpatient clinic without sequelae.

Clinical disease characteristics according to karyotype in Turner syndrome / 소아과

PURPOSE: Turner syndrome (TS) is a disorder in which various anomalies can be accompanied, especially cardiovascular, renal, thyroid and auditory problems. The aim of this study is to identify the incidence of these disorders in patients with TS according to karyotype. METHODS: We reviewed medical records of 90 patients with TS diagnosed by chromosomal analysis in 4 hospitals from Jan 1998 to Dec 2007. We evaluated these cases by prepared protocol of 4 medical problems. RESULTS: The distribution of karyotype was 45,X (47.8%), mosaic pattern (34.4%) and structural aberration group (17.8%). Renal anomalies, cardiovascular anomalies, thyroid disorders and auditory problems are accompanied in 4.4%, 10.0%, 11.1% and 5.6%, respectively. 45,X group had renal anomalies (7.0%), cardiovascular anomalies (18.6%), thyroid disorders (9.3%) and auditory problems (11.6%). Mosaic group had renal anomalies (3.2%), thyroid disorders (12.9%), no cardiovascular anomalies and auditory problems. Structural aberration group had cardiovascular anomalies (6.3%), thyroid disorders (12.5%) and no other 2 problems. Patients with 45,X group had a significant higher incidence of cardiovascular anomalies (P=0.025). CONCLUSION: Our results indicate that there are differences clinically according to karyotype of TS, especially in incidence of cardiovascular anomalies.

Growth Changes after One Year of Gonadotropin-Releasing Hormone Agonist Treatment in Idiopathic True Precocious Puberty Girls: Multicenter Study in Honam Area / 대한소아내분비학회지

PURPOSE: We evaluated the effects of treatment with gonadotropin-releasing hormone agonist (GnRHa) on growth and sex hormone changes in idiopathic true precocious puberty girls. METHODS: From January 2003 through May 2007, forty-three female children, who were diagnosed as idiopathic true precocious puberty and were administered GnRHa for one year were enrolled in this retrospective study. We divided the patients into two groups according to midparental height (MPH) minus predicted adult height (PAH) (MPH-PAH > or = 5 cm, or MPH-PAH or = 5 cm), height standard deviation score for bone age (Ht SDS for BA) was significantly increased before and after treatment (-1.8 +/- 0.7 vs. -1.3 +/- 0.8). PAH after treatment was increased to 153.6 +/- 5.8 cm from 149.1 +/- 4.6 cm before treatment (PAH gain 4.5 +/- 4.4 cm). Furthermore, as MPH-PAH increased, so did PAH gain (r = 0.59, P or = 5 cm) before treatment attained significant height gain with GnRHa administration. The successful gonadal suppression was also observed.

Growth Changes after One Year of Gonadotropin-Releasing Hormone Agonist Treatment in Idiopathic True Precocious Puberty Girls: Multicenter Study in Honam Area / 대한소아내분비학회지

PURPOSE: We evaluated the effects of treatment with gonadotropin-releasing hormone agonist (GnRHa) on growth and sex hormone changes in idiopathic true precocious puberty girls. METHODS: From January 2003 through May 2007, forty-three female children, who were diagnosed as idiopathic true precocious puberty and were administered GnRHa for one year were enrolled in this retrospective study. We divided the patients into two groups according to midparental height (MPH) minus predicted adult height (PAH) (MPH-PAH > or = 5 cm, or MPH-PAH or = 5 cm), height standard deviation score for bone age (Ht SDS for BA) was significantly increased before and after treatment (-1.8 +/- 0.7 vs. -1.3 +/- 0.8). PAH after treatment was increased to 153.6 +/- 5.8 cm from 149.1 +/- 4.6 cm before treatment (PAH gain 4.5 +/- 4.4 cm). Furthermore, as MPH-PAH increased, so did PAH gain (r = 0.59, P or = 5 cm) before treatment attained significant height gain with GnRHa administration. The successful gonadal suppression was also observed.

Comparison and analysis of the effectiveness to high dose of aspirin and ibuprofen in acute phase of Kawasaki disease / 소아과

PURPOSE: We evaluated the effectiveness of treatment and cardiac complications of replacing a high dose of aspirin with a high dose of ibuprofen for children in acute phase of Kawasaki disease. We also analyzed the possibility of replacing a high dose of aspirin with a high dose of ibuprofen to prevent complications such as Reye's syndrome caused by aspirin. METHODS: One hundred eight children with Kawasaki disease were admitted in the pediatrics department from January 1, 2004 to December 31, 2008. Echocardiography and laboratory tests were performed during diagnosis, and the children were followed-up at 6-8 weeks after the diagnosis. We retrospectively analyzed their characteristics and clinical results. RESULTS: The children were assigned to receive either a high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or a high dose of ibuprofen with IVIG (ibuprofen group). A total of 55 and 53 children were included in the aspirin and ibuprofen groups, respectively. The mean defervescence period was 6.5+/-2.1 days in the aspirin group, and 6.9+/-1.9 days in the ibuprofen group (P=0.309). The number of failed treatments, during and after treatment, was 8 in the aspirin group and 10 in the ibuprofen group (P=0.547). There were 11 initial cardiac complications in the aspirin group, and 14 in the ibuprofen group, but children who showed improvement at follow-up was 7 and 13 in the aspirin and ibuprofen groups, respectively (P=0.133). Laboratory findings were also improved in both groups. CONCLUSION: We can be considered whether we will replace high dose of aspirin by high dose of ibuprofen in acute phase of Kawasaki disease. Therefore, we can prevent the severe complications of aspirin use, such as Reye's syndrome.

Causes of Precocious Puberty : Multicenter Study in Honam Area / 대한소아내분비학회지

PURPOSE:We analysed the spectrum of diagnoses made in a consecutive group of children referred for signs of precocious puberty and evaluated the clinical and endocrinologic characteristics. METHODS:Retrospective analysis of 375 children (365 girls and 10 boys) referred for evaluation of signs of precocious puberty between January 2003 and May 2007 was done. Results:The conditions causing precocious puberty were early puberty (36.3%), true precocious puberty (30.4%), premature thelarche (29.1%), pseudo-precocious puberty (3.7%), and premature pubarche (0.5%). Among girls, there were differences in the age of onset of puberty (premature thelarche, 5.4+/-2.6 years vs. true precocious puberty, 6.9+/-1.1 years vs. early puberty, 8.6+/-0.5 years). True precocious puberty girls showed higher height SDS (standard deviation score), weight SDS, BMI (body mass index) percentile, basal FSH (follicle stimulating hormone), LH (luteinizing hormone) and estradiol, more accelerated growth velocity and bone age than those with premature thelarche. True precocious puberty patients showed higher height SDS, weight SDS, and more bone age advancement when compared to those with early puberty. Later onset (>2 years) premature thelarche appeared in 89 girls (81.7% of premature thelarche) at 6.4+/-1.6 years, and among 42 patients followed-up, 8 girls developed true precocious puberty later. CONCLUSION:Common conditions causing precocious puberty are early puberty, true precocious puberty, and premature thelarche. Although premature thelarche may be regarded as a benign condition, true precocious puberty can develop in some patients, so careful follow-up will be needed.

Clinical characteristics of Epstein-Barr virus infection detected by polymerase chain reaction in children less than 15 years old / 소아과

PURPOSE: Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR). METHODS: EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (> or =37.5degrees C), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested. RESULTS: Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (> or =37.5degrees C) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31%); leukocytosis (WBC> or =10,000/mm3), in 54 patients (47%); and atypical lymphocyte (> or =20%), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients. CONCLUSION: The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.

Platelet count and mean platelet volume in low birth weight infants (< or =2,000 g) with sepsis / 소아과

PURPOSE: Sepsis is a common complication in Neonatal Intensive Care Units (NICU), seen especially in low birth weight (LBW) infants. A recent study showed that fungal or gram-negative sepsis is associated with a greater degree of thrombocytopenia than is seen with gram-positive sepsis. So, this study was undertaken to examine the platelet counts and platelet indices in LBW infants during episodes of sepsis. METHODS: We analyzed 36 cases with culture-proven sepsis on chart review in LBW infants admitted to the NICU at Wonkwang University Hospital from January 2001 to June 2006. RESULTS: Patients were grouped by organism type: gram-positive bacteria (1,521+/-309 g, 31.3+/-2.9 wk, 15/36), gram-negative bacteria (1,467+/-290 g, 30.6+/-3.6 wk, 17/36), and fungi (1,287+/-205 g, 30.0+/-3.9 wk, 4/36). The most common organism was Staphylococcus epidermis and the incidence of thrombocytopenia was 88.9%. When compared with infants with gram-positive sepsis, those with gram- negative sepsis had significantly higher incidences of thrombocytopenia, lower initial platelet count, lower platelet nadir, and greater mean percentage decrease in platelet count from before the onset of sepsis. Those with fungal infections were similar to gram-negative sepsis, but they were not significant because of the small number of patients. And mean platelet volume (MPV) in sepsis was increased more significantly in time of platelet nadir than before the onset of sepsis. CONCLUSION: We conclude that decrease in platelet count was significantly greater in gram-negative sepsis than gram-positive sepsis, and also greater than fungal sepsis-which was insignificant because of the small number of patients-in LBW infants. And elevation in MPV will be helpful in the diagnosis and treatment of sepsis in LBW infants.

Lower respiratory tract infection of positive antigen test for respiratory syncytial virus on children under 2 years of age / 소아과

PURPOSE: This study was design and performed for evaluations of resent clinical pattern of bronchiolitis caused by RSV infection with children under 2 year of age for 5 years, who were admitted to pediatric ward. METHODS: The inclusion criteria of the patients were children under 24 month-of-age, clinical manifestations of lower respiratory tract infection, and RSV antigen that was detected by a direct immunofluorescence test from the nasal secretions. The additional laboratory and simple chest X-ray findings were reviewed from the medical records of children who were admitted Wonkwang university hospital from Jan. 1999 to Dec. 2003. RESULTS: In the 5 year study duration, 127 patients were enrolled and outbreak of RSV bronchiolitis took place in 2001. The 80 cases(63 percent) of RSV infection were concentrated in later autumn and winter. Number of the cases show coughing were 120(94.5 percent), but rale was audible in 78 cases(61.4 percent). Dyspnea, wheezing, and intercostal retraction were noticed in 27(21.3 percent), 21(16.5 percent), and 4(3 percent) cases respectively. The most common chest X-ray finding was hyperinflation of the lung that was noticed in 110 cases(86.6 percent). Care with mechanical ventilator for more than 2 days required in 5 cases. CONCLUSION: Lower respiratory tract infection by RSV was common in late autumn and winter season but year-round infection was noticed. The severity of RSV respiratory tract infectiontakes in some degree a grave course. So we suggest that population-based surveillance of acute respiratory infection due to RSV is necessary for assessment of prevalence and epidemiology of this disease.

Indication of Gonadotropin-Releasing Hormone Agonist: Precocious Puberty or Advanced Puberty? / 대한소아내분비학회지

No abstract available.

Hypothyroidism / 소아과

Hypothyroidism is a deficiency in thyroid hormone secretion by the thyroid gland and a defect in thyroid hormonal receptor activity. It is categorized by the two major forms in children, the one is congenital hypothyroidism and the other is acquired hypothyroidism. Congenital hypothyroidism is one of the commonest treatable causes of mental retardation and occurs in 1 in 3, 000-4, 000 infants worldwide. Acquired hypothyroidism is a diseases that have an onset usually after 6 months of age and it may be relate to deceleration in linear growth. The objectives of this article are obtain general and practical concepts of congenital and acquired hypothyroidism during infancy, childhood, and adolescence.

Acute Glomerulonephritis / 소아과

No abstract available.

A basic study for respiratory sybcytial virus detection using polymerase chain reaction

No abstract available.

Milk Feeding Methods and the Changes of Serum Lactate Level in Infants with Iron Deficiency Anemia

PURPOSE: Infants undergo critical and rapid stages of growth. Optimal nutrition during this period is therefore essential. Iron deficiency is especially impotant and common. The aim of this study was to determine the present status and problems of milk feeding methods in infants with iron deficiency anemia and, futhermore, to develop appropriate feeding guidelines for adequate iron nutrition. Latate is the end product of the anaerobic metabolism of glucose. Also we studied the changes of serum lactate level in this patients and calculated correlations between serum lactate level and diagnostic parameters of iron deficiency anemia. METHODS: We studied 42 children with iron deficiency anemia who visited Wonkwang university hospital from February 1995 to July 1996. We analyzed the type and duration of milk feeding method. And we measured serum lacate level and diagnostic parameters of iron deficiency anemia. RESULTS: The mean age was 17.0 months and male to female ratio was 7:1. On the analysis of milk feeding methods the breast feeding, the cow's milk, the mixed feeding were 73.8%, 11.9%, 14.3% respectively. The breast feeding group distributed mainly from 6 month to 18 month and 1 patient showed prolonged breast feeding until 48 month. We checked serum lactate level in 22 subjects. The mean serum lactate level was increased than normal adult level but there were no significant correlation between serum lactate level and diagnostic parameters of iron deficiency anemia (Hb, Hct, MCV, MCH, MCHC, serum iron, TIBC, ferritin). CONCLUSION: The most common problem of milk feeding method in infants with iron deficiency anemia was prolonged breast feeding and some infants fed excessive cow's milk. We need correct and proper education about merits and disadvantages of breast and cow's milk feeding to mothers. The mean serum lactate level in children with iron deficiency anemia was increased but serum lacate level can't use a diagnostic parameter of iron deficiency anemia.

Effects of Growth Hormone Secretion with Insulin Induced Hypoglycemia and L-dopa in Children with Short Stature / 대한소아내분비학회지

PURPOSE:Insulin induced hypoglycemia and L-dopa are potent for growth hormone(GH) secretion in children. We evaluated the effects of GH secretion with insulin and L-dopa in 22 children with height percentile below 3 and 11 children with height percentile between 10 to 25. METHODS:Thirty four children were performed GH secretion study after classified by height percentile and bone age according to their age and sex. Twenty two children are height percentile below 3 and bone age is delayed more than one years compare to chronologic age(group A). As a control group, twelve children took part in this study and their height percentile were between 10 to 25 but, bone age was not concerned(group B). Serum GH concentration and blood glucose level was detected on 0, 30, 60, and 90 minutes after insulin 0.1U/kg was injected intravenously. And then serum GH concentration was measured on 0, 30, 60, and 90 minutes after L-dopa 10mg/kg was administered orally. Serum GH was measured by radioimmunoassay. RESULTS:GH level in group A was below 7ng/mL in 13 children(59%) after insulin and L-dopa administration respectively but in 11 children(50%) GH level were all below 7ng/mL after insulin and L-dopa adminstration. GH deficiency(7ng/mL) was detected only one children in group B. In Group A and B, peak GH concentration was noted on 30 minutes after insulin administration, but on 60 minutes after L-dopa, peak GH concentration appeared in group B. GH concentration in zero time to 90 minutes after L-dopa was steady increased in group A. CONCLUSION: Anthropometric data such as height percentile and bone age are good for prediction of GH deficiency and if we use these data and GH secretory effects of insulin induced hypoglycemia and L-dopa, we can predict GH deficiency more accurately.

A Clinical Study of Acute Glomerulonephritis in Children

No abstract available.