이 연구는 공공기관에서 도입하고 있는 일‧가정 양립을 위한 가족친화적 제 도의 활용과 공직만족도의 관계에 있어서 직무성과와 직무 스트레스의 매개 효과를 분석하였다. 분석결과는 다음과 같다. 첫째, 가족친화적 제도 활용에 대한 만족도가 높을수록 공직만족도가 높아지는 것으로 나타났다. 둘째, 가족 친화적 제도 활용 만족도와 공직만족도의 관계에 있어서 직무성과와 직무스 트레스의 매개효과가 유의미한 것으로 나타났다. 즉, 가족친화적 제도 활용에 대한 만족도가 높을수록 직무성과가 높아지고, 직무성과가 높을수록 공직만 족도가 높아지는 것으로 나타났다. 그리고 가족친화적 제도 활용에 대한 만족 도가 높을수록 직무 스트레스가 낮아지고, 직무스트레스가 낮을수록 공직만 족도가 높아지는 것으로 나타났다. 이러한 분석결과는 우리나라 공무원의 직 무성과를 높이고, 직무 스트레스를 낮춤으로써 공직만족도를 높여 공직 수행 의 효율성을 높일 수 있도록 조직의 차원에서 가족친화적 제도를 확대하기 위한 노력이 필요함을 보여주는 것이라고 할 수 있다.

필자는 지금까지 일본 헤이안 시대의 자서인 新撰字鏡에 수록된 이체자의 이체 유형과 부건을 분석하고, 각종 중요한 이체자, 특히 중국의 대형 자전에서도 다루지 않은 難字들을 가려내어 그 계통을 밝히는 작업을 해 왔다. 이 과정에서 新撰字鏡의 이체자들이 중국의 이체자와 자형 변천 과정에서 기본적으로는 동 일한 양상을 보이지만, 일반적인 이체 규율로 규정지을 수 없는 독특한 이체자들 도 즐비하다는 사실을 누구보다 잘 알게 되었다. 이처럼 독특한 이체자형은 한편 으로는 이 책의 가치를 높여주는 장점이 되지만 다른 각도에서 보면 이 책이 널리 읽히고 연구되는 데 저해요소가 되기도 한다. 따라서 필자는 新撰字鏡 연구의 첫 단계는 반드시 자형에 대한 연구, 특히 이체자에 대한 식자율을 높이고 정확한 자형을 판별해내는 일부터 시작해야 한다고 생각했다. 이에 따라 본 논문에서는 필자 본인을 비롯한 新撰字鏡을 접하는 독자들이 이 책에 수록된 이체자를 좀 더 쉽게 알아보고 이해할 수 있도록 다양한 글자들에서 나타나며, 이체현상이 활 발하게 일어나 다양한 이체자형을 보존하고 있으며, 중국의 자서에서도 잘 나타나 지 않는 독특한 이체자형이 많으면서도 그 이체현상이 문자학적으로 분석할 가치 가 높은 것들을 우선적으로 가려 뽑아 그 이체 현상을 상세하게 분석하였다.

Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder that predominantly affects the stomach and the small intestine, although its pathogenesis is not yet known precisely. EGE shows distinct peripheral eosinophilia and eosinophilic infiltration of the intestinal wall. A 12-month-old girl who was breastfeeding presented with bilateral eyelid swelling without gastrointestinal symptom. Laboratory examination showed peripheral eosinophilia and hypoalbuminemia and iron deficiency anemia. Gastric and duodenal biopsy specimens revealed eosinophilic infiltration of the mucosal layer. We experienced a case of eosinophilic gastroenteritis without any gastrointestinal symptom, associated with maternal food contained allergen.

Acute disseminated encephalomyelitis (ADEM) is a rare, postinfectious autoimmune inflammatory demyelinating disease of the central nervous system. ADEM presents clinically encephalopathy in association with polyfocal neurologic deficits. Of them, optic neuritis is less common symptom. We experienced ADEM with optic neuritis associated with Mycoplasma pneumoniae infection in a 5 year-old girl. She initially presented lethargy, irritability, ataxia and loss of pain sense on right hand and progressed to decreased visual acuity and papilledema of both eyes on the 4th hospital day. Brain magnetic resonance imaging showed multiple bilateral hyperintense lesions in the subcortical white matter on T2 weighted images. After administration of intravenous immunoglobulin and high dose intravenous methylprednisolone, she recovered completely.

There are very few reports and limited evidence that premedication with steroids decreases early recurrence of ileocolic intussusception after a successful hydrostatic reduction. The purpose of this study was to examine the role of steroids in decreasing early recurrence of idiopathic intussusceptions. A retrospective review of children that underwent successful hydrostatic reduction was conducted. Two groups were identified: group 1 (38 cases) that received intravenous methylprednisolone (1 mg/kg/dose) on diagnosis or immediately after the reduction maneuver, and group 2 (59 cases) were not given. There were 60 boys and 37 girls ranging in age from 6 to 84 months. There were no statistical differences between the groups regarding age, sex, duration of symptoms and laboratory findings on admission. There was no significant difference (p=0.76) in the rate of early recurrent intussusception between the steroid group (15.8%, 6/38) and the non-steroid group (13.6%, 8/59). We found that premedication of children with idiopathic intussusception with methylprednisolone did not decrease early recurrence of idiopathic intussusceptions.

The aim of this study was to determine the effect of acute respiratory viral infection on Kawasaki disease. From July 2016 to June 2018, among the patients who underwent respiratory virus screening at the Kwangju Christian Hospital, those diag-nosed 88 patients with Kawasaki disease were enrolled in this study. The effects of acute respiratory viral infection on Ka-wasaki disease were compared according to whether 2nd intravenous immunoglobulin (IVIG) treatment was administered or not, and whether coronary artery complications occurred. Respiratory virus was detected in 44 out of 88 patients. 2nd IVIG treatment rates were 16% (n=7) and 27% (n=12) in the virus positive group and the virus negative group, respectively (p>0.05). The incidence of coronary artery complications was 11% (n=5) and 25% (n=11) in the virus positive group and the virus negative group, respectively (p>0.05). There was no statistically significant correlation between the 2nd IVIG admin-istration and coronary artery complications following the detection of respiratory virus in patients with Kawasaki disease. We think it is necessary to actively study the effects of acute respiratory viral infection on Kawasaki disease through large-scale studies of multiple centers in the future.

The aim of this study was to investigate the factors associated with cerebrospinal fluid (CSF) pleocytosis in pediatric enteroviral meningitis. A retrospective analysis of the medical records was performed in 281 patients under 18 years of age who were diagnosed with enteroviral meningitis by reverse transcription-polymerase chain reaction (RT-PCR) at Kwangju Christian Hospital from January to December 2016. Clinical symptoms and laboratory findings were compared according to the presence or absence of CSF pleocytosis. 112 children (39.9%) did not have CSF pleocytosis. When we compared the group of meningitis without pleocytosis and the group with pleocytosis, age were younger (< 2years), and the interval between onset of symptoms and the time of lumbar puncture was shorter (<24 hours), peripheral white blood cell counts were lower, but C-reactive protein (CRP) was higher in the group of meningitis without pleocytosis. Enteroviral meningitis should not be excluded even if CSF pleocytosis is not seen in patients. And enterovirus CSF RT-PCR should be performed with high suspicion in children younger than 2 years.

Genetic factors are increasingly found as potential causes of children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Representative genes include cationic trypsinogen, serine protease 1 (PRSS1), serine protease inhibitor Kazal type 1 (SPINK1), cystic fibrosis transmembrane conductance regulator (CFTR), chymotrypsin C (CTRC) and calcium sensing receptor (CASR) genes, etc. In Korean children, PRSS1 and SPINK1 genes have been most commonly studied, while CFTR mutations were reported in one patient to date. We report a case of a 13-year-old male adolescent with CP with CFTR mutations. Since he was first diagnosed with idiopathic acute pancreatitis (IAP) based on laboratory and computed tomographic findings, he was admitted with ARP and CP over four times in a year at the secondary and tertiary hospital. No etiology was detected by several examinations including magnetic resonance cholangiopancreatography (MRCP), endosco-pic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS) with fine needle aspiration (FNA) biopsy and genetic test including PRSS1 and SPINK1. Although he had no typical symptoms associated with cystic fibrosis (CF), CFTR mutations were detected with additional gene examination. Testing for CFTR mutations should be concerned in pediatric patients with APR and CP without other identified causes.

There are reports that inhaling hypertonic saline with bronchodilator is helpful in the treatment of bronchiolitis. However, further studies are needed to determine if it is helpful to inhale hypertonic saline with bronchodilator in children with recurrent wheezing. We aimed to investigate the effect of hypertonic saline inhalation in children with recurrent wheezing. A total of 40 patients under 6 years of age admitted to Kwangju Christian Hospital from December 2014 to May 2016 were enrolled. Patients were randomly assigned to receive salbutamol. In the control group (n=21), salbutamol (2.5-5 mg / 0.5-1 mL) was inhaled four times a day with physiological saline (0.9% normal saline 1-3 mL). In the experimental group (n=19), the same amount of hypertonic saline (5% saline 1-3 mL) was inhaled four times a day instead of physiological saline. We compared the duration of wheezing remission between patients who had recurrent wheezing (n=40). There was no difference in the duration of wheezing remission in patients who had recurrent wheezing. But the hypertonic saline inhalation group had a lower post treatment clinical score on the 2nd-3rd day of admission than the physiological saline inhalation group. In this study, hypertonic saline inhalation therapy was not significantly effective in the treatment of recurrent wheezing. More additional research is needed to determine whether inhaled hypertonic saline is effective in the treatment of recurrent wheezing.

This study aimed to identify the respiratory viral etiology and clinical features in febrile neonates and young infants younger than 3 months of age. From June 2015 to March 2016, 126 patients who admitted to the pediatrics department of Kwangju Christian Hospital due to febrile illness (body temperature ≥ 38.0℃) without definite focus of fever. We tested nasopharyngeal aspiration specimens with real time reverse transcriptase polymerase chain reaction. Respiratory viruses identified in 66 patients, and not identified in 60 patients. Among identified viruses, the most common pathogen was rhinovirus. Respiratory virus identified patients showed significantly higher presence of sibling (p=0.015), sibling who attending day care center (p=0.022), respiratory symptoms of family members (p=0.022), concomitant respiratory symptoms of the patient (p=0.001).

This study aimed to identify initial predictive factors of meningitis among the febrile neonates. Retrospective analysis was conducted on the clinical data of 147 cases who admitted the neonatal intensive care unit due to fever (temperature ≥ 38.0 ℃) from 2010 to 2014. Lumbar puncture was performed on every case before administration of antibiotics. 37 cases (25.2%) were diagnosed as meningitis, who included 7 cases of bacterial meningitis (4.8%). When we compared meningitis group with non-meningitis group (110 patients), moaning was statistically higher in meningitis group. In a comparison of bacterial meningitis with aseptic meningitis (30 patients), grunting, fever peak on admission day and C-reactive protein were significantly higher in bacterial meningitis group.

Enterobius vermicularis is one of the most common parasites in the world and the infection rate is higher in children than adults. Although the most common clinical manifestation is perianal pruritus, it may cause other gastrointestinal manifestations. We report one case of appendicitis caused by Enterobius vermicularis. The clinical difference between typical appendicitis and the appendicitis due to Enterobius vermicularis is unclear. The patient had a repetitive Enterobius vermicularis infection for a past year, which was treated with occasional vermicides only. It is considered that the appendicitis is developed from the intractable Enterobius vermicularis infection.

The intussusception recurs in approximately 10 percent of children after successful nonoperative reduction. The main objective was to determine the clinical and sonographic findings that could be used to predict recurrence of ileocolic intussusception in children that had been successfully reduced by enema. A retrospective search was performed on 66 children, at age of 3 months to 7 years, with successful enema reduction of intussusception during a 2.5-year period from January 2013 to July 2015. The clinical, laboratory records, and sonographic findings were compared between recurrence of intussusceptions group (ROI) and non-recurrence group (NROI). Statistical significances were found in age (median, 26.0 vs 18.5 months; P =0.022) and terminal ileal wall thickening (mean, 10.23 vs 7.8 mm; p=0.002); in contrast, there was no significance considering gender, irritability (p=0.074), currant jelly stool (p=1.0), or C-reactive protein (p=0.908). Recurrence is associated with age and the thickening of terminal ileal wall, but clinical or laboratory findings. Given the small number of cases, further studies should be conducted.

The present study aimed to identify the factors that can clinically predict responses to macrolides treatment in patients with Mycoplasma pneumoniae pneumonia. Of the patients admitted to the pediatrics department of Kwangju Christian Hospital during December 2012 to March 2015, 195 patients who had pneumonia according to findings of chest radiography, positive Mycoplasma IgM, and fever at the time of admission were selected as study subjects. Patients were divided into one group wherein the duration of fever after macrolides treatment was 3 days or less and another group wherein the duration of fever was 4 days or more (169 patients [86.7%] vs 26 patients [13.3%]). In the group with fever duration of 4 days or more, a greater number of patients had a history of atopic dermatitis (3.6% vs 15.4%, p=0.11), and the symptom duration before admission was longer (cough: 4.04 days vs 6.38 days, p<0.001; fever: 3.96 days vs 6.08 days, p<0.001). Moreover, according to laboratory test results in the group with fever duration of 4 days or more, LDH levels were high (648.16 IU/L vs 829.92 IU/L, p=0.001), and there was a significant correlation between LDH levels and the duration of fever after macrolides treatment.

Retrospective analysis was conducted on the clinical data of 38 cases of bacterial meningitis that were proven by cerebrospinal fluid culture. Each case occurred by GBS (68.4%), Pneumococcus (15.8%), E. coli (5.3%), Streptococcus mitis (5.3%), Streptococcus bovis (2.6%), and Staphylococcus xylosus (2.6%). Compared to 28 cases with normal outcome, 10 cases who died or had adverse outcomes at hospital discharge were more likely to present with coma, seizure (before or within admission, focal, status epilepticus), require pressor or ventilator support, have initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have hydrocephalus or cerebral infarction by brain imaging.

Prevalence of Mycoplasma pneumoniae pneumonia in preschool children has shown a recent increase and macrolideresistant Mycoplasma pneumoniae pneumonia has been reported. We investigated the clinical features of Mycoplasma pneumoniae pneumonia among children of different ages and different years for the most recent seven years. Retrospective analysis was performed on the clinical data of 735 children who were hospitalized due to Mycoplasma pneumoniae pneumonia between January 2006 and December 2012. The children were divided into three groups according to age: the A group (<3 years), B group (≥3 years and <7 years), and C group (≥7 years). In addition, the children were divided into two groups according to the year in which the disease had developed: the early period (2006 and 2007 year), and the late period (from 2010 to 2012 year). The infant group (A group) presented mainly with a shorter duration of fever and more frequent wheezing. In the late period, the interval until improvement after a macrolide was prescribed increased. Clinical features of Mycoplasma pneumoniae pneumonia differed among children of different ages, particularly between infants and school-aged children.