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.

The aim of this study was to investigate the clinical relations of eating behaviors to body mass index (BMI) and obesity in girls with idiopathic central precocious puberty. This study included 30 precocious puberty patients who were diagnosed at Chosun University Hospital between February and December 2013. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors. We rechecked their BMI and questionnaire after 12 months to identify the changes. Six (20%) of the 30 patients children were overweight and obesity at diagnosis. Overweight and obesity group tended to overeat. Normal weight group ate an unbalanced diet more than overweight and obesity group, particularly lack of fruit and vegetable (p=0.010). Eight (27%) of the 30 patients children were overweight and obesity and 24 (80%) of the 30 patients children showed increased BMI after 12 months follow up. BMI-decreased group ate breakfast with whole family members more frequent than BMI-increased group (p=0.006). This study showed the importance of healthy diet during treatment of precocious puberty. Children with precocious puberty should avoid overeating and make a balanced diet with preferable eating behaviors from the family meals.

Increased total IgE and eosinophil count levels are thought to provoke the occurrence of urticaria. The purpose of this study is to measure serum total IgE levels, specific IgE sensitization rates, and blood eosinophil count and to investigate the relationship between those factors. Among children who visited the Department of Pediatrics at Chosun University Hospital from January 2011 to December 2013, we retrospectively analyzed 63 patients with acute urticaria. Positive rates of the total serum IgE level, specific IgE, and blood eosinophil count were analyzed in patients with acute urticaria. A total of 63 patients were included in the study and the rate of males to females was 1: 0.8. Mean age of patients was 6.41±4.97 years (range 0-17 years). Among the subjects, 42.9% of patients showed an elevated serum total IgE and 63.5% of patients showed at least more than one allergen-specific IgE by MAST (multiple allergosorbent test). The mean number of allergens detected in positive patients was 2.42±2.56/patient. The serum total IgE and allergen specific IgE showed significant positive correlation (OR = 0.290, p=0.02). This study is meaningful as it revealed a positive correlation between serum total IgE and allergen specific IgE in urticaria patients.

The aim of this study is to investigate the clinical significance of acanthosis nigricans scales and locations in order to validate the relation of hyperinsulinemia and insulin resistance in obese children. We conducted a retrospective analysis of clinical records of obese children who visited Chosun University Hospital between January 2013 and February 2014 due to their obesity. Five anatomical sites were examined for evaluation of acanthosis nigricans. Clinical characteristics were compared according to the presence and severity of acanthosis nigricans. Among 55 children, 37 children had acanthocis nigricans. A consensus score of acanthosis nigricans was calculated by summing the scores of five locations. The diagnostic categories were: No acanthosis nigricans group, mild group, moderate group, and severe group. Elevated acanthosis nigricans total score showed strong association with elevated BMI, triglyceride, and c-peptide in all groups. Elevated acanthosis nigricans total score also showed strong association with elevated fasting insulin and HOMA-IR. We also found that the neck was the most frequent location of acanthosis nigricans. However, acanthosis nigricans on axilla showed strong association with elevated fasting insulin and HOMA-IR. Estimation of scales and locations of acanthosis nigricans could be useful as a clinical alternative for determining hyperinsulinemia and insulin resistance in obese children.

This study investigated the problem of the existing rural development plan where the opinions of local residents are excluded due to the lack of expert knowledge and limited participation and sought the village development plan driven by the voluntary participation of local residents by applying a rural forum targeting rural villages to solve the problem. As a result of the study, (1) the problem of the current village development plan should be made based on the participation of local residents, and (2) this problem has remained as an important challenge. Therefore, the village improvement activities that have reflected the opinions of local residents can be said to be (3) the process that seeks the change into the rural planning process led by local residents, and this study derived the ways to ensure the voluntary behavior of local residents, strengthen local residents' capacity to create on-going villages, and expand local residents' participation opportunities in the entire process of rural planning through the application of the rural forum. (4) Although it is generally difficult for local residents to propose opinions directly and exert influence in the rural planning and design process and it is not easy to reduce the difference in the perspective between the professionals and local residents, significance lies in the fact that local residents voluntarily determine the future of their region and derive the plan. Therefore, the experience of decision-making and consensus process through the rural forum can promote the sustainability of the village creation participated by local residents and the increase of local residents' role. This study took one village as an example to reflect the results applied to the rural forum, and it is difficult to determine that it has been fully verified with the method of residents' participation. Therefore, future studies to verify the effectiveness of village creation and seek the empirical utilization measures are needed more, and the operation of education programs and various support plans suitable to the capacity and level of local residents should be promoted rather than the traditional lecture-style stereotyped education in the future for sustainable rural development.

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.

Syncope is a common symptom, with 15% to 25% of children and adolescents experiencing at least one syncopal episode by young adulthood. In most cases, syncope is a symptom of benign diseases however may be a symptom of severe cardiac disease that results in sudden death. The purpose of this study is to analyze the etiologies and clinical characteristics of syncope in children and adolescents. We retroprospectively analyzed 51 patients with syncope. A total of 51 patients were included in the study and the ratio of males to female was 1: 1.04. The mean patient age was 12.7±3.1 years. Abrupt standing was the most common state of patients with syncopal attack. The etiologies of syncope were noncardiac syncope (60.7%), cardiac syncope (2%), neuropsychiatric syncope (25.5%), and unknown (11.8%). Abnormality of the head-up tilt test was more common in noncardiac syncope than the others [38.7% (12/31) vs 5% (1/20) (p=0.007)]. Further, EEG is a useful diagnostic test for neuropychiatric syncope [41.6% (5/12) vs 2.7% (1/36) (p=0.002)]. Therefore, detailed history taking and physical examinations were useful tools to diagnose the etiology of sycope. The head-up tilt test is an effective diagnostic test in noncardiac syncope and EEG is a valuable test in neuropychiatric syncope, especially in seizure.

교원연수는 교사의 전문성 계발의 방법으로 가장 보편적인 수단이 될 수 있으며, 현장에 적합한 연수과정을 개발하기 위해서 역량기반의 교육과정 개발(competency-based curriculum)이 효과적으로 적용되고 있다. 그러나 시간과 비용이 들고, 급변하는 환경에 민감하지 못하는 등 역량기반의 교육과정 개발의 단점을 극복하기 위해서는 보다 다양한 현장 상황에 적합한 대안적인 개발 방법론이 필요하다. 따라서 이 연구에서는 스마트교육을 위한 교원연수과정 개발 사례를 통해 모듈 개념을 활용한 역량기반 교원연수과정의 개발 방법론을 소개하고자 한다. 이를 위하여, 우선 스마트교육의 개념을 정리하고 역량 모델의 범위를 규명하였다. 그리고 문헌분석, 행동사건인터뷰, 설문조사 및 전문가 검토를 통해 스마트교육에 필요한 4개 범주 9개의 교원역량 모델을 도출하였다. 마지막으로 도출된 역량을 기반으로 연수모듈을 개발하였다. 역량기반의 연수모듈은 연수내용의 기초 단위로 레고(Lego)블럭과 같이 연수과정을 구성하는 작은 조각이다. 이를 기반으로 7개의 연수과정안을 도출하였다. 연수과정은 목적과 상황에 따라 연수모듈을 재조합하여 더욱 다양하게 개발될 수 있다. 이 연구를 통해 연수의 합의된 공동의 목표 달성과 현장 맞춤형 연수를 지원함으로써 일관성과 다양성, 공유와 맞춤의 연수효과가 기대된다.

Xp21 contiguous gene deletion syndrome involves the glycerol kinase (GK) gene, adrenal hypoplasia congenital (AHC) gene and Duchenne's muscular dystrophy (DMD) gene, which are located contiguously on Xp21 chromosome. The clinical features of a patient with Xp21 contiguous gene deletion syndrome are the sum of those of each disease; psychomotor retardation and lethargy for GK deficiency, hyperpigmentation and salt wasting dehydration for AHC, and muscular weakness and hypotonia for DMD. Chromosomal microarray analysis is performed for confirmation of Xp21 contiguous gene deletion syndrome. The goal of treatment is to control each of the diseases. We experienced and reported on a neonatal case of Xp21 contiguous gene deletion syndrome of AHC, GK deficiency, and DMD.

XX male syndrome is a genetic disease associated with gender dysplasia and characterized by a spectrum of clinical presentations, which range from ambiguous to normal male genitalia. The incidence of XX male syndrome is about 1 per 20,000- 25,000. The majority of XX males with SRY gene have normal genitalia, whereas most SRY-negative cases have ambiguous genitalia. Here, we report a case of a SRY-negative XX male with ambiguous genitalia.

Txnip는 Thioredoxin (Trx)과 결합하여 그 기능을 억제함으로써 세포 내의 산화환원 환경을 조절하고, Txnip를 과발현시키면 Trx와는 독립적으로 glucose uptake와 lactate output을 억제한다고 알려져 있지만, 난자 내에서의 역할은 아직 밝혀진 바가 없다. 따라서 본 연구는 RNA interference (RNAi)를 이용하여 난자 내의 Txnip의 발현을 효과적으로 억제하고, Txnip가 생쥐 난자 성숙에 미치는 영향을 알아보고자 수행하였다. ICR 생쥐에 PMSG를 주사하고 44시간 후에 cumulus-oocyte complex(COC)형태의 GV 난자를 채취하였다. Cumulus cell을 물리적으로 제거한 후 Txnip dsRNA를 GV난자의 세포질 내에 미세 주입하여 Txnip RNAi를 수행하였다. 0.2mM IBMX가 첨가된 M16 배양액에서 24시간 배양 후 plain M16 배양액에서 16시간 배양하면서 난자의 성숙율과 표현형을 관찰하고, 염색체와 spindle의 모양은 immunofluorescence staining으로 동시에 관찰하였다. Time-Lapse imaging으로 cytoplasmic streaming, polar body emission 등의 표현형 및 시간차 등을 비교하였다. Txnip RNAi 결과, Txnip RNAi 된 난자는 MI 단계에서 정지하는 표현형을 보였고, 세포질이 응축되고, 난자 중심부에 spindle과 염색체가 분리되지 않은 상태로 뭉쳐서 존재함을 관찰하였다. IBMX 배양액 안에서 Txnip knockdown이 시작될 때 이미 난자의 세포질 안에 과립형성이 증가하고 cytoplasmic streaming이 어려워지는 것을 관찰하였으며, 세포질의 rigidity가 증가하는 것을 관찰하였다. Txnip은 lactate의 생산을 억제하기 때문에 Txnip 발현을 억제시키면 반대로 세포 내 lactate 생산이 증가된다고 알려져 있어, 본 연구진은 lactate의 농도를 높인 배양액에서 난자를 배양하였다. 이 때 시간이 지날수록 난자의 중심부에 과립이 형성되는 현상 즉, Txnip RNAi를 수행한 난자에서 나타나는 현상과 유사한 표현형을 확인하였다. 따라서 Txnip가 난자 성숙과정에서 lactate의 생성과 관련하여 작용할 것이라는 가설을 세우고, 따라서 Txnip의 감소로 증가된 lactate로 인해 glycogen granule이 과형성되고, 그 결과 cytoplasmic streaming이 현저히 줄어들면서 spindle과 염색체의 이동이 방해되는 것으로 추측된다. 이번 연구를 통해서 생쥐 난자의 포도당 대사와 Txnip의 연관성을 알 수 있었고, 이는 생쥐 난자의 대사적 조절기전과 난자 성숙과의 연관 관계를 규명하는데 중요한 역할을 할 것이라고 사료된다.