Obstructive sleep apnea syndrome (OSAS) is the most severe form of obstructive sleep-disordered breathing. It can produce cardiovascular problems, growth retardation, cognitive deficits, and behavioral problems such as attention deficit/hyperactivity symptoms in children. The diagnostic gold standard for OSAS is overnight polysomnography, but it is expensive, time-consuming, and labor intensive, and is conducted by specialized centers which have trained personnel. Therefore, sleep questionnaires as screening tools for OSAS was developed. The benefits of sleep questionnaires are easy/quick application and low cost. The objective of this review is to describe several available pediatric sleep questionnaires which are helpful in screening OSAS.
Child ; Cognition Disorders ; Humans ; Mass Screening ; Polysomnography ; Problem Behavior ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Adenotonsillar hypertrophy is the most common cause of pediatric obstructive sleep apnea (OSA) in children, and therefore, adenotonsillectomy is the first-line therapy in most pediatric patients. In cases of residual OSA after adenotonsillectomy, and in cases where surgical intervention is not feasible, positive airway pressure (PAP) therapy is often employed. Those conditions include obesity, craniofacial malformation, Down syndrome, and neuromuscular disorders. In this article, continuous positive airway pressure (CPAP) preparation, titrations, barriers to effective CPAP therapy, monitoring, and adherence to CPAP in children will be described.

PURPOSE: Airway inflammation is considered to be a characteristic feature of asthma, and eosinophils are recognized as the most important inflammatory cells. This study aims to assess the importance of blood eosinophil count and serum eosinophil cationic protein(ECP) levels as a non- invasive marker of bronchial hyperresponsiveness(BHR) in children with suspected asthma. METHODS: This study used data from 87 subjects with asthma-like symptoms(6-18 years old). The FEV1 and provocative concentration producing a 20% fall in FEV1(PC20) on methacholin inhalation challenge test were measured. Four groups were classified based on PC20[Group I : <2 mg/ mL; Group II : 2-8 mg/mL; Group III : 8-18 mg/mL; Group IV : (18 mg/mL), and blood eosinophil count and serum ECP levels were analyzed. In addition, subjects were classified based on the cutoff value of PC20(BHR positive group : <18 mg/mL; BHR negative group : (18 mg/mL). Then blood eosinophil count and serum ECP level were compared between these two groups. RESULTS: Likelihood ratio test for trends revealed a significant association between the blood eosinophil count or serum ECP level, and the degree of BHR as measured by methacholine PC20. Blood eosinophil count or serum ECP level was significantly higher in the BHR(+) group than in the BHR(-) group. Blood eosinophil count had a positive correlation with serum ECP level. CONCLUSIONS: Blood eosinophil count and serum ECP level may be a useful non-invasive clinical marker of BHR in subjects with suspected asthma. This supports the hypothesis that BHR in asthma is a consequence of airway eosinophilic inflammation.
Asthma* ; Biomarkers ; Child* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Inhalation ; Methacholine Chloride

Purpose: The purpose of this study was to examine the effects of organizational socialization, perceived organizational vision, and attitude toward organizational change on organizational commitment of nurses working in one hospital. Methods: This study was conducted with 441 participants in a hospital in A city, South Korea from Nov. 1 to 30 2017.Data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffé test, Pearson Correlation and Multiple Regression with the SPSS/WIN 23.0 program. Results: There were significant correlations among organizational socialization, perceived organizational vision, attitude toward organizational change and organizational commitment. The factors that significantly influenced organizational commitment were organizational socialization (β=.10 p=.015). perceived organizational vision (β=.20, p<.001), and attitude toward organizational change (β=.44, p<.001). These variables explained 50.0% of the variance in organizational commitment. Conclusion The findings indicates that organizational socialization, perceived organizational vision and attitude toward organizational change affect organizational commitment.

PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.
Aged ; Anesthesia ; Anterior Chamber ; Conjunctiva ; Cryotherapy ; Female ; Glaucoma ; Humans ; Ischemia* ; Mannitol ; Muscles ; Ophthalmic Artery ; Paracentesis ; Retinal Artery Occlusion ; Retinal Detachment ; Retinal Perforations ; Young Adult

PURPOSE: To compare the clinical characteristics and laboratory finding between adenoviral and group A streptococcal (GAS) pharyngitis. METHODS: A retrospective review of medical records was performed in the patients with adenovirus infection among those who were admitted for febrile respiratory disease from January 2011 to July 2013 and GAS pharyngitis among those who visited for symptoms of scarlet fever from August 2006 to July 2013. RESULTS: 179 patients (AV1 group) were diagnosed with adenoviral pharyngitis and 37 (AV2 group) of these patients had adenovirus single infection. 26 patients (GAS group) were diagnosed with scarlet fever. Adenoviral infection (AV2 group) developed in younger patients compared to GAS group (2.8+/-2.1 years vs. 5.4+/-1.8 years, P=0.000). Total durations of fever and admission were longer in AV2 (6.3+/-2.6 days vs. 3.3+/-1.9 days, P=0.000; 4.1+/-1.2 days vs. 1.9+/-1.8 days, P=0.000, respectively). WBC counts were higher in AV2 (11,449+/-5,680 cells/mm2 vs. 6,722+/-6,941 cells/mm2, P=0.000). CRP was not significantly different between AV2 and GAS group (3.8+/-3.2 mg/dL vs. 5.2+/-5.1 mg/dL, P=0.368). No difference was found between two groups in the percentage of antibiotics use (91.9% vs. 100%, P=0.261). CONCLUSION: Clinical characteristics and measures of inflammation in the laboratory findings were similar between adenoviral and GAS pharyngitis group. It is necessary to conduct the test for respiratory virus and bacteria in early stage to differentiate in the pharyngitis patients with leukocytosis and elevation of CRP level.
Adenoviridae ; Adenoviridae Infections ; Anti-Bacterial Agents ; Bacteria ; Child* ; Fever ; Humans ; Inflammation ; Leukocytosis ; Medical Records ; Pharyngitis* ; Retrospective Studies ; Scarlet Fever

Human herpesvirus-6 (HHV-6) often causes mild illnesses, but is rarely associated with encephalitis or other fatal neurological conditions. We report a girl who died of a intractable status epilepticus from HHV-6. A 14-month-old girl presented with focal motor seizures in right extremities evolving to generalized convulsive status epilepticus. She had a history of mild diarrhea for 4 days and high fever for 2 days. Although she was treated with lorazepam, phenytoin, phenobarbital, and continuous midazolam infusion, generalized seizures continued for 3 hours after arrival. She became seizure free, but remained unconscious and ended up to death at the 44 days of hospitalization. The CSF HHV-6 DNA PCR turned out to be positive.
Brain Death ; Diarrhea ; DNA ; Encephalitis ; Extremities ; Fever ; Herpesvirus 6, Human ; Hospitalization ; Humans ; Infant ; Lorazepam ; Midazolam ; Phenobarbital ; Phenytoin ; Polymerase Chain Reaction ; Seizures ; Status Epilepticus ; Unconscious (Psychology)

We aimed to compare the immune response induced by natural infection with 2009 pandemic influenza A/H1N1 (pH1N1) virus and by monovalent pH1N1 vaccination in children and adolescents. This cross-sectional clinical study was conducted at 3 hospitals in Korea from February to May 2010. A total of 266 healthy subjects aged from 6 months to 18 yr were tested for the presence of the antibody against pH1N1 using hemagglutination inhibition (HI) test. Information about pH1N1 vaccination and laboratory-confirmed pH1N1 infection history was obtained. The overall rate of HI titers of > or = 1:40 against pH1N1 was 38.7%, and the geometric mean titer (GMT) was 20.5. Immunogenicity of pH1N1 vaccination only was reflected by a 41.1% of seroprotection rate and a GMT of 22.5. Immunogenicity of natural infection only was reflected by a 61.0% of seroprotection rate and a GMT of 40.0. GMT was significantly higher in the subjects of natural infection group than in the subjects of pH1N1 vaccination group (P < 0.001). The immune responses induced by natural pH1N1 infection exceed those induced by pH1N1 vaccinations.
Adolescent ; Antibodies, Neutralizing/blood ; Antibody Formation ; Child ; Child, Preschool ; Cross-Sectional Studies ; Hemagglutination Inhibition Tests ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype/*immunology/metabolism ; Influenza, Human/epidemiology/*immunology/prevention & control ; Pandemics ; Vaccination

PURPOSE: We conducted a prospective comparative clinical study to determine the field efficacy of the 2010-2011 influenza vaccines [Influenza virus strains; A/California/7/2009 (H1N1), A/Perth/16/2009 (H3N2), B/Brisbane/60/2008] in healthy Korean children under 18 years of age. METHODS: In this study, we enrolled subjects aged between 6 months and 18 years and divided them into 2 study groups: a group who received the influenza vaccines (407 subjects), and a control group who did not receive the influenza vaccines (230 subjects). Ours was a multicenter study that involved 7 hospitals, including the Korea Cancer Center Hospital. The study was conducted between September 2010 and February 2011. We collected nasal wash or throat swab samples from subjects who presented with acute febrile respiratory or influenza-like illnesses at the hospital. We used PCR to confirm the presence of the influenza virus in the respiratory samples and characterize the virus type. RESULTS: In this study, we collected 22 respiratory samples from the influenza-vaccinated group and found 3 cases of influenza virus infection. Similarly, we collected 21 samples from the control group and found 12 cases of influenza virus infection among 10 subjects during the study period. We determined the field efficacy of the 2010-2011 seasonal influenza vaccines to be 83.2% in healthy Korean children and adolescents. CONCLUSION: In this study, we determined the field efficacy of the 2010-2011 seasonal influenza vaccines in healthy Korean children and adolescents. We found that the field efficacy of 2010-2011 seasonal influenza vaccines was adequate.
Adolescent ; Aged ; Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Orthomyxoviridae ; Pharynx ; Polymerase Chain Reaction ; Prospective Studies ; Seasons ; Viruses