• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.784-789
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• 2006

Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.241-249
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• 2005

Herein, two patients of acute toxic hepatitis occurred to persons had eaten Aplysia kurodai and their eggs. The authors report 2 patients of acute toxic hepatitis with reviews of the clinical features. One patient had gathered Aplysia kurodai and it's eggs from Ulleungdo sea shore on May 17, 2003. He ate with boiling the eggs. This patient developed acute toxic hepatitis and symptoms of aplysianin poisoning, such as abdominal pain, nausea, vomiting and watery diarrhea about 10 and half hours after ingestion. The other patient had gathered Aplysia kurodai and its egg from Ulleungdo sea shore on 16 May 2004, which were consumed without boiling the eggs. This patient developed acute toxic hepatitis and symptoms of aplysianin poisoning, such as abdominal pain, nausea, vomiting and watery diarrhea, about 10 and half hours after ingestion. This patient complained of jaundice and pruritus, about 10 days after ingestion. The 2 patients all improved within 15~25 days with conservative treatment. This is the first significant report of acute toxic hepatitis caused by aplysianin poisoning following the consumption of Aplysia kurodai and their eggs in Korea. The clinical features, management and preventive counterplan of acute toxic hepatitis caused by aplysianin poisoning are also presented.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.29-38
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• 1989

5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were in defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M : E ratio was 0.7 : 1. The lead concentration in serum was in creased in 4 cases (80%) of patients. Lead concentration, deltaaminolevulinic acid concentration in 24 hours collected urine were in creased in 5 patients (100%). Qualitative test of coproporphyrin of urine was positive in all 5 cases. 3 patients treated with Ca-EDTA, abdominal pain was improved rapidly and hemoglobin level was in creased slowly.

• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.1-22
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• 2002

Purpose : This Study was conducted to evaluate clinical characteristic of children with recurrent abdominal pain (RAP) and to be classified by its six subtype in the Oriental Pediatric Text Book and to find out relationship of western classification. Methods : Patients who visited Dong-Eui Oriental Medical hospital from August, 2001 to October, 2002 due to RAP were included. According to questionnaire and history taking, RAP was classified by its six subtype based on Oriental medical theory. Results : 1. Patients with RAP were more internalized, have a close relation with their parents, and have strong desires of success, but social intercourse is low. 2. 76% of Patients have a less desire to eat and 67% of Patients have a diarrhea or constipation. 3. According to questionnaire, first abdominal pain was their $3{\sim}5$ ages most, cause of occurrence was more 'eating cold foods' most, time of AP (abdominal pain) was $1{\sim}2$ hours after eating and no characteristic most, site of AP was the umbilicus most, shape of AP was impotent pain most, cause of reduce pain was abdominal massage and defection most. 4. frequency of RAP's type, AP caused by diet(食積腹痛) is 45.5%, AP caused by cold(寒腹痛) is 29.1%, AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛) is 12.7%, stagnation of qi and stasis of blood(氣滯血瘀腹痛) is 10.9%, AP caused by internal diet and external cold(內食外寒腹痛) is 1.8%. There is no AP caused by parasites(蟲腹痛). 5. During clinical classifications of RAP, cause of occurrence was most important cause of reduce pian, defection practice was helpful for diagnosis, but shape of AP, site of AP was not helpful. 6. With relationship of Oriental classification and western classification, AP caused by diet is similar to dysmotilitylike dyspepsia and irriTable bowel syndrome. AP caused by cold is similar to irriTable bowel syndrome. AP caused by cold in internal organs of deficiency is similar to unspecified dyspepsia. stagnation of qi and stasis of blood and AP caused by internal diet and external cold is not like to western classification. Conclusion : RAP in Childhood is most occurred by food and cold. there is few AP caused by stagnation of qi and stasis of blood and internal diet and external cold. So the study on subclassification and clinical Manifestations of RAP in Childhood is more performed.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.107-111
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• 2006

Crohn disease (CD) is rare, but the incidence of CD has been increasing over the past ten years. We found two cases of CD, associated with myelodysplastic syndrome (MDS), for the first time in children. In the first patient, MDS was diagnosed at three years of age and CD developed later at eight years of age. The patient presented with recurrent abdominal pain, diarrhea, bloody stools and failure to thrive. Colonoscopy revealed cobble stone like mucosa and mass like lesions with superficial ulceration and inflammatory exudates, observed from the cecum to ascending colon. Ileo-cecal biopsy samples showed ulcers with skipped areas and lymphoid infiltrations. The patient was started on treatment with mesalazine and deflazacort, and symptoms remitted. In the second patient, MDS was diagnosed at nine years of age and CD developed at 13 years of age. This patient has recurrent hematochezia, abdominal pain, vomiting and fever. Colonoscopy revealed a large, deep indurative ulceration on the cecal side of the ileo-cecal valve. Ileocecectomy was done, and histology revealed ulceration with transmural inflammation and lymphoid aggregates. Symptoms improved after ileocecectomy.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.572-575
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• 2003

Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.169-177
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• 1998

Purpose : Renal duplication is a common occurrence, and the range of ureteral and renal anomalies draining the two poles of the duplex kidney leads to a variety of clinical presentations. Method : A series of 61 children with duplicated systems was studied retrospectively who were admitted during last 12years. Results : Of the children $60.6\%$ were accompanied with urologic anomalies that required surgical treatment, and most children initially were presented with urinary tract infection. $42.6\%$ of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : From our point view, children with history of abnormal antenatal renal sonogram, or with symptoms such as urinary tract infection, hematuria, abdominal pain should be evaluated radiologially fully to confirm further abnormality and accompanied complications. And routine follow-up using abdominal ultrasonogram, VCUG, and urine culture should be used to prevent and detect early treatable complications.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.176-180
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• 2009

Two year-old female miniature schnauzer was presented with depression, abdominal pain and inappetence. Physical examination revealed tachypnea, fever, and abdominal pain. Leukocytosis with neutrophilia was shown in complete blood count. Radiograph revealed the increase of opacity in parallel to vertebra and dislocation of descending colon. Calculi and sludge in bladder, hydronephrosis and dilation of proximal ureter in right kidney were observed in ultrasonographic examination; also, irregular shape of structure in retroperitoneal cavity was observed. Urinalysis showed protein urine and hemtauria. Many epithelial cells, spindle cells, calcium oxalate dihydrate crystals, struvite crystals, amorphous crystals and granular casts, WBC, cocci were examined in urine sediment test. ERD-kit test result was highly positive. Based on those test and excretory urogram pyelonephritis and complete unilateral obstruction of ureter were confirmed. A balloon type structure in retroperitoneal cavity was found through the exploratory laparotomy. In cytologic examination of aspirated fluid from dilated area many degenerated neutrophils and phagocytized cocci were observed. Staphylococcus intermedius was cultured from aspirated fluid. Based on these clinical results retroperitoneal abscesses caused by Staphylococcus intermedius was diagnosed with ureter obstruction and concurrent cystic calculi. Nephrectomy of right kidney with ureter was performed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.120-132
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• 2009

Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (${\kappa}$=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.20-27
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• 2007

Purpose: This study was performed to review the recent experiences of pediatric gastrointestinal (GI) endoscopy done in one university hospital. Methods: A retrospective review of medical records was conducted of 1,040 pediatric cases who underwent GI endoscopy at the Pusan National University Hospital between January 2001 to June 2005. Results: A total of 1,040 endoscopies (upper 840 and lower 200) were performed. The male/female ratio was 1.25:1. Neonates and infants accounted for 6.0% and 16.5% respectively. Half of the children were below 5 years (mean age $8.5{\pm}2.1$ years). Upper and lower GI diagnostic endoscopies were performed in 634 and 163 children respectively. Abdominal pain (38.8%), vomiting (19.4%), foreign body (17.7%), and hematemesis (10.3%) were the main reasons for esophagogastroduodenoscopy. Hematochezia (56.0%), abdominal pain (27.5%) and diarrhea (3.0%) were the main reasons for colonoscopy. Upper GI therapeutic procedures included retrieval of foreign bodies, balloon dilatations of esophageal stricture, PEG, and variceal ligation in 148, 27, 15, and 3 children, respectively. Therapeutic lower GI endoscopies were performed in 37 children (polypectomy in 92%, argon lazer cauterization for angiodysplasia in 4%). Conclusion: GI endoscopy played an important role in the diagnosis and treatment of GI diseases in children. Procedures in younger aged children, cases evaluated by colonoscopy and therapeutic endoscopies are increasing in pediatric practice.