• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.201-207
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• 2002

Purpose : We analyzed clinical features and causal viruses of acute lower respiratory tract infections(LRTIs) in order to improve the management of these infections. Methods : From end of April to early May 2001, amongst 30 children at a local institute for children's adoption and welfare, 13 were admitted to the hospital with the diagnostic impression of acute LRTIs. Nasopharyngeal aspirates were sent in Seoul National University Hospital for viral culture of respiratory syncytial virus(RSV), adenovirus, parainfluenza virus. Results : One or more viral agents were identified in 4 cases(30.7%) : were RSV(15.4%), adenovirus(7.7%), and a mix of these two viruses(7.7%). Initial symptoms were fever(69%), cough(100%), tachypnea(54%), chest retraction(69%), rale(85%) and wheezing(15%). Leukocytosis was noted in 23%, CRP increased more than 10 mg/L in 46%. Chest X-ray abnormalities were 69%. Conclusion : Although viruses were identified in 30.7%, further studies should be made for prevention and treatment of acute viral LRTIs.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.180-185
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• 2006

Invasive Pseudomonas infections most often occur in the immunocompromised patients and are associated with high mortality rate. Rarely this disease may develop in healthy infants and children. We report two cases of invasive Pseudomonas aeruginosa infections that were diagnosed in otherwise healthy infants. The first case was a previously healthy 5-month-old infant with ecthyma gangrenosum and septicemia. She presented with fever, swelling of left periorbital area and multiple erythronodular skin lesions. Each skin lesion formed a black eschar surrounded by an erythematous areola over time. Cultures of blood, urine and discharge from skin lesions grew P. aeruginosa. On the day of visit, she showed pancytopenia which was normalized after 10 days. The patient responded well to the management with ceftazidime and tobramycin. The other case was a previously healthy 9-month-old infant with community-acquired pneumonia. He was referred from an outside hospital with fever and cough. Chest x-ray revealed pneumonic infiltrations on both lower lungs with pleural effusion on the right side. Cultures of blood and pleural fluid grew P. aeruginosa. Chest CT performed on the ninth day demonstrated pneumatoceles, lung abscess and necrosis of lung parenchyma. He was managed with ceftazidime and amikacin for 50 days. No residual pulmonary complications were noted during the three month follow-up. Laboratory results to evaluate immunologic defects of phagocytic cells, complement components and T- and B-lymphocytes were all within normal range in both patients. It should be kept in mind that Pseudomonas can be, though uncommon, a cause of community-acquired invasive infections in the previously healthy infants.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.99-105
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• 2006

Purpose : The serotyping results of the Quellung reaction was compared with the newly developed multiplex latex assay and the sensitivity of the Quellung reaction was compared. Methods : We checked the serotypes of 35 samples obtained from patients treated at Yonsei University Medical Center using the multiplex latex bead method and compared the results with the serotypes previously obtained via the Quellung reaction. Results : A decrease in the mean fluorescence was detected in the samples tested with the multiplex assay. Seventeen samples out of the 27 samples agreed to the results of the Quellung assay. We were only able to confirm the concordance of 11 serotypes out of 14 serotypes available. Conclusion : The Quellung reaction is time consuming procedure and prone to errors even with expertise in the procedure, and other alternate methods in serotyping have been investigated to overcome these problems. The newly developed multiplex latex bead assay can test more samples at the same time and has a higher degree of sensitivity. A large scale trial is required to test the sensitivity of the new assay across various serotypes along with efforts to increase the sensitivity of the Quellung assay. The preliminary data suggests that this method may be widely used.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.95-100
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• 2014

Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.317-322
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• 2008

The moderners of industrial society suffer from various stresses, which bring about increase in prevalence of temporomandibular disorders, oral mucosal disease and chronic neuropathic pain, therefore, the number of patients seeking help of those symptoms tend to increase. The purpose of this study was to discuss the importance of oral medicine related disease by investigating questions that appeared in cyber consultation of Kangnung National University Dental Hospital web site. Among the nearly 2000 questions, the rate of questions related to oral medicine was 20.92%, and the rate of questions related to other departments were oral and maxillofacial surgery 16.87%, conservative dentistry 16.67%, orthodontics 14.02%, prosthodontics 12.25%, periodontics 8.36%, pediatric dentistry 4.93%, preventive dentistry 2.08% and otherwise questions 3.90%. Among the 403 questions related to oral medicine, the frequent questions were oral mucosal diseases 44.17%, temporomandibular disorders 41.19%, halitosis 4.47%, xerostomia 3.23%, other orofacial pain 2.23%, forensic dentistry 1.49% and otherwise questions 2.98%. From the higher rate of questions related to oral medicine compared with other fields of dentistry, we would consider that the people are considerably concerned about the oral medicine related disease, such as oral mucosal diseases and temporomandibular disorders.

• Tuberculosis and Respiratory Diseases
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• v.58 no.1
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• pp.68-73
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• 2005

Pulmonary sequestration is a very rare congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic artery. It may be clinically asymptomatic or it has a wide spectrum of various clinical manifestations. The clinical therapeutic approach is to resect the sequestered lobe to prevent frequent complication such as infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We have experienced a 17-year-old male with pulmonary sequestration whose complaints were pain in left lower chest. He was diagnosed by computed tomography and aortography and successfully treated with embolization of feeding artery. We report a case of pulmonary sequestration treated with arterial embolization instead of surgery.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.510-516
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• 1996

Cardiopulmonary bypass cannulas are usually characterized by the French number. However this de- scription provides only the external diameter of the cannula, which gives no information about the press- ure-flow characteristics of the cannula itself. A standardized system to describe the pressure-flow characteristics of a given cannula has recently been proposed and has been termed the M-number It is reported that the pressure-flow characteristics of a particular cannula can be determined from a novo- gram or chart, if the experimentally derived M-number of the cannula is known. In this regard, we conducted an investigation to analyze correlation between experimentally and clinical y derived M-numbers using three different sizes of pediatric aortic cannulas in fifty cardiac patients on cardiopulmonary bypass. The clinical and experimental M-numbers showed a strong correlation. The clinical M-numbers were typically 0.)5 to 0.55 greater than the experimental M-numbers. The clinical M-numbers also showed an inverse relationship to the temperature change of the patient, most probably due to an increase in blood viscosity from hypothermia. This inverse clinical M-numbersltemperature re- lationship was more marked in higher M-number cannulas. The clinical data obtained in this study suggest that the experimentally derived M-numbers correlated strongly with the clinical performance of the cannula with the significant influence of the temperature.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.162-169
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• 2010

The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1 %) were males and 14 (35.9 %) were females. Thirty patients (76.9 %) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7 %. Twenty-seven patients (69 %) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83 %) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.135-143
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• 2007

Biliary atresia (BA) is an uncommon neonatal surgical disease that has a fatal outcome if not properly treated. The survival rates of the patients with native liver after Kasai's operation in countries outside Japan are not so good. We reviewed the results of 22 cases of biliary atresia treated in Kosin University Hospital between October 1987 and March 2001. There were 13 males and 9 females aged from 21 to 106 days (mean 52 days). There were 3 cases of Type I (13.6%), and 3 of Type II (13.6%), and 16 Type III (72.7%). The operative methods were resection of the common bile duct remnant and cyst followed by Roux-en-Y hepaticojejunostomy in 3 cases for Type I BA; Kasai I in 15 cases, Kasai II in 1 case, and Ueda's operation in 3 cases for Types II and III BA. There was no death within the first 30 days after operation. We were able to follow 21 of the 22 patients (95.4%) for more than 5 years. The actual 5 year survival rate (YSR) was 40.9%. One Type I case received a living-related liver transplantation at 6 years of age because of the multiple intrahepatic stones and liver cirrhosis. Five YSR after biliostomy group (Kasai II and Ueda op.) was 75 % (3/4) while that of Kasai I was 20% (3/15). One case had no bile duct in the resected fibrotic plaque on microscopic review and died 8 months after Kasai I operation, would have been a strong candidate for early liver transplantation. From the above result, our conclusions are as follows; (1) early liver transplantation should be considered for cases of no bile duct after pathologic examination of the resected specimen, (2) measures to prevent postoperative cholangitis and prevention of postoperative liver cirrhosis are needed, (3) liver transplantation program should be available for failed cases.

• Journal of Radiation Protection and Research
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• v.27 no.3
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• pp.155-164
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• 2002

Methodology to evaluate the effective doses to adults undergoing various diagnostic x-ray examinations were established by Monte Carlo simulation of the x-ray examinations. Anthropomorphic mathematical phantoms, the MIRD5 male phantom and the ORNL female phantom, were used as the target body and x-ray spectra were produced by the x-ray spectrum generation code SPEC78. The computational procedure was validated by comparing the resulting doses to the results of NRPB studies for the same diagnostic procedures. The effective doses as well as the organ doses due to chest, abdomen, head and spine examinations were calculated for x-rays incident from AP, PA, LLAT and RLAT directions. For instance, the effective doses from the most common procedures, chest PA and abdomen AP, were 0.029 mSv and 0.44 mSv, respectively. The fact that the effective dose from PA chest x-ray is far lower than the traditional value of 0.3 mSv(or 30 mrem), which results partly from the advances of technology in diagnostic radiology and partly from the differences in the dose concept employed, emphasizes necessities of intensive assessment of the patient doses in wide ranges of medical exposures. The methodology and tools established in this study can easily be applied to dose assessments for other radiology procedures; dose from CT examinations, dose to the fetus due to examinations of pregnant women, dose from pediatric radiology.