• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.124-137
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• 2024

Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while nonspecific symptoms such as recurrent abdominal pain may be present in older children. Malrotation can be associated with duodenal obstruction caused by an abnormal peritoneal fibrous band or congenital anomalies, such as an annular pancreas or a preduodenal portal vein. Volvulus can lead to bowel ischemia and a life-threatening condition, thus prompt and accurate diagnosis is crucial. Diagnosis can be made through upper gastrointestinal series, ultrasonography, and CT, with ultrasonography being preferred as a screening tool due to its rapid and accurate diagnosis, without radiation exposure, in children. This pictorial essay discusses the key imaging findings and diagnostic approaches for malrotation and midgut volvulus, as well as diagnostic pitfalls based on actual cases.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.64-68
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• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.736-741
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• 2008

Purpose : The incidence of thromboembolic episodes in children with nephrotic syndrome (NS) is low; however, these episodes are often severe. Moreover, both pulmonary thromboembolism (PTE) and renal vein thrombosis (RVT) rarely show clinical symptoms. This study was performed to determine the benefits of routine screening in the detection of thrombosis in childhood NS. Methods : Among 62 children with nephrotic syndrome, a total of 54 children (43 males, 11 females) were included in this study. When the patients experienced their first NS episode, we performed renal Doppler ultrasonography in order to detect RVT. To rule out the possibility of PTE, a lung perfusion scan was performed. Computed tomographic (CT) pulmonary angiography was recommended to patients who showed possible signs of PTE. All patients were evaluated for clinical signs of thrombosis, biochemical indicators of renal disease, as well as clotting and thrombotic parameters. Results : RVT or related clinical symptoms were not observed in any children. Based on the findings of the lung perfusion scans, 15 patients (27.8%) were observed with as a high probability of PTE. We were able to perform a CT pulmonary angiography only on 12 patients, and 5 patients were diagnosed with PTE (prevalence 8.1%). The serum fibrinogen level in the group with PTE was significantly higher ($776.7{\pm}382.4mg/dL$, P<0.05) than that in the group without PTE, and other parameters were not significantly different between each group. Conclusion : Further studies are required for clarifying the role of renal Doppler ultrasonography for the detection of RVT in NS. Children with NS who developed non-specific respiratory symptoms should be evaluated for the diagnosis of PTE. In the management of NS, a lung perfusion scan should be performed at the time of the initial episode of NS regardless of the pulmonary symptoms, since patients having PTE are either often asymptomatic, or present with nonspecific symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.129-138
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• 2002

Objectives：In order to treatment guideline of ADHD, present clinical practise of child psychiatrists and their opinion of optimal intervention were evaluated. Methods：Structured questionnaire items about diagnostic workup, drug choice of 5 different situations according to different co-morbid disorders, and non - pharmacological treatment were applied to 32 child psychiatrists working at university and general hospital. we compared the data with Texas Algorithm Project guideline. Results：(1) Intelligence Test, Sentence Completion Test, sustained attention test, and Conner's questionnaire were the basic routine test that must be performed. (2) Main trend of medication in this study was not different from TAP guideline. (3) In case of co-morbid tic disorder, first recommending drug is still psychostimulant in the TAP guideline. But in this study initial psychostimulant prescription was not main trend. (4) In case of MPH non-response co-morbid disruptive behavior disorder, MPH medication combined with other drug were more common than switching to other drug as suggested the TAP guidelines. (5) In non-pharmacological treatment, most child psychiatrists reported the importance of parent management. Conclusion：There were some difference in medication trend in this study compared with TAP guideline. Further study and conference are needed for experts consensus in Korea.

• Pediatric Infection and Vaccine
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• v.20 no.2
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• pp.89-97
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• 2013

Purpose: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. Methods: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. Results: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older ($4.7{\pm}4.1$ years vs. $3.3{\pm}2.5$ years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. Conclusions: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.2
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• pp.223-237
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• 2009

본 임상연구는 임상연구 모집 공고를 통하여 모집된 대상자 중 Atopic Dermatitis Research Group (2005) 한국인 아토피 피부염 진단기준에 따라 아토피 피부염으로 판정되고 현재 약물(한약, 양약)치료나 외용제 치료를 하고 있지 않은 만 5$\sim$50세의 아토피 피부염 환자를 대상으로 하였다. 피험자들을 이중맹검, 블록무작위배정하여 시험군과 대조군으로 나누어 6주간의 시험기간 동안 육안적 평가, 혈액학적 검사, 피부측정 장비를 통한 기기적 평가를 시험 전후에 실시하여, 시험군에 사용된 제품이 대조군 사용된 제품에 비하여 얼마나 효과적으로 아토피 피부염으로 손상된 피부 장벽을 회복하는지 관찰하였다. 본 임상시험을 통해 'Atomento solution & cream'이 손상된 피부장벽을 회복시키고 피부 보습력을 증가시켜 아토피 피부염에 효과적이었으며, 인체에 이상반응이나 부작용 없이 안전하게 사용될 수 있음을 확인하였다.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.3-14
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• 2004

In this article, the effects of stress on central nerve system and heart function and the concept of heart rate variability were reviewed. HRV(Heart Rate Variability), the periodical change of the heart rate, is indicated larger in the healthier because they respond flexibly to various sorts of facts influencing on HR. HRV analysis is largely composed of the time domain analysis and the frequency analysis. In the former the flexibility of heart function is analysed, while in the latter autonomic nerve function is examined, which is the degree of sympathetic and parasympathetic nerve activity and the state of balance. Furthermore, existence or nonexistence of disease and/or level of stress can be estimated by measuring the variability and normality of heart rate, and balance of autonomic nerve system, and through HRV biofeedback the symptoms of anxiety disorder or asthma can be reduced.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.754-759
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• 1998

Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.266-275
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• 2005

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.97-105
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• 2015

Purpose: Serotyping pneumococcal isolates is important to monitor efficacy of pneumococcal vaccines. Because of difficulties of typing pnueumocci, a multiplex bead-based (multibead) serotyping assay was recently introduced. The aim of this study is to establish a new multibead serotyping assay and to apply this method to analyze clinical isolates of pneumococci in Korea. Methods: To establish the multibead serotyping assay, six key reagents were transferred from University of Alabama at Birmingham (UAB) to Ewha Center for Vaccine Evaluation and Study (ECVES): bead set coated with polysaccharide and monoclonal antibody pool were used in one multiplex inhibition-type immunoassay and 2 bead sets coated DNA probe and 2 primer pools were used in two multiplex PCR-based assays. After multibead serotyping assay was set up, 75 test samples of pneumococci were analyzed whether ECVES is able to identify serotype correctly. After confirming the performance, serotyping assay was applied to identify serotypes of 528 clinical isolates of pneumococci collected from 3 different hospitals. Results: After establishment of the multibead pneumococcal serotyping assay system at ECVES, 75 test samples were analyzed. There was no discrepancy of serotypes of 75 test samples between the results assigned at UAB and those at ECVES. The serotypes of 528 pneumococci isolated from patients or healthy subjects were determined in 94.3% of isolates (498/528). Conclusions: The multibead pneumococcal serotyping assay can be successfully established in Korea. With this method, surveillance of serotypes of pneumococci isolated from patients as well as healthy subjects could be studied.