• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.54-59
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• 2001

Objectives : With the advancement of a social life, the pediatric head injuries(PHI) occur greater than ever. Since the PHI differs from adult head injury with regards to mechanism of trauma, prognosis, and mortality, it is important to identify the characteristics of the PHI for its proper treatments and prognosis. Methods : For this study, a series of 365 PHI patients under 15 years of age who were admitted to our hospital, were evaluated from January 1991 to December 1996. The clinical variable studied were age, sex, Glasgow coma score(GCS), causes of trauma, diagnosis, symptoms, associated injuries and Glasgow outcome score (GOS). The characteristics of PHI were evaluated according to presentations of skull fractures, intracranial hemorrhages, associated injuries, GCS at admission and GOS. Results : Mean age of the studied patients was 6.51 years of age. The majority of PHI patients were under the 7 years of age(66.7%). The ratio of male to female was 2.2:1. Seasonally, PHI occurred more frequently during March to August(61.6%). The main causes of the injuries were accidental falls and traffic accidents(47.1% and 46.3%). One hundred ninety seven(54%) patients suffered from skull fractures and 110(30.1%) patients were developed intracranial hemorrhages and acute epidural hematomas(17.8%) which were the most common intracranial hemorrhages. There was statistical significance between skull fractures and intracranial hemorrhage (p=0.032) and between GCS and GOS(p=0.001). However, there was no statistical significance between skull fractures and intracranial hemorrhage(epidural hematomas, subdural hematomas, and intracerebral, intraventricular and subarachnoid hemorrhage)(p=0.061, 0.251 and 0.880). Also there were no significance of prognosis between under the seven and over the 8 years of age(p=0.349). Conclusions : The core management for PHI is prevention from its occurrences. However, when unexpected accident occurs, early diagnosis and treatment for PHI by through examination for associated injuries and other damages even if there is no skull fracture are essential in managing patient's outcome.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.1
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• pp.43-47
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• 2013

Introduction: ALT/AST enzymes are present inside the cells. AST is found in cardiac and skeletal muscle and red blood cells but the ALT is checked mainly in the liver. In general, the rise of these two indicators shows liver damage. The usual measurements of these enzymes are used in liver function tests, but the levels of AST and ALT do not always reflect liver function. Method and Cases: 17 cases of liver dysfunction transiently were evaluated clinically, biochemically, and imaging study of sonogram in pediatric in-patients for 3 years. Result: Most common causes of transient liver dysfunction were infection, especially viral gastroenteritis, and bacterial infection interfering oral food intake. More often occurred in the children who have infant hyperbilirubinemia, positive history of mitochondrial dysfunction or hypoglycemia. Fasting study in one case of hypoglycemia patient showed reversible liver dysfunction during fasting over 20 hours fasting. Discussion: A significant increase in AST and ALT with normal bilirubin can be observed in clinically healthy people during blunt trauma, viral infection, severe pain, metabolic syndrome, fasting or accidental health screening.

• Journal of Korean Public Health Nursing
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• v.14 no.2
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• pp.332-341
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• 2000

Children's accident is a largely preventable public health problem. Little is known. however, about population-based incident and outcome of pediatric accident. From 1997.9 through 1998,8. admission data from emergency center in I city were collected. 1418 patient from 0 through 13 years of age were selected. All children with unintensional accidental problems were identified through coded sheet which categorizes epidemiologic characteristics. The specific purposes of this study are analysis about the characteristics of pediatric accidents. And it aims to produce the basic data necessary for accident prevention policy development. The results of this study were as follows; 1. The number of male children$(62.6\%)$ were higher than female children$(37.4\%)$ 2. The age group from 1 to 3 years represents the highest proportion$(45.4\%)$ of every accidents except on traffic accident. 3. The highest proportion of accident were as follows occured during the June-August$(34\%)$, Sunday$(22.6\%)$, and 17-21 p.m. $(37.2\%)$ 4. The main causes of accident include general trauma$(70.9\%)$, environmental accident$(l6.8\%)$. and traffic accident$(l2.1\%)$, 5. Preschool age group represents more than half$(65.4\%)$ of traffic accident. 6. environmental injury includes burns $(46.6\%)$, foreign body$(43.6\%)$, exposure to poisonous materials$(6.3\%)$. and bite(3.3) This results could be used to develope prevention programs and assist in accident prevention system development. And also these data substantiate that accident prevention program decrease safety-related injury rate in preschool age group must be concentrated on enhancing access to a system to have a significant effect. Furthermore, it is necessary for accident prevention. So several suggestions are described here: 1. Development of parent's educational program for accident prevention and safety education should be done actively. 2. Home safety surveillance system should be initiated. 3. The initiation of children's accident report system could be contribute the analysis and the reduction of accident.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.156-161
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• 2007

Pediatric dentists are frequently encountered with fractured root fragments of primary teeth caused either by the traumatic injuries or by the accidental fractures during the procedure of tooth extractions. In these situations, we often hesitate which method to choose, extract or retain it. In general, it is recommended to retain apical fragments, as the attempts to extract the apical fragments might harm the developing permanent tooth germ. This study was designed to ensure the validity of intentional retention of the root fragments of primary teeth in the situations described above. 6 children with intentionally root fragments who experienced root fracture in primary anterior teeth were available Periodic radiographic assessment was performed at 3 months interval for $7{\sim}37$ months. The results of this study showed that apical fragments had been resorbed through physiologic process in 5 patients. Apical fragment had been gingival emergence along with the erupting permanent tooth in 1 patient. There were no evidence of interference with eruption of permanent successors. In summary we have been ensured the validity of intentionally retention of the root fragments of primary teeth. Children with being remained apical root fragment should be recalled regularly for assessment and parents should be thoroughly informed about the situation with special emphasis on the necessity of periodic check-up.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1232-1235
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• 2008

Imipramine, a tricyclic antidepressant (TCA), is used for the treatment of non-polar depression and nocturnal enuresis in children in whom an organic pathology has been excluded, anxiety disorders, and neuropathic pain. Clinical toxicity following the treatment of TCAs, including imipramine, is well known. The anticholinergic effects initially present include a dry mouth, ileus, dilated pupils, urinary retention, and mild sinus tachycardia. The central nervous system toxicity includes delirium, agitation, restlessness, hallucinations, convulsions, and CNS depression or coma. However, the most life-threatening toxicity remains the development of cardiac dysrhythmias. Conduction delays such as QRS and corrected QT prolongation, wide QRS complex tachycardia, and the Brugada electrocardiographic pattern have been reported. Sodium bicarbonate decreases QRS widening and suppresses dysrhythmias by providing excess sodium to reverse the TCA-induced sodium-channel blockade and possibly by binding directly to the myocardium. There are no pediatric case reports on imipramine or other TCA associated toxicity in Korea. Here, we describe a patient who presented with convulsions, tachycardia with a wide QRS complex, a Brugada electrocardiographic pattern, and anuresis associated with an accidental overdose of imipramine and the outcome of treatment with sodium bicarbonate.

• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.446-452
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• 2009

Purpose : This study was performed to demonstrate the usefulness of early endoscopy for predicting the development of stricture following corrosive ingestion in children. Methods : We conducted a retrospective study on 34 children who were brought to Seoul National University Childrens Hospital and Seoul National University Bundang Hospital for corrosive ingestion from 1989 to 2007. Results : The corrosive burns were classified as grade 0 in 8 patients, grade 1 in 2, grade 2a in 7, grade 2b in 13, and grade 3 in 4. There was no significant correlation between the presence of esophageal injury and symptoms including vomiting, dysphagia, and drooling. There was a statistically significant relation between the presence of oropharyngeal injury and esophageal injury (P=0.014). There were no complications including hemorrhage and perforation related to endoscopy. Strictures of the esophagus or the stomach developed in 12 patients (36.4%). Esophageal stricture was observed in 11 patients and pyloric stenosis in 1 patient. The endoscopic grade of mucosal injury was significantly related to the frequency of development of esophageal stricture (P=0.002). Two of eleven patients with esophageal stricture responded to repeated dilation. The remaining seven patients underwent surgery. Conclusion : Early esophagogastroduodenoscopy is not only a safe and useful diagnostic tool for children with accidental caustic ingestion but also a necessity for determining the degree and the extent of caustic burns and for predicting the development of late complications.