• Clinical and Experimental Pediatrics
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• v.63 no.4
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• pp.125-132
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• 2020

Coronavirus disease-2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates can suffer from COVID-19, and children may spread the disease in the community. This review summarizes what is currently known about COVID-19 in children and adolescents.

• Child Health Nursing Research
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• v.2 no.2
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• pp.19-27
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• 1996

The purpose of this study is to explore the level of children's anxiety related to disease characteristics The subjects of this study were 72 childrens (6year-10 year) who were admitted to the pediatric wards at University Hospital and 24 healthy children, and 24 mothers of children with fatal & chronic illness. The data were collected with sarason's Anxiety scale for children & spielberger's State Trait Anxiety Inventory for mothers and analyzed of One way Anova, Duncun Test, Pearson correlation, and T-test. The results of this study were as follows : 1) There was significant difference in children's anxiety related to disease characteristics(P<0.01) Fatally ill children showed highest level of anxiety and chronically, acutely ill children in order. And there was no significant difference in anxiety between acutely ill children and healthy children. There was significant difference in anxiety between groups of ill and healthy children(P<0.01) .The anxiety of ill children was higher than that of healthy children. 2) There was no significant correlation between children's anxiety and their age. 3) There was no significant difference in children's anxiety related to frequency of hospital admission. 4) There was significant correlation between children's anxiety and duration of illness(P<0.01). The longer the duration of illness is, the higher children's anxiety is. 5) There was significant difference in mothers' anxiety between groups of fatally ill and chronically ill children(P<0.05). The anxiety of mothers of fatally ill children was higher than that of mothers of chronically ill children. 6) There was no significant correlation between children's anxiety of fatal and chronic illness and their mothers' anxiety.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.391-401
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• 2013

Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.26 no.2
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• pp.68-77
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• 2013

Objectives : This study reports a massive vision screening on preschool children of Yangsan city in Kyungnam Province. Methods : From March to July 2012, we conducted vision and color test on 1,409 preschool children aged from one to six and used Auto Kerato-Refractometer(KR-8900) on children with naked vision below 0.5 in order to detect the cause of poor vision. Written form of test result is filled and distributed to each parents. Uncooperative 195 children were excluded and the rest were statistically analyzed by using SPSS version 18.0 program. Results : 16 children(1.1%) had dyschromatopsia and the number of boys was threefold higher than that of girls. The average visual acuity was 0.8 to 0.9 regardless of age. 45 children(3.8%) showed myopia, 82 children showed hyperopia(6.8%), 4 children showed anisometropia(0.3%), among which 16 children were wearing glasses. Conclusions : This study has a great significance that a massive preschool vision screening was carried out by Korean medicine hospital for the first time.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.413-418
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• 2005

Objective : Although an encephaloduroarteriosynangiosis procedure using the superficial temporal artery [STA-EDAS] is an effective indirect bypass method in children with moyamoya disease[MMD], there is still a need for an additional bypass operation that can cover the area of the posterior circulation. The goal of this study is to evaluate the efficacy of the EDAS procedure using the occipital arteries [OA-EDAS]. Methods : From August 2003 to April 2004, We performed OA-EDAS in sixteen patients with MMD who have a circulatory insufficiency in the territory of the posterior cerebral artery[PCA]. The medical records were reviewed retrospectively. The surgical outcomes, including the changes in neurological status and imaging studies, with the degree of neovascularization on the cerebral angiogram, and the hemodynamic changes on single-photon emission computed tomography[SPECT], were analyzed. Results : These 16 children consisted of 5 boys and 11 girls aged 2 to 9 years. The clinical outcome of their PCA symptoms, such as visual transient ischemic attacks[TIAs] or visual field defect, was favorable in 14 patients of 16. Nine patients of 11 who underwent follow up magnetic resonance imaging[MRI] showed favorable MRI changes. On angiogram most of the patients exhibited good or fair revascularization of the PCA territory [7 of 8]. The hemodynamic changes on SPECT in the PCA territory after surgery showed improved vascular reserve in 13 of the 16 territories. Conclusion : OA-EDAS is a safe and efficacious revascularization procedure in patients with MMD who have compromised cerebral perfusion in PCA territory, or with visual TIAs.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• Medical Lasers
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• v.8 no.1
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• pp.1-6
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• 2019

Background and Objectives A facial laceration is a commonly occurring trauma of children. In addition, appropriate treatment and scar management are very important because the psychosocial impact of facial scars is much greater in children than in adults. Materials and Methods In the authors' hospital, primary closure was conducted targeting a total of 8,924 patients from January 2015 to December 2017. Of these, scar management was conducted on 808 people using a CO₂ fractional laser and Q-Switch Nd:YAG laser. To prove the effectiveness of the laser treatment on the linear scar, the patients were divided retrospectively into children and adults and sub-divided into those who received the treatment and those who did not. The subjective satisfaction of patients was evaluated using the Numeric Rating System (NRS). The objective scar scoring was evaluated using the image panel assessment based on the Vancouver Scar Scale (VSS), and the scoring was made by averaging the evaluations of three plastic surgeons. Results Evaluated NRS showed 8.50 ± 1.83 for adults without a laser, 8.51 ± 1.47 for adults with a laser, 7.93 ± 2.10 for children without a laser, and 8.9 ± 1.24 for children with a laser. The image panel assessment revealed 7.06 ± 1.31 for adults without a laser, 6.40 ± 2.37 for adults with a laser, 6.86 ± 1.45 for children without a laser, and 5.93 ± 1.21 for children with a laser. Conclusion When the linear scar is managed using a CO₂ Fractional laser, it can be managed in children better than adults, which is believed to be useful because it leads to better satisfaction and prognosis.

• Journal of Genetic Medicine
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• v.10 no.2
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• pp.113-116
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• 2013

Alexander disease is a rare degenerative leukodystrophy caused by dominant mutations in glial fibrillary acidic protein (GFAP). The neonatal form of Alexander disease may manifest as frequent and intractable seizures or obstructive hydrocephalus, with rapid progression leading to severe disability or death within two years. We report a case of a 50-day-old male who presented with intractable seizures and obstructive hydrocephalus. His initial magnetic resonance imaging (MRI) suggested a tumor-like lesion in the tectal area causing obstructive hydrocephalus. Despite endoscopic third ventriculostomy and multiple administrations of antiepileptic drugs, the patient experienced intractable seizures with rapid deterioration of his clinical status. After reviewing serial brain MRI scans, Alexander disease was suspected. Subsequently, we confirmed the de novo missense mutation in GFAP (c.1096T>C, Y366H). Although the onset was slightly delayed from the neonatal period (50 days old), we concluded that the overall clinical features were consistent with the neonatal form of Alexander disease. Furthermore, we also suspected that a Y366 residue might be closely linked to the neonatal form of Alexander disease based on a literature review.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.99-102
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• 2016

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.

• Journal of Genetic Medicine
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• v.19 no.1
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• pp.22-26
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• 2022

Cerebrotendinous xanthomatosis (CTX) is a rare genetic disease caused by a deficiency of enzymes for the synthesis of bile acid, resulting in the accumulation of cholestanol with reduced chenodeoxycholic acid (CDCA) production and causing various symptoms such as chronic diarrhea in infancy, juvenile cataracts in childhood, tendon xanthomas in adolescence and young adulthood, and progressive neurologic dysfunction in adulthood. Because oral CDCA replacement therapy can effectively prevent disease progression, early diagnosis and treatment are critical in CTX. This study reports the case of CTX in a 10-year-old male who presented with Achilles tendon xanthoma and mild intellectual disability. Biochemical testing showed normal cholesterol and sitosterol levels but elevated cholestanol levels. Genetic testing showed compound heterozygous variants of CYP27A1, c.379C>T (p.Arg127Trp), and c.1214G>A (p.Arg405Gln), which confirmed the diagnosis of CTX. The patient had neither cataracts nor other focal neurologic deficits and showed no abnormalities on brain imaging. The patient received oral CDCA replacement therapy without any adverse effects; thereafter, the cholestanol level decreased and no disease progression was noted. The diagnostic possibility of CTX should be considered in patients with tendon xanthoma and normolipidemic conditions to prevent neurological deterioration.