• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.87-91
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• 2022

Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.131-140
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• 2012

Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : A 5-year retrospective study of pediatric hemato-oncologic patients with bacteremia in Seoul National University Children's Hospital, from 2006 to 2010 was conducted. Results : A total of 246 pathogens were isolated, of which 63.4% (n=156) were gram-negative, bacteria 34.6% (n=85) were gram-positive bacteria, and 2.0% (n=5) were fungi. The most common pathogens were Klebsiella spp. (n=61, 24.8%) followed by Escherichia coli (n=31, 12.6%), coagulase-negative staphylococci (n=23, 9.3%), and Staphylococcus aureus (n=22, 8.9 %). Resistance rates of gram-positive bacteria to penicillin, oxacillin, and vancomycin were 85.7%, 65.9%, and 9.5%, respectively. Resistance rates of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin were 37.2%, 17.1%, 6.2%, 32.2%, and 13.7%, respectively. Overall fatality rate was 12.7%. Gram-negative bacteremia was more often associated with shock (48.4% vs. 11.9%, P<0.01) and had higher fatality rate than gram-positive bacteremia (12.1% vs. 3.0%, P=0.03). Neutropenic patients were more often associated with shock than non-neutropenic patients (39.6 % vs. 22.0%, P=0.04). Conclusion : This study revealed that gram-negative bacteria were still dominant organisms of bloodstream infections in children with hemato-oncologic diseases, and patients with gram-negative bacteremia showed fatal course more frequently than those with gram-positive bacteremia.

• Childhood Kidney Diseases
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• v.14 no.1
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• pp.42-50
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• 2010

Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.2
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• pp.63-68
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• 2017

Gaucher disease (GD) is caused by the deficiency of glucocerebrosidase. In pediatric patients with GD, especially Type I GD, enzyme replacement therapy (ERT) can reduce the hepatosplenomegaly and improve the hematologic finding and growth velocity. Herein, we report a 2-year-old girl with Type I GD presented with hepatosplenomegaly, bone pain and growth retardation. A 2 year-old-girl was referred to our hospital due to severe hepatosplenomegaly and growth retardation. She suffered from both leg pain and chronic fatigue. Simple x-ray showed widened distal long bones like that of an 'Erlenmeyer flask' which is associated with GD. The laboratory test showed anemia and thrombocytopenia. The enzyme activity was markedly reduced and the direct sequencing of the GBA gene showed the compound heterozygous mutations, p.G46E and p.L444P. As the G46E have been considered as the protective gene against neuronopathic genotype, we could assess the Type I GD in this patient. After one year of ERT, the growth velocity became 11 cm per year. Bone pain and fatigue disappeared. The volume of liver and spleen was reduced from $683cm^3$ and $703cm^3$ to $590cm^3$ and $235cm^3$, respectively. Although GD is an extremely rare disease in Korea, growth retardation and bone pain in children are the important signs which lead to early detection of GD and a simple radiologic finding is helpful to assess the GD at outpatient clinic. We highlight that the early diagnosis and early ERT is important for good growth and outcome for pediatric patients with GD.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.128-135
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• 2021

Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘²=14.397, p<0.001; 𝛘²=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.2
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• pp.90-96
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• 2009

Objectives: This study examined clinical characteristics associated with bullying in children with attention-deficit/hyperactivity disorder(ADHD). Methods.: Children and their parents were asked to fill out a structured self-report form regarding bullying incidents. To evaluate the characteristics of the children, the results of the ADHD Rating Scale, the Korean version of the Child Behavior Checklist, the ADHD Diagnostic system and the Emotional Recognition Test were used. The agreement of bullying data between each child and their mother and father was measured using Cohen's kappa. The association between victim and perpetrator was analyzed by calculating a contingency coefficient based on chi-square. To compare the characteristics of victimized children and didn't, an independent sample T-test was performed. Results: When children were victims of bullying incidents there was significant agreement between children and parents on the information provided on the self-reports. However, more children reported themselves as a perpetrator of bullying than their parents did. Victimization, that is, the tendency towards being a perpetrator, is associated with the higher level of parental reports of aggressiveness. Conclusion: Victimization of bullying is associated with aggression in children with ADHD. This study suggests that victimized children with ADHD warrant careful evaluation, in particular with regard to the credence placed on parental reports of aggressiveness, and management for aggression.

• Journal of Korean Medicine for Obesity Research
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• v.12 no.1
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• pp.9-19
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• 2012

Objectives This study was designed to find out the relationships between obesity and growth, skeletal maturity among children by analyzing body composition and bone age. Methods Subjects were composed of 577 children from six years to seventeen years of age, without any other diseases related to growth, were measured their body composition and bone age. Results As obesity index was increased, the RH-MPH(%) and skeletal maturity significantly was also increased. The RH-MPH(%) of the obesity group was significantly increased than that of normal weight group; the skeletal maturity was more increased in th obesity group. It means the recent height of obese children was more taller than that of inherited from the parents, while skeletal maturity of obese children was more rapidly progressing. The RH-MPH(%) was increased in children who revealed stage of second sexual character; skeletal maturity was decreased in children who developed secondary sexual character. Conclusions Obesity children might be taller than what it supposed to be. However, obesity could cause the increase of skeletal maturity. It means the growth plate of obese children has been closed early.

• Journal of Korean Biological Nursing Science
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• v.8 no.2
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• pp.73-92
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• 2006

Purpose: This study was to understand actual state of supportive behavior of parents and nurses during invasive procedure for children who visit emergency medical center. Method: The object group was children's parents who have from 0 to 7 aged children takes invasive procedure except neonates and nurses who take part in the invasive procedure. Among them, 80 children's parents and 31 nurses were selected. For data analysis, SPSS for Window 8.0 was used and especially content analysis was performed for concrete supportive behavior of parents and nurses by survey. Results: Supportive behavior of parents and nurses during children's invasive procedure gave negative influences to the children, because most parents supplied poor supportive behavior without preparation, nurses performed work-oriented and treatment-oriented nursing due to speciality and busy business in emergency medical center. Conclusion: To lead positive and affirmative supportive behavior of parents and nurses during children's invasive procedure, for parents, positive supportive behavior ability must be strengthen through the overall education about children's invasive procedure when they visit emergency medical center or go to hospital: for nurses, hospital must provide successive instruction and policy to make nurses perform not work-oriented but patient-oriented nursing and positive supportive behavior.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.575-579
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• 2005

Urinary incontinence is the most common urinary symptom in children and causes considerable anxiety in children and parents. In most cases, there is no underlying organic pathology and the longterm prognosis is excellent. Despite these reassuring facts, children with wetting problems can be a challenge for primary pediatrician. This is probably because the problem is poorly understood, there is no readily identifiable medical pathology, and because treatment is usually time consuming and arduous. There is a great demand for treatment because wetting is an unpleasant symptom that can cause a stress and anxiety in the family. There may also be other coexisting problems such as urinary tract infection, constipation, soiling, and behavioral or emotional difficulties. Despite the frequency and vexing nature of voiding dysfunction, physicians may not always obtain a careful history to identify and to treat children properly with this condition. This article addresses the comprehensive diagnostic and therapeutic approach to such children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.141-148
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• 2017

Objectives: The current study examined the effect of birth weight on the relationship between age and IQ of children, who were born preterm with very low birth weight (VLBW) or extremely low birth weight (ELBW). Methods: The study subjects were 82 children, aged between 3-5 years, who visited the neonatal intensive care unit of a university hospital located in Seoul. The children had been born prematurely with VLBW or ELBW. Their IQ was tested using the performed Korean-Wechsler Preschool and Primary Scale of Intelligence fourth edition. Results: A hierarchical regression analysis showed a significant interaction effect of birth weight and age on Full Scale IQ (FSIQ); the effect of age on FSIQ differed according to birth weight. For the group with VLBW, FSIQ was more likely to be higher with increasing age. Conversely, for the group with ELBW, FSIQ remained low regardless of the age level. In addition, birth weight and age had a significant interaction effect on the Visual Spatial Index. Birth weight had a significant main effect on Verbal Comprehension Index. Conclusion: This research suggested the possibility of predicting the cognitive developmental of premature children, by highlighting the fact that prematurely born children, with VLBW/ELBW, have different cognitive developmental trajectories.