• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권1호
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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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• 제19권3호
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• pp.131-140
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• 2012

목 적 : 소아 종양 환자의 균혈증의 원인균과 위험 인자에 대한 지속적인 감시 및 조사를 통해 적절한 치료와 생존율 향상에 기여하고자, 2006년부터 2010년의 최근 5년간 서울대학교 어린이 병원 소아 종양 환자에게 발생했던 균혈증의 원인균 분포와 이들의 항생제 감수성을 분석하여 항생제 선택에 실제적인 도움을 얻고자 하였다. 방 법 : 2006년 1월부터 2010년 12월까지 5년간 서울대학교 어린이병원에서 입원 치료를 받은 소아 종양환자들에게 발생한 균혈증에 대하여, 의무기록을 후향적으로 분석하였다. 의무기록 분석 시, 선행 질환 및 호중구 수치, 치료 경과 등을 조사하였고, 호중구 감소증, 중심 정맥관 등 균혈증의 예후 인자에 대한 분석을 함께 시행하였다. 결 과 : 총 176명의 소아 종양 환자에게 226례의 균혈증이 발생하였고, 246균주가 분리되었다. 이 중 그람 음성균, 그람 양성균, 진균이 각각 63.4%, 34.6%, 2.0%이었다. 그람 음성균 중에는 Klebsiella species, E. coli, 그람 양성균 중에는 coagulase-negative staphylococci, S. aureus 등이 높은 비율로 분리되었다. 그람 양성균의 penicillin, oxacillin, vanconycmin 내성률은 각각 85.7%, 65.9%, 9.5%이었으며, 그람 음성균의 cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, amikacin 내성률은 각각 37.2%, 17.1%, 6.2%, 32.2%, 13.7%이었다. 전체 환자에서 치사율은 12.7%였다. 그람 음성균 균혈증의 쇼크 발생률이 그람 양성균 균혈증보다 유의하게 높았고(48.4% vs. 11.9%, P<0.01), 치사율 역시 그람 음성균이 더 높았다(12.1% vs. 3.0%, P=0.03). 쇼크 발생률은 호중구 감소증을 동반한 환자군에서 호중구 감소증을 동반하지 않은 환자군에서보다 유의하게 높았다(39.6% vs. 22.0%, P=0.04). 결 론 : 그람 음성균이 소아 종양 환자의 균혈증의 흔한 원인균이며, 불량한 예후와도 관련성이 높은 점들은 기존 연구결과들과 일치하였다. 향후 원인 균주의 분포와 항생제 내성률의 변화에 대한 지속적인 모니터링이 필요할 것으로 생각된다.

• Childhood Kidney Diseases
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• 제14권1호
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• pp.42-50
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• 2010

목 적 : 단일신을 가진 소아의 임상적 특징과 동반기형 및 장기적 신기능 등에 대해 알아보고자 하였다. 방 법 : 1989년 12월부터 2009년 12월까지 20년간 서울대학교 어린이병원에서 진단된 38예의 단일신 환자를 대상으로 후향적 조사를 하였으며, 단일신은 영상검사를 통해 진단된 일측성 신장 무형성으로 정의하였고, 일측성 이형성 신의 퇴행으로 발생한 단일신은 제외하였다. 결 과 : 진단 연령의 중앙값은 6.5개월(출생직후-13세)이었고, 남자가 12명(31.6%), 여자가 26명(68.4%) 이었다. 19예(50.0%)에서는 좌측 신장이 없었고 19예에서는 우측 신장이 없었다. 산전 초음파에서 진단된 경우가 14예(36.8%), 신장 혹은 요로계 질환에 대한 검사 도중 13예(34.2%), 우연히 발견된 경우가 10예(26.3%)이었다. 동반 기형으로는 방광요관 역류 11예(28.9%)를 포함한 신장기형이 17예(44.7%), 기타 비뇨생식기계의 기형이 16예(42.1%) 그리고 다 기관 증후군 혹은 염색체 이상이 9예(23.7%)에서 진단되었다. 혈청 크레아티닌의 중간값은 0.6 mg/dL이었으며 만성 신부전이 2예(5.3%)에서 확인되었다. 결 론 : 단일신은 신장의 선천성 기형 중 상대적으로 흔한 질환이며, 일반적으로 증상이 없다. 그러나 일부에서는 단일신은 다른 기관의 이상과 연관이 되어있거나 관련된 증상이 발생한다. 단일신을 가진 소아의 연관 기형의 조기 발견과 추적 관찰이 장기적인 신 손상의 위험을 감소시키기 위해 필요하다.

• 대한유전성대사질환학회지
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• 제17권2호
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• pp.63-68
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• 2017

고셔병은 리소좀축적병으로 lysosomal hydrolase glucocerebrosidase 결여로 간비장비대, 골격계 증상, 빈혈, 혈소판 감소증의 증상을 나타내는 드문 상염색체 유전 질환이다. 본 증례에서는 2세 여아에서 간비장비대, 다리 통증, 성장부진이 관찰되어 시행한 단순 방사선 촬영 검사에 Erlenmeyer flask 변형을 확인하여 고셔병을 의심하였고 효소 분석 및 유전자 검사를 통해 확진하였다. 환아에서 한국인 비신경형 고셔병에서만 관찰되는 G46E 돌연변이를 확인하였고 1년 간의 효소 대체 요법을 통해 성장, 혈액학적 지표, 간비장비대 및 골증상의 호전을 확인하였기에 본 증례를 보고하는 바이다.

• 정신신체의학
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• 제29권2호
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• pp.128-135
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• 2021

연구목적 본 연구는 코로나19가 소아청소년 자해의 발생 및 심각도에 미치는 영향을 조사하고자 한다. 방 법 건양대학교병원 응급실을 내원한 만 18세 이하 환자를 대상으로 의무기록을 후향적으로 검토하여 코로나19 발생 전후 자해 시도로 응급실을 내원한 환자의 비율, 인구학적, 임상적 요인 및 자해 관련 양상을 비교하였다. 결 과 코로나19 발생 후 건양대학교 병원에 내원한 자해 소아청소년의 실인원과 연인원의 비율은 발생 전에 비해 유의미하게 증가하였다(𝛘²=14.397, p<0.001; 𝛘²=24.156, p<0.001). 코로나19 발생 전후로 응급실에 내원한 자해 소아청소년의 자해 과거력 및 정신건강의학과적 과거력, 타과 입원 비율은 유의미한 차이를 보였다(p<0.05; p<0.05; p<0.05). 결 론 코로나19 상황에서 소아청소년의 자해로 인한 응급실 내원 및 타과 입원 비율이 증가하는 것으로 나타났으며, 이전 자해 과거력 및 정신건강의학과 과거력이 있는 소아청소년에서 자해 발생이 유의미하게 증가한 것으로 나타났다. 범유행 상황에서 소아청소년 정신건강 고위험군의 평가와 개입에 대한 추가적 연구가 필요할 것으로 사료된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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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.

• 한방비만학회지
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• 제12권1호
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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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• 제8권2호
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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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• 제48권6호
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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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• 제28권2호
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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.