• Journal of Korean Clinical Nursing Research
• /
• v.15 no.1
• /
• pp.79-91
• /
• 2009

Purpose: The purpose of this study was to describe the characteristics of children who visited the pediatric emergency department (PED) following an accident. Method: Data were obtained from the medical records of 4,010 children who visited the PED from January 1, 2004 through December 31, 2006. Data were analyzed using SPSS WIN 13.0 version. Results: The percentage of children who visited the PED for treatment following an accident was 14.9%. There were more boys (63.5%) than girls. The largest age group for children visiting the PED was preschool aged children. Slip downs were the most frequent accident (37.1%). The face was the most frequently injured area of the body (26.0%). Most (93.3%) of the children who visited the PED were classified as non-emergency, 6.5% as emergency and 0.2% as urgent. About 70.0% of children were examined and 50% of children were medicated. Fifty percent stayed in the PED department for less than 2 hours, and 88.0% of children were discharged to home. Nine percent were admitted, and 2.2% were transferred to other hospitals. Conclusion: The results of this study suggest the need for accident prevention education for parents, and the need to develop effective education for clinical nurses working in PED.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.9 no.1
• /
• pp.18-24
• /
• 2013

Objectives: The goal of this study is to establish data baseline to ameliorate oral health policies for patient. The research was conducted in dental clinic at Seoul Metropolitan Children's Hospital - the major municipal hospital for the disabled. The outpatients' visiting patterns to the dental clinic were analyzed, compared to other medical departments. For further research related to TMD, the questionnaires were given to the subjects. Material and methods: Data for visiting patterns/frequencies was collected from patient records of 1419 outpatients who visited the dental clinic at Seoul Municipal Children's Hospital in 2011. Then TMD-related questionnaires were given to 127 outpatients who were over 13 years old. Results: 1. 219 out of 1419 patients (15.4%) who visited the dental clinic at Seoul Municipal Children's Hospital in 2011 were the disabled. 2. Compared to normal patients, disabled patients visited the dental clinic and rehabilitation medicine department more frequently.(p<0.05) However, there was no apparent difference in visiting frequencies between the disabled and the normal patients in the psychiatric department.(p=0.3237) 3. 44% of the TMD-related questionnaire subjects responded that they often consumed relatively hard or tough food, 53% answered they had unilateral chewing habit, 3% had bruxism, and 12% had clenching habit. Conclusion: In the dental clinic at Seoul Municipal Children's Hospital, 19% of outpatients over 13 years old had TMD such as clicking and pain. Also, the disabled patients' visits to the dental clinic were considerably more frequent, compared to the normal patients and to other medical departments. Accordingly, the result may suggest that the proper systematic supports from the government are essential to the dental clinic at municipal hospital for the disabled.

• Advances in pediatric surgery
• /
• v.19 no.2
• /
• pp.98-107
• /
• 2013

Debates exist about the appropriate treatment for pancreatic trauma in children. We intended to examine the safety of the operation of pancreatic trauma in children. This is a retrospective study of 13 patients, younger than 15, who underwent surgery for pancreatic trauma, between 1993 and 2011 in Seoul National University Children's Hospital. Medical records were reviewed for mechanism of trauma, clinical characteristics, radiological findings, operation and outcomes. Organ injury scaling from the AAST (American Association for Surgery of Trauma) was used. All injuries were caused by blunt trauma. Patients with grade III, IV, and those who were difficult to distinguish grade II from IV, underwent surgery due to severe peritonitis. Three patients with grade II were operated for reasons of mesenteric bleeding, tumor rupture of the pancreas, and progression of peritonitis. Distal pancreatectomy was performed in 10 patients and subtotal pancreatectomy and pylorus preserving pancreaticoduodenectomy in 1 patient each. The remaining one underwent surgical debridement because of severe adhesions. The location of injury, before and after operation, coincided in 83.3%. The degree of injury, before and after the operation, was identical in all the patients except for those who were difficult to tell apart grade II from grade IV, and those cannot be graded due to severe adhesion. Postoperative complications occurred in 23.1%, which improved with conservative treatment. Patients were discharged at mean postoperative 12(range 8~42) days. Even though patients with complications took longer in time from diagnosis to operation, time of trauma to operation and hospital stay, this difference was not significant. In conclusion, When pancreatic duct injury is present, or patient shows deterioration of clinical manifestation without evidence of definite duct injury, or trauma is accompanied by other organ injury or tumor rupture, operative management is advisable, and we believe it is a safe and feasible method of treatment.

• Advances in pediatric surgery
• /
• v.14 no.2
• /
• pp.164-172
• /
• 2008

The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8 %), and embryonal type was predominant (n=11, 6 %). Before the treatment, most patients were in advanced TNM stage (stage III 50 %, IV; 25 %). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3 %, Group II 12.5 %, Group III 31.3 % and Group IV 25 %. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3 %), gross total resection (GTR, n=7; 43.8 %) and incomplete resection (IR, n=4; 25 %). Recurrence was observed in 9 patients (56.3 %) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however postsurgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.23 no.3
• /
• pp.143-151
• /
• 2023

Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion: Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

• Clinical and Experimental Pediatrics
• /
• v.52 no.9
• /
• pp.1029-1034
• /
• 2009

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15-year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.

• Clinical and Experimental Pediatrics
• /
• v.58 no.5
• /
• pp.194-198
• /
• 2015

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.1
• /
• pp.48-54
• /
• 2015

Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed. Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated. Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period. Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

• Childhood Kidney Diseases
• /
• v.8 no.2
• /
• pp.239-243
• /
• 2004

Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinulra. Serial urine cultures grew Escherichia coli. ${^99m}$Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin 0 titer, and low serum complement levels. The patient improved completely with supportive treatment, Including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be .superimposed on each other.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.2
• /
• pp.138-143
• /
• 2015

Glycogen storage disease type IX (GSD IX) is caused by a defect in phosphorylase b kinase (PhK) that results from mutations in the PHKA2, PHKB, and PHKG2 genes. Patients usually manifest recurrent ketotic hypoglycemia with growth delay, but some may present simple hepatomegaly. Although GSD IX is one of the most common causes of GSDs, its biochemical and genetic diagnosis has been problematic due to its rarity, phenotypic overlap with other types of GSDs, and genetic heterogeneities. In our report, a 22-month-old boy with GSD IX is described. No other manifestations were evident except for hepatomegaly. His growth and development also have been proceeding normally. Diagnosed was made by histologic examination, an enzyme assay, and genetic testing with known c.3210_3212del (p.Arg1070del) mutation in PHKA2 gene.