• Pediatric Infection and Vaccine
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• 제17권2호
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• pp.148-155
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• 2010

Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

• Childhood Kidney Diseases
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• 제15권2호
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• pp.154-162
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• 2011

Purpose: With increasing prevalence of hypertension (HTN) in children and adolescent, pediatricians have become more interested in blood pressure (BP) measurements. The ambulatory blood pressure monitoring (ABPM) is known to be useful to differentiate true HTN and white coat HTN. The object of this study is to assess the clinical usefulness of ABPM in Korean children and adolescents. Methods: A retrospective review of 51 patients in Kyungpook National University Hospital from January 2002 to February 2010 was done. All patients were 6-18 years old and underwent ABPM. We calculated the mean value of ABP, BP load, nocturnal dip and compared the results with the patients' diagnosis and characteristics. Results: The mean age of the 51 patients was $17.8{\pm}1.8$ years and 19 children were obese. 37 patients (72.5%) were truly hypertensive and 1 patient was diagnosed as masked HTN and 7 children (14%) as white coat HTN. The rest of the patients were normotensive. Among patients with white coat HTN, 5 were in a prehypertensive state. Mean systolic and diastolic BP load of patients with true HTN were significantly higher than non-hypertensive children (P<0.001). Although the nocturnal dip of all patients were below 10%, there was no statistical significance. The obese patients showed higher systolic and diastolic BP. Their systolic and diastolic BP load were significantly higher than non-obese patients (P<0.001). Conclusion: ABPM in children and adolescents seems to be a valuable tool in the assessment of white coat HTN and in the confirmation of true HTN. A considerable number of white coat HTN patients are revealed to be in a prehypertensive state and need close follow-up.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6521-6526
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• 2015

Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

• Journal of the korean academy of Pediatric Dentistry
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• 제33권3호
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• pp.411-421
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• 2006

In children, during developing occlusion stage, many studies confirm a high prevalence of gingival inflammation. Prevention, early diagnosis and treatment of gingival and periodontal disease is important because by establishing excellent oral hygiene habits in children, the risk of periodontal disease can be on the decrease in adulthood. This study evaluated the gingival conditions of 50 children$(8.5{\pm}3.1years)$ and 20 $adults(26.1{\pm}3.3 years)$ receiving clinical examination and GCF test at the pediatric dentistry of Chonbuk national university hospital in Jeonju, Korea. I estimated children's and adult's gingival states by measuring gingival crevicular fluid(GCF) using Periopaper and $Periotron^{(R)}$ 8000, gingival index, plaque index, DMFT scale. The results were as follows : 1. There are no statistical differences of GCF volume among the groups of the primary dentition, tooth erupting stage, complete eruption stage(p>0.1). But mean value of GCF is highest at the tooth erupting stage. 2. Comparing with adults, children have higher mean value of GCF volume with statistical differences (p<0.001). 3. There is statistically positive relationship between volume of GCF and gingival index (GI), plaque index(PLI) in both adults and children(GI; r=0.394, PLI ; r= 0.642). 4. There is no relationship between GCF volume and dental caries, composite resin treatments (p>0.05). But There is statistically positive relationship between GCF and orthodontic treatments(p<0.001) 5. Primary dentition has higher mean value of DMFT than permanent dentition(p<0.001). But there is no statistical relationship between GCF and DMFT (p>0.1).

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.790-795
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• 2006

Purpose : This study was performed to compare the therapeutic effects according to duration of medium-dose aspirin(50-60 mg/kg/day) therapy at the acute stage of Kawasaki disease(KD). Methods : Total 87 patients with KD were enrolled in this study. We performed retrospective analysis of clinical characteristics and echocardiographic findings based on medical records. Patient were randomly divided into 2 groups according to the duration of aspirin therapy at the acute stage of KD. Long-term group(LG, n=55) was administered medium-dose aspirin for 2 weeks after diagnosis of KD, and short-term group(SG, n=32) for 48 hours after intravenous immunoglobulin(IVIG) administration. The parameters of therapeutic effects were duration of fever after IVIG administration, incidence of unresponsive patients to single administration of IVIG, and development of transient dilatation or aneurysm of coronary arteries. Results : There was no significant difference in the duration of fever after IVIG between the both group(LG $1.7{\pm}1.1$ days, SG $1.8{\pm}1.1$ days; P=0.588). The incidences of unresponsive patient to the single administration of IVIG were 5.5 percent, 6.3 percent in the each group. Transient dilatation of coronary arteries occurred at 18.2 percent(10/55) in the LG, and 15.6 percent(5/32) in the SG(P=0.761). Prevalence of coronary aneurysm after subacute stage were 7.3 percent(4/55) in the LG, and 9.4 percent(3/32) in the SG(P=0.728). Conclusion : There was no significant difference in the therapeutic effects between long-term(2 weeks) and short-term(48 hours) administration of medium-dose aspirin at the acute stage of KD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.199-206
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• 2009

Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.164-169
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• 2008

Purpose : There have been some reports on the prevalence of positive antineutrophil cytoplasmic antibody(ANCA) in Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the results were conflicting. We performed this study to evaluate the clinical significance of ANCA(c-ANCA and p-ANCA) in Korean children with HSP. Methods : The medical records of 30 patients(13 boys and 17 girls) aged 6.0$\pm$1.9(5-12) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2008, the sera from children with acute HSP were tested for antineutrophil cytoplasmic antibodies(ANCA). The target antigens of these autoantibodies are proteinase 3(c-ANCA) or myeloperoxidase(p-ANCA). Results : Palpable purpura was seen in all 30 patients(100%), abdominal pain in 20(67%), arthralgia in 17(57%), and renal involvement in 11(37%). Laboratory findings showed leukocytosis in 4 patients(13%), thrombocytosis 18 in(60%), and elevated erythrocyte sedimentation rate in 18(60%). Anti-streptolysin O titers were elevated in 7% of the patients and no patient showed elevation of serum IgA level. The sera from 29 patients were negative for c-ANCA and p-ANCA by indirect immunofluorescence, but only one patient had weakly positive results, which became negative at follow-up. Conclusions : We conclude that c-ANCA or p-ANCA is not an important serologic marker in children with HSP, because it was neither diagnostically nor immunologically specific in children with HSP. These results suggest that ANCA are not involved in the pathogenesis of HSP in children.

• Neonatal Medicine
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• 제16권2호
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• pp.190-196
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• 2009

Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

• Nuclear Medicine and Molecular Imaging
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• 제40권3호
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• pp.155-162
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• 2006

Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

• Tuberculosis and Respiratory Diseases
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• 제54권4호
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• pp.378-385
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• 2003

Background : Wheezing is an important clue in the diagnosis of asthma. Previously, a Korean National asthma survey used a written questionnaire, containing the question, "Have you ever experienced a breathing sound-like 'sack-sack' or a flute sound (the Korean description for wheezing) during the last 12 months?" The response to this question showed a large discrepancy between the prevalence of wheezing and physician diagnosed asthma. This might have resulted partly from a misunderstanding of the question, due to an inadequate description for wheezing. This study was aimed at finding how well the layman understands the term "wheezing" when described as a breathing sound-like 'sack-sack', a whistle or a flute. Subjects and method : Sixty subjects, without experience of wheezing(group I), and 45 subjects, with chronic cough alleging wheezing(group II), were recruited from the Hallym University's Sacred Heart Hospital, in Anyang, Korea. Four different breathing sounds; vesicular, wheezing, tracheobronchial and crackle, were played for the subjects, without any experience with wheezing, and they were asked "which sound is most like that you would imagine when asked about a breathing sound-like 'sack-sack', a whistle or a flute?" This was followed by replaying the true wheezing sound, and then a global assessment was requested for the concordance between the real wheezing sound and the imagined wheezing sound. The wheezing sound was played for those subjects alleging wheezing, and they were asked, "have you really experienced that sound". Results : Only 46.7% of group I answered correctly, with 13.3% choosing the vesicular sound, 16.7% the tracheobronchial sound, 5.0% the crackle and 18.3% failed to answer. The concordance between their imagined wheezing and the real sound was $69.3{\pm}22.4%(mean{\pm}S.D.)$. 77.8% of group II recognized the correct sound as the one they had experienced. Conclusions : Language is not sufficient to the layman for describing natural sounds, such as wheezing.