• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.364-369
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• 2021

Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.

• Advances in pediatric surgery
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• 제1권1호
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• pp.40-45
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• 1995

Anal fistula and perianal abscess in pediatric patients have been reported to have several characteristics, e.g. prevalent in less than 2 years of age, male preponderance, straight course of tract, and low type of fistula. We performed a retrospective study of twenty nine pediatric patients to see these characteristics comparing with the transitional age group of adolescents. Between June 1989 and December 1993, twenty-nine pediatric (<15year-old) and sixteen adolescent patients(${\geqq}$15, <25 year-old) with anal fistula and perianal abscess were treated by surgical intervention. Perianal abscess and anal fistula in the pediatric group had the predilection for male(100%), age less than two years (72.4%), low type(100%), and lateral localization(87.5%). But the features of the adolescent group were similar to those of adult. Twenty-one(87.5%) and 10(66.7%) enteric bacterial colonies were isolated from 16 pediatric and 11 adolescent patients, respectively. Considering the predominance of low type and the organisms cultured in the pediatric group, crypt-glandular infection seems to be a major preceding event. Incision and drainage were sufficient for cure in 15 among 16 perianal abscesses, and fistulas were cured by either fistulotomy or fistulotomy in all the 14 patients. The importance of effective drainage of perianal abscess and fistulotomy including internal opening cannot be overemphasized.

• Advances in pediatric surgery
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• 제20권2호
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• pp.28-32
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• 2014

Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ${\leq}$ 15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p<0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p<0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] vs. OA 12/166 [7.2%]; p<0.01). Readmission rate was also higher in the LA group (LA 9/108 [8.3%] vs. OA 3/166 [1.8%]; p<0.01). Conclusion: The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.

• 대한장애인치과학회지
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• 제12권2호
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• pp.50-54
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• 2016

Regular dental visit of disabled patients is an important strategy for maintenance of oral health because of the lack of awareness of oral care. But there is limited information about follow up period in disabled patients after dental treatment. The aim of this study was to investigate the pattern of dental visit and dental management of special care needs patients according to the types of disabilities. A total of 140 patients who received dental treatment at Seoul National University Dental Hospital from 2010 to 2012 were reviewed. Patients were divided 3 groups according to the types of disabilities (disorder of external physical function, disorder of internal organ, psychic disability). Patient's characteristic, dental treatment performed, follow up period and frequency were investigated. The mean follow up period was 28.2 months and average frequency of visit was 3.69 times per year. There was no difference in period and annual visit between 3 groups, but significantly difference in cooperation with medical hospital in affiliation. Regular check-up was the most common dental treatment in all groups. In psychic disorder group, the proportion of sedative treatment was significantly higher than other groups. The results of this study provide information necessary for treatment planning and dental management of disabled patients.

• Advances in pediatric surgery
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• 제2권1호
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• pp.8-16
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• 1996

Laparoscopic appendectomy is relatively well-established as an alternative to conventional open appendectomy by many laparoscopic surgeons. However, experience in the pediatric population remains limited. Over a period of 2 years, a total of 155 pediatric patients with acute appendicitis or complicated appendicitis were studied to compare laparoscopic and open appendectomies in childhood. Laparoscopic appendectomy was attempted in 49 patients and completed in 48 patients(98.0%). Open appendectomy was performed in 107 patients. The severity of disease, age, and male to female ratio were similar in both groups. The operation time was shorter in the laparoscopic group than open group but the difference was not significant statistically($43.7{\pm}11.3$ minutes versus $49.0{\pm}21.4$ minutes, p=0.066). In the laparoscopic group, the mean duration of surgery for the former half patients was significantly longer than for the latter half($49.6{\pm}9.2$ minutes versus $38.1{\pm}10.3$ minutes, p=0.001). The mean number of doses of analgesia required postoperatively was significantly less in patients undergoing laparoscopic appendectomy($2.4{\pm}1.8$ versus $3.3{\pm}2.5$, p=0.021). There were only 2(4.2%) wound infections after laparoscopic appendectomy compared with 10(9.3%) complications including 7 wound infections, 1 intestinal obstruction, and 2 pulmonary complications after open appendectomy, but the difference was not significant(p=0.614). Patients undergoing laparoscopic appendectomy had a shorter period of hospitalization($3.2{\pm}2.2$ days versus $6.4{\pm}1.6$ days. p=0.001). The present study suggests that laparoscopic appendectomy shortens operating time and hospital stay with diminished postoperative pain. Laparoscopic appendectomy in children offers advantages over open appendectomy as noted in adults. The authors consider laparoscopic appendectomy to be the reasonable alternative to open appendectomy in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.164-172
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• 2021

Purpose: The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood. Methods: Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Results: Of the 41 patients included in the study 25 were girls (61.0%), mean age was 12.2±4.2 years. EUS was performed for biliary colic in 21 (51.2%), for recurrent pancreatitis in 12 (29.2%), for cholecystitis/cholangitis in 5 (12.2%), and for acute pancreatitis in 3 (7.4%) patients. EUS had a significant clinical effect in the decision of treatment and follow-up of 6/21 biliary colic cases, in diagnosis and follow-up of 6/12 recurrent pancreatitis cases, in decision-making and monitoring of invasive procedures (ERCP/surgery) of 3/5 acute cholecystitis/cholangitis and 2/3 of acute pancreatitis cases as well as in follow-up of the other cases. The effectiveness of EUS in determining direct treatment and invasive intervention was 43.9%. None of the patients had complications related to the EUS procedure. Conclusion: Although current guidelines show that EUS can be used in pediatric patients, this is limited to a few published studies. In this study, it is shown that EUS is a safe method for the diagnosis, follow-up and treatment of common pancreatobiliary pathologies in childhood.

• 대한치과마취과학회지
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• 제4권2호
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• pp.90-95
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• 2004

Background: Sevoflurane, a rotatively new inhalational anesthetic. has non-pungent odor and is less reluctant to pediatric patients. The purpose of this study is to examine the feasibility of sevoflurane in inhalational sedation instead of the nitrous oxide for short and simple dental treatments in pediatric patients. Patients and Methods: Fifteen healthy children, whose dental treatment was abandoned due to their little or no cooperation, were selected with their caregivers' written permission. Deep sedation was induced and maintained with oxygen and 1-5% sevoflufane via specially designed nasal mask. Blood pressure, heart rate, oxygen saturation, and electrocardiogram were monitored at 3-nin interval. A dental anesthesiologist, who was independent of dental treatments, was wholly responsible for the sedation procedure. Post-sedation complications and operator's and caregiver's acceptability of this type of inhalational sedation were also investigated. Results: The systolic and diastolic blood pressure, heart rate, and oxygen saturation was significantly depressed during the deep sedation using sevoflurane (P < 0.05). No severe post-sedation complications were found, however, bradycardia was reported in 3 patients. Almost all the operators and caregivers answered that they would adapt this sedation procedure again if possible. Conclusion: In this study, inhalational deep sedation using sevoflurane for dental treatments was found to be very useful. Furthermore, the application of sevoflurane to conscious sedation for pediatric and adult dental patients should be added.

• 대한소아치과학회지
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• 제46권2호
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• pp.200-208
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• 2019

이 연구는 연세대학교 세브란스 병원에 입원한 환자의 소아치과 협진의뢰에 대한 정보를 분석하여 소아치과에 의뢰되는 전신질환 환자에 대해 파악하고 협진 및 진료 경향에 변화가 있는지 분석하기 위해 시행되었다. 2017년 한 해 동안 연세대학교 세브란스 병원에 전신질환으로 입원한 소아환자 중 소아치과에 의뢰되어 실제로 진료를 받은 384건(268명)에 대한 자료를 조사하였다. 평균연령은 6.6세였으며, 소아혈액종양과와 재활의학과에서 가장 많은 의뢰가 있었다. 협진주소는 기본 구강검진(31%), 치아우식증(20%), 구강통증(10%), 치아동요도(10%), 수술 전 검진(9%) 순으로 많았고, 협진의뢰된 환자의 41%는 치료 없이 구강검사만 시행하였다. 의뢰된 환자의 치과적 진단명은 치아우식증이 가장 많았으며, 이에 대한 보존치료 및 예방치료가 시행되었다. 협진의뢰된 환자의 28%(111건)는 보존치료를 받았으며 그 중 22건은 전신마취 하에 진행되었다. 구강건강은 입원환자의 전신질환과 밀접한 연관성이 있으므로 구강질환의 예방 및 치료를 위하여 치과협진이 적극적으로 이루어져야 한다. 이를 위해 협진의뢰 체계 확립과 전신마취를 통한 치과치료의 활용이 필요하다.

• 대한소아치과학회지
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• 제31권3호
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• pp.459-473
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• 2004

본 연구는 보다 효과적인 치료계획 수립과 행동조절을 시행하는데 도움을 얻고자, 1999년 1월 1일부터 2002년 12월 31일까지 강릉대학교 치과병원 소아치과에 내원한 환아를 진료기록부를 통해 조사하고, 진정치료를 받은 환아들 및 보호자의 특성을 진료기록부 및 초진시 설문지를 통해 진정치료를 받지 않은 환아들과 비교, 분석하여 다음과 같은 결과를 얻었다. 1. 내원 환아수 증가와 함께 진정치료환아들의 수가 1999년부터 2002년의 4년 동안 계속적으로 증가하였다. 2. 진정환아군은 비진정환아군에 비해 어린 연령 대에 집중되어 유의할만한 분포의 차이를 보였다(p<0.001). 3. 월별 내원경향에 있어서 진정환아군은 3, 7, 11월에 높은 비율을 보여 전체 환아에 비해 내원빈도 분포에 유의할 만한 차이를 보였다(p<0.001). 4.보호자 직업의 분포에서도 추후 계속된 연구가 필요하지만, 진정환아와 비진정환아군 간에 통계적으로 유의한 차이가 있었다(p<0.001). 5. 진정환아군은, 비진정환아군에 비해 예방, 교정적인 치료보다는 충치치료를 주소로 내원하는 비율이 높아 내원동기의 분포에 유의할만한 차이가 있었다(p<0.001). 6. 이전 치과치료시 진정환아군에서 부정적 반응을 보인 비율이 더 높았고, 보호자 기대치에서도 진정환아군에서 부정적 반응을 기대한 비율이 더 높았다(p<0.001). 7. 진정환아군의 31.2%는 소개를 통해 소아치과에 내원하였으며, 치과의사에 의한 소개가 가장 높은 58.3%를 차지하였다. 8. 달래도 치료를 거부할 경우, 진정환아군의 보호자들은 50.9%가 진정치료를 선호한 반면, 비진정환아군의 보호자들은 물리적 방법을 54.6%로 선호하여 유의할만한 분포의 차이를 보였다(p<0.001).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.163-169
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• 2018

Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged between 2 and 18 years who underwent colonoscopy and esophagogastroduodenoscopy (EGD) for the first time due to the prediagnosis of IBD. In EGD, samples were taken from duodenum, antrum, corpus, and esophagus; and gastritis, duodenitis, and esophagitis were identified through histopathologic examination. The data gathered the ends of the research were compared between IBD with non-IBD groups and between CD-UC with non-IBD groups, and the presence of significant differences between groups were determined. Results: In our study, 16 patients were diagnosed with CD, 13 with UC, 3 with undeterminate colitis, and 13 with non-IBD. In the histopathological examination of the groups, GIS involvement was found in 94.1% of patients diagnosed with IBD and in 38.5% of non-IBD patients. Moreover, the difference was found to be statistically significant (p=0.032). No significant difference was found between the CD and UC groups. Gastritis was mostly observed in 93.8% of CD-diagnosed patients, 76.8% of UC-diagnosed patients, 81.2% of IBD-diagnosed patients, and 38.5% of non-IBD-diagnosed patients. On the other hand, significant differences were found between CD and non-IBD groups (p=0.03), UC and non-IBD groups (p=0.047), and IBD and non-IBD groups (p=0.03). Conclusion: The results of the study show that gastritis was highly observed in UC- and CD-diagnosed patients than in non-IBD-diagnosed patients.