• Advances in pediatric surgery
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• v.16 no.2
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• pp.108-116
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• 2010

Air reduction is a safe, effective, and fast initial treatment for pediatric intussusception. There is low dose radiation exposure. Factors affecting outcomes of air reduction were analyzed by reviewing the clinical features and results of treatment. A total of 399 out of 485 patients with pediatric intussusceptions were treated at the Seoul National University Children's Hospital from 1996 to 2009. All of the patients received air reduction as the first line of treatment. Clinical features such as gender, age, seasonal variation, symptoms, signs, types, pathologic leading point, and treatment results including success rate, complication, recurrence, NPO time, and duration of hospitalization were reviewed. The Pearson chi-square, student T-, and logistic regression tests were used for statistical analysis. P-value less than 0.05 was considered to be statistically significant. The prevalent clinical features were: male (65.4 %), under one-year of age (40.3 %), ileocolic type (71.9 %), abdominal pain (85.4 %), and accompanying mesentery lymph node enlargement (2.2 %). The overall success rate for air reduction was 78.4 % (313 of 399 patients), and the perforation rate during reduction was 1.5 %. There were 23 recurrent cases over 21.6 months. All were successfully treated with re-do air reduction. Reduction failures had longer overall NPO times (27.067hrs vs. 43.0588hrs; p=0.000) and hospitalization durations (1.738d vs. 6.975d; p=0.000) compared to the successful cases. The factors affecting success rates were fever (p=0.002), abdominal distension (p=0.000), lethargy (p=0.000) and symptom duration (p=0.000) on univariate analysis. Failure rates were higher in patients with symptom durations greater than 24 hours (p=0.023), and lethargy (p=0.003) on multivariate analysis. Air reduction showed high success rates and excellent treatment outcomes as the initial treatment for pediatric intussusception in this study. Symptom duration and lethargy were significantly associated with reduced success rates.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.188-196
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• 2022

The purpose of this study was to investigate pediatric emergency department visits patterns and characteristics of children and adolescents under the age of 20 in South Korea from 2002 to 2015 due to dental conditions. This study used a stratified sample of approximately 1 million people from the Health Insurance Review and Assessment Service Database. The age, region, household income, and treatment cost were included for the patient characteristic analysis. Pediatric patients were compared to the adult group (over 20 years old). In children and adolescents, the rate of emergency department visits due to dental conditions was higher for traumatic conditions than for non-traumatic conditions. Children and adolescents with higher household income visited the emergency department more often than those with lower household income. The region with the highest number of children and adolescents visiting the emergency department for dental conditions was Busan (per 100,000 population). Although this study could not confirm the annual trend of children and adolescents' dental emergency visits due to the sample size limitation, the characteristics of children and adolescents' dental emergency visits were compared with those of adults using a stratified sample.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.187-193
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• 2024

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

• Journal of Trauma and Injury
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• v.30 no.3
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• pp.75-79
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• 2017

Purpose: Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims Methods: The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record. Results: The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance ($6.50{\pm}7.60$ vs. $3.00{\pm}8.10$; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury. Conclusions: We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.3
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• pp.233-241
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• 2015

The aim of this study was to determine the bite force and lip closing force in preschool children and to analyze the correlation between these forces by age, height and weight, respectively. Data were obtained from 98 children (56 males, 42 females) ranging from 3 to 6 years of age. The magnitude of the bite force was measured bilaterally corresponding with the 2nd primary molars using a bite force gauge, $GM10^{(R)}$ (Nagano Keiki) and the force of lip closure was measured using LIP DE $CUM^{(R)}$ (Cosmo Instruments). The averages of bite force for boys and girls were 217.69 N and 205.05 N, respectively. The relationship between bite force with age, height, and weight present significant positive correlation (p < 0.001, p < 0.001, and p < 0.001, respectively). The averages of lip closing force for boys and girls were 4.81 N and 4.07 N respectively. The relationship between lip closing force with age, height, and weight present significant positive correlation (p < 0.001, p < 0.001, and p < 0.001, respectively). No significant differences were observed between boys and girls (p > 0.05) in both forces. A significant correlation was observed between lip closing force and bite force (p = 0.002).

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.2
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• pp.209-218
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• 2019

This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars. Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian's method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated. Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency. Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.89-97
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• 2020

Purpose: Obese children may often present with advanced bone age. We aimed to evaluate the correlation between factors associated with childhood obesity and advanced bone age. Methods: We enrolled 232 overweight or obese children. Anthropometric and laboratory data, and the degree of nonalcoholic fatty liver disease (NAFLD) were measured. We analyzed factors associated with advanced bone age by measuring the differences between bone and chronological ages. Results: The normal and advanced bone age groups were comprised of 183 (78.9%) and 49 (21.1%) children, respectively. The prevalence of advanced bone age significantly increased as the percentiles of height, weight, waist circumference, and body mass index (BMI) increased. BMI z-score was higher in the advanced bone age group than in the normal bone age group (2.43±0.52 vs. 2.10±0.46; p<0.001). The levels of insulin (27.80±26.13 μU/mL vs. 18.65±12.33 μU/mL; p=0.034) and homeostatic model assessment-insulin resistance (6.56±6.18 vs. 4.43±2.93; p=0.037) were significantly higher, while high density lipoprotein-cholesterol levels were lower (43.88±9.98 mg/dL vs. 48.95±10.50 mg/dL; p=0.005) in the advanced bone age group compared to those in the normal bone age group, respectively. The prevalence of advanced bone age was higher in obese children with metabolic syndrome than in those without (28.2% vs. 14.7%; p=0.016). The prevalence of advanced bone age was higher in obese children with a more severe degree of NAFLD. Conclusion: Advanced bone age is associated with a severe degree of obesity and its complications.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.390-394
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• 2017

Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.300-311
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• 2022

Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.3
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• pp.229-244
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• 2024

This study aimed to evaluate various factors related to cooperation levels in pediatric dentistry and determine their correlation with children's cooperation during dental treatments. This study included one hundred children and their guardians who visited the dental hospital at the Chonnam National University. Children and their guardians completed surveys regarding dental fear, dental caries experience, dental treatment experience, temperament, and guardians' dental anxiety, as well as the background characteristics of the children. Based on these data, factors associated with children's cooperation during dental treatment were investigated. Dental fear, caries experience during the primary and mixed dentition stages, and temperament traits such as shyness and negative emotionality significantly impacted children's cooperation during dental visits, with higher levels of these factors corresponding to lower cooperation. The extent of dental experience also modestly influenced children's cooperation, with higher levels of cooperation observed in children with greater dental experience. Additionally, children's dental fear was strongly correlated with guardians' dental anxiety, increasing as guardians' anxiety levels increased. Twelve-year-old children exhibited significantly lower levels of dental fear compared to other age groups, and regardless of cooperation levels, injections (shots) were identified as the primary factor inducing dental fear among the children. To improve children's cooperation in pediatric dentistry, strategies should focus on alleviating their fears and adopting an individualized approach that consider their oral health status and temperamental traits.