• Journal of Trauma and Injury
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• v.18 no.2
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• pp.119-126
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• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.321-328
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• 2020

Background: Pediatric hypertension is the main cause of morbidity and mortality in pediatric populations. Purpose: To examine pediatric hypertension in a clinical setting, we used the percentile rank approach and defined hypertension as that above the 95th percentile. Methods: The present study was linked to the a national analytical cross-sectional community-based Iranian Children and Adolescents' Psychiatric Disorders (IRCAP) survey. The survey was nationwide and funded by the National Institute of Medical Research Development. The IRCAP survey included 31,000 children and adolescents aged 6-18 years in all 31 Iran provinces. The current study included 1,035 children and adolescents and linked the data of the risk factors of cardiovascular disease only in Yazd province via random cluster sampling. Results: Of the total participants, 456 (44.1%) were male and 579 (55.9%) were female. The mean age was 11.2±3.8 years (11.7±3.7 years for males, 11.0±3.6 years for females), while mean height was 146±20.0 cm overall, 147.2±22.0 cm for males, and 144.6±17.0 cm for females (P=0.009). The blood pressure distributions and percentiles were evaluated. Conclusion: Here we determined age- and height-specific 50th, 90th, 95th, and 99th percentiles of systolic and diastolic blood pressures in Yazd boys and girls using 10-cm height intervals.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.109-114
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• 2012

Purpose: Medullary sponge kidney (MSK) is a rare congenital disease characterized by diffuse ectasia or dilatation of precalyceal collecting tubules. MSK incidence and prevalence in the general population is uncertain and only a few patients are reported especially in the pediatric age. There has been increasing reports of patients with MSK who have other malformative disorders. Also several case reports concerning about etiological association of some genes. Methods: Collaborative study through nation-wide survey was done to investigate the incidence and etiological association of some genes such as GDNF gene, ATP6V1B1, ATP6V0A4 gene in developing MSK in Korean children. Results: Four cases of MSK who have various other malformative disorders were collected. There are no mutations of GDNF gene, ATP6V1B1, ATP6V0A4 gene in all patients. Conclusion: MSK is one of the very rare diseases in pediatric age. The etiological association of GDNF gene, ATP6V1B1, ATP6V0A4 gene in developing MSK in Korean children is not proved.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.15-24
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• 2018

Purpose: This study was conducted to analyze the factors associated with intoxicated patient's disposition in the pediatric emergency department. Methods: We retrospectively evaluated pediatric intoxicated patients visiting the pediatric emergency department of a hospital between January 1, 2011 and December 31, 2013. Specifically, we analyzed the association between hospitalization recommended rate and the following variables: patient age group, symptoms, intentional poisoning, decontamination and toxic level of substance. Results: We collected data from 345 patients. A high incidence was noted in the 1-4 years of age group and 10-15 years of age group. Unintentional poisoning occurred in 306 patients (88.7%). A total of 115 patients (33.3%) had symptoms when visiting. Forty three patients (12.5%) ingested cleaning substances, which was the most common agent. Potentially-toxic level was the most common level of the substance. The hospitalization recommended rate associated with visits in 2011 was 2.5 times greater than in 2012 and 2013, decontamination was 2.0 times greater than no decontamination, and poisoning with potentially-toxic substances was 2.6 times greater than poisoning with other toxic substances. Additionally, the hospitalization recommended rate associated with symptomatic patients was 2.4 times greater than that of asymptomatic patients and intentional poisoning was 2.4 times greater than unintentional poisoning. Conclusion: Patients with decontamination, ingestion of potentially-toxic substances, symptoms and intentional poisoning had increased hospitalization rates. In addition, the hospitalization rate for patients who visited in 2011 was greater than that of patients who visited in 2012 or 2013.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.35-40
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• 2016

Purpose: This study aimed to investigate the characteristics of the symptoms of temporomandibular disorders (TMD) in Korean children and adolescents using representative samples and questionnaires. Methods: A survey involving the interview of 10-, 12-, and 15-year-old children and adolescents regarding the symptoms of TMD was conducted as a part of the 2010 National Oral Health Surveys. The study population included 18,112 subjects (male, 9,734; female, 8,378). The interview involved three questions related to the symptoms of TMD. The prevalence of symptoms of TMD, correlation of the symptoms with sex and age, and the difference in the number of symptoms according to sex and age were analyzed. Results: Among the symptoms of TMD in children and adolescents, the prevalence of temporomandibular joint (TMJ) sounds during mouth opening was 13.0%, while those of TMJ pain and limitation were 3.1% and 4.3%, respectively. While the prevalence of TMJ sounds during mouth opening did not show any statistically significant difference between the sexes, the rates of prevalence of TMJ pain and limitation of mouth opening in were higher in the female subjects than the male (p<0.05). It was also observed that the older the subjects, the higher the prevalence of TMJ sounds, TMJ pain, and limitation of mouth opening (p<0.05). The number of symptoms of TMD was found to be increased among female subjects as well as the older ones (p<0.05). Conclusions: There are variations in the prevalence of symptoms of TMD among Korean children and adolescents according to sex and age, which is consistent with the results of previous studies. It is necessary to conduct a national cohort study to evaluate the risk factors for TMD in children and adolescents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.142-151
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• 2019

Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.2
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• pp.183-189
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• 2019

The purpose of this study was to investigate the changes of the position of the mental foramen according to age by using panorama of children with mixed and early permanent dentition. 180 panorama of 6 to 13-year-old boys and girls were analyzed and PiView(Infinitt, Korea) program was used. The horizontal position of the mental foramen was evaluated by the relative position of the teeth. The vertical position of the mental foramen was evaluated by the ratios between the distance from the center of the mental foramen to the inferior border of the mandible and the distance from to the alveolar crest to the inferior border of the mandible. The mental foramen was horizontally located in the anterior aspect of the second primary molar(premolar), and vertically slight below the half of mandibular body. As the age increased, it moved to the posterior and the downward and showed a significant correlation with age.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.67-74
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• 2008

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.

• Korean Parent-Child Health Journal
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• v.15 no.1
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• pp.20-32
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• 2012

Purpose: The purpose of this study was to identify clinical decision making pattern of pediatric nurses and analyze how it shows the differences in types of decision making pattern by nurses characters. Methods: A self-administered questionnaire was used to pediatric nurses of 4 general hospitals in Seoul from February 2004 to April 2004. The data of 251 nurses was analyzed by varimax rotation factor analysis, t-test, and ANOVA. Results: 6 decision making patterns were identified: Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, Nursing Model-oriented, Medical Knowledge-oriented, and Patient-Family-Nurse Collaborative. Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, and Nursing Model-oriented decision making pattern got meaningful differences in age, marital status, total number of years in nursing practice, and number of years in pediatric nursing practice. Conclusion: We expect the result of this study can be applied for promotion of understanding the decision making of nurses that occurs in pediatric nursing practice and also can be used as foundation data for development and expansion of pediatric nursing practice.

• Advances in pediatric surgery
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• v.15 no.2
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• pp.141-148
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• 2009

Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3 %, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69 %) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3 %) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5 %). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.