• Archives of Plastic Surgery
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• v.39 no.6
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• pp.606-611
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• 2012

Background Facial fractures are infrequent in children and adolescents and have different clinical features from those in adults. The low incidence in children and adolescents reflects the flexibility and underdevelopment of their facial skeletons, as well as their more protected environments. Only a few reports have reviewed such patients in Korea. The authors performed a retrospective study to analyze the characteristics of facial fractures in the Korean pediatric population. Methods We conducted a retrospective review on a series of 741 patients, aged <18 years, with facial fractures who had been treated at our hospital between 2006 and 2010. The following parameters were evaluated: age, sex, cause, location and type of fractures, associated injuries, treatment and complications. Results A total of 741 consecutive patients met the inclusion criteria. The ratio of boys to girls was 5.7:1. Facial fractures most commonly occurred in patients between 13 and 15 years of age (36.3%). The most common causes of injury was violence. The nasal fracture was the most common type of fracture (69%) and the blowout fracture was the second most common (20%). Associated injuries occurred in 156 patients (21%). Conclusions The incidence of pediatric facial fractures caused by violence is high in Korea. Our results show that as age increases, etiological factors and fracture patterns gradually shift towards those found in adults. This study provides an overview of facial fractures in these age groups that helps illustrate the trends and characteristics of the fractures and may be helpful in further evaluation and management.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.176-183
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• 2018

Purpose: Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. Methods: We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. Results: Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). Conclusion: Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.202-212
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• 2006

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.

• Advances in pediatric surgery
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• v.20 no.1
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• pp.17-22
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• 2014

The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ${\geq}12$ months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (${\geq}48$ hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.581-586
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• 2006

Purpose: Pediatric burn still generates social problem leading to physical and mental sequelae for ages. We studied to help make a program for the prevention of pediatric burn. Methods: We analyzed retrospectically 2759 acute burn patients under the age of 15 years in recent 5years (January 2000 - December 2004). Results: 1553 males and 1226 females were investigated, with a male to female ratio of 1.25 : 1. The greatest number of burn patients were those with an age of 1 - 2 years(1435, 52%). Scalding burn was the most common cause of injury, which accounted for 1980 (71.8%) patients, followed by contact burns(286, 10.4%), flame burn(229, 8.3%), steam burn(141, 5.1%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the same in the age over 3 years. During recent 5 years, incidence of contact burn increased over twofold despite the others did not changed substantially. Variation of seasonal incidence is minimal and most of the patients(2545 cases, 92.2%) had burns of ${\leq}20%$ TBSA. The median hospital stay was 18.3 days, and the rate of operation was 35.4% with an high rate in electrical burn(70.6%), steam burn(68.8%), contact burn(65%). 27 patients died in this series, which yielded a mortality rate of 1%. Conclusion: We expect that these data will be used as a basis for prevention of pediatric burn.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.705-710
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• 2010

Purpose: To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit. Methods: A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007. Results: The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were $37^{+2}$ weeks and $2.5{\pm}0.7kg$, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age. Conclusion: Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.366-376
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• 2020

Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.146-151
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• 2017

Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.263-268
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• 2018

Purpose: Obesity and headache are two highly prevalent diseases both in childhood and adolescent. In this study, we assessed the prevalence of obesity in pediatric headaches patients in a single institution in Korea, and differences according to age, sex, headache type, frequency, intensity, and disability. Methods: We retrospectively reviewed the medical records of 340 subjects (6-18 years of age) who visited the Pediatric Headache Clinic of Bucheon St. Mary's Hospital during the period from January 2015 through March 2018. Data on age, sex, height and weight, as well as headache type, frequency, intensity and disability, were collected. Body Mass Index (BMI) percentile was calculated based on the 2017 Korean Children Adolescence Growth Chart. Results: 17.6% of the pediatric headache patients were obese. The prevalence of obesity in male patients was higher than females (Male 23.8% VS Female 11.6%, P=0.002). There were no significant differences in obesity rate according to age, headache type, frequency, intensity, and disability. Conclusion: The prevalence of obesity in the pediatric headache population was 17.6% which is higher than 10.1% in general population (Korea National Health and Nutrition Examination Survey, KNHANES, 2013).

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.51-59
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• 2016

The purpose of the present retrospective study was to analyze gender, age, awareness, etiology, and treatment choice in patients with failed eruption of the mandibular first molar. Radiographic material and dental records from 67 patients with 74 mandibular first molars with failed eruption treated during the years 2001-2014 were evaluated. As results, the prevalence of mandibular first molar with failed eruption was higher in males than females, and the average awareness age was 9.19 years old. The most common etiological cause was unknown, and the next most common causes were abnormal eruption pathway and odontogenic tumor in order. In this study, it is suggested that more dental education to children about the time of eruption of permanent tooth is required, and the importance of regular dental check-ups is emphasized during mixed dentition.