• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.411-422
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• 2020

With the increasing number of children with inflammatory bowel disease (IBD), very early-onset IBD (VEO-IBD), defined as IBD that is diagnosed or that develops before 6 years of age, has become a field of innovation among pediatric gastroenterologists. Advances in genetic testing have enabled the diagnosis of IBD caused by gene mutations, also known as monogenic or Mendelian disorder-associated IBD (MD-IBD), with approximately 60 causative genes reported to date. The diagnosis of VEO-IBD requires endoscopic and histological evaluations. However, satisfactory small bowel imaging studies may not be feasible in this small population. Both genetic and immunological approaches are necessary for the diagnosis of MD-IBD, which can differ among countries according to the available resources. As a result of the use of targeted gene panels covered by the national health insurance and the nationwide research project investigating inborn errors of immunity, an efficient approach for the diagnosis of MD-IBD has been developed in Japan. Proper management of VEO-IBD by pediatric gastroenterologists constitutes a challenge. Some MD-IBDs can be curable by allogenic hematopoietic stem cell transplantation. With an understanding of the affected gene functions, targeted therapies are being developed. Social and psychological support systems for both children and their families should also be provided to improve their quality of life. Multidisciplinary team care would contribute to early diagnosis, proper therapeutic interventions, and improved quality of life in patients and their families.

• Journal of Korean Neurosurgical Society
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• v.57 no.6
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• pp.440-444
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• 2015

Quality of life is the current trend and issue for the most of human diseases. In moyamoya disease (MMD), surgical revascularization has been recognized as the possible assistance to reduce the neurological insult. However, the progressive nature of the disease has been invincible so far. To improve the quality of life of MMD patients not only the protection from the neurological insult but also the maintenance or improvement of cognitive function is inevitable. For pediatric MMD patients, younger age or longer duration of disease is the key factor among the prognostic factors for bad neurological outcomes. Hence, 'the earlier, the better' is the most precious rule for treatment. Protection from neurological insult is very critical and foremost important to improve cognitive outcome. Clinicians need to know the neuropsychological profile of MMD patients for the care of whole person and make an effort to protect the patients from neurological insults to maintain or improve it.

• YAKHAK HOEJI
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• v.59 no.1
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• pp.29-39
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• 2015

In recent years, physiologically based pharmacokinetic (PBPK) modeling has been widely used in pharmaceutical industries as well as regulatory health authorities for drug discovery and development. Several application areas of PBPK have been introduced so far including drug-drug interaction prediction, transporter-mediated interaction prediction, and pediatric PK prediction. The purpose of this review is to introduce PBPK and illustrates one of its application areas, particularly pediatric PK prediction by utilizing existing adult PK data and in vitro data. The evaluation of the initial PBPK for adult was done by comparing with experimental PK profiles and the scaling from adult to pediatric was conducted using age-related changes in size such as tissue compartments, and protein binding etc. Sotalol and lorazepam were selected in this review as model drugs for this purpose and were re-evaluated using the PBPK models by GastroPlus$^{(R)}$. The challenges and strategies of PBPK models using adult PK data as well as appropriate in vitro assay data for extrapolating pediatric PK at various ages were also discussed in this paper.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.1-13
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• 2017

Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neurodevelopment of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.

• Advances in pediatric surgery
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• v.19 no.1
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• pp.32-38
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• 2013

The purpose of this study is to analyze the early experience of the laparoscopic adhesiolysis for the intestinal obstruction due to postoperative adhesion. Seven patients were included in this study. The median age of those patients was 13, and there were 3 males and 4 females. Previous diagnosis and surgical procedure were various in seven cases, including small bowel resection with tapering enteroplasty, Boix-Ochoa fundoplication, Ladd's procedure with appendectomy, mesenteric tumor resection with small bowel anastomosis, ileocecal resection and anastomosis, primary gastric repair, and both high ligation. A successful laparoscopic adhesiolysis was performed in one who had high ligation for inguinal hernia and had a single band adhesion. Six out of 7 (86%) cases needed to convert open surgery due to multiple and dense type of adhesion. In conclusion, laparoscopic approach with postoperative small bowel adhesion seems safe. However, it might be prudently considered because of high rates of conversion in children.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.50-55
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• 2000

Pathologic lead points are found in a few intussusception patients. To evaluate the pathologic lead points in childhood intussusception, a retrospective review of 227 operated cases of intussusception treated at the Yeungnam University Hospital from January 1986 to April 1999. The patients were divided into 2 groups; idiopathic group 209 cases, (92.1 % and lead points group 18 cases, 7.9 %). Intussusception developed between age two months and six months in both groups. Enteroenteric type of intussusception was relatively more frequent in the lead point group than in idiopathic group. The lead points were veil (10 cases, 52.6 %), Meckel's diverticulum(3 cases, 15.8 %), lymphoma(3 cases, 15.8 %), ectopic pancreas(2 cases, 10.5 %), Henoch-Sch$\ddot{o}$nlein purpura(1 cases, 5.3 %). The bowel resection rate was 44.4 % in the lead point group and 8.6% in idiopathic group. The recurrence rate was 5.56 % in lead points group and 1.44 % in idiopathic group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.75-80
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• 2021

Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.275-281
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• 2022

Purpose: The aim of this study was to assess the performance of a deep learning system for permanent tooth germ detection on pediatric panoramic radiographs. Materials and Methods: In total, 4518 anonymized panoramic radiographs of children between 5 and 13 years of age were collected. YOLOv4, a convolutional neural network (CNN)-based object detection model, was used to automatically detect permanent tooth germs. Panoramic images of children processed in LabelImg were trained and tested in the YOLOv4 algorithm. True-positive, false-positive, and false-negative rates were calculated. A confusion matrix was used to evaluate the performance of the model. Results: The YOLOv4 model, which detected permanent tooth germs on pediatric panoramic radiographs, provided an average precision value of 94.16% and an F1 value of 0.90, indicating a high level of significance. The average YOLOv4 inference time was 90 ms. Conclusion: The detection of permanent tooth germs on pediatric panoramic X-rays using a deep learning-based approach may facilitate the early diagnosis of tooth deficiency or supernumerary teeth and help dental practitioners find more accurate treatment options while saving time and effort

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.4
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• pp.427-436
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• 2017

The purpose of this study was to examine guardian's attitudes toward behavior guidance techniques used in pediatric dentistry. In this study, 117 guardians participated and the several behavior guidance techniques being used during actual pediatric dental treatment were explained to the guardians prior to writing a questionnaire. The behavior guidance techniques explained were: tell-show-do, voice control, protective stabilization by device, protective stabilization by staff, nitrous oxide sedation, sedation, and general anesthesia. For analysis, 106 completed survey forms were selected. Tell-show-do was rated as the most acceptable technique, followed (in order of decreasing acceptance) by: voice control; protective stabilization by staff; nitrous oxide sedation; protective stabilization by device; sedation; general anesthesia. Acceptance of each behavior guidance technique was not related to guardian age, gender, patient age, patient gender, patient dental experience, type of visit, and position of doctor. Within the limit of this study, the communicative guidance techniques (tell-show-do, voice control) were more acceptable than advanced behavior guidance techniques (protective stabilization, sedation, general anesthesia). The acceptability of general anesthesia was the lowest. The results of this survey may contribute to maintain optimal dentist - guardians communication in pediatric dentistry.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.635-641
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• 2008

The purpose of study was to investigate the etiologic factors of maxillary primary anterior caries. The subjects of study were 401 preschool children, 214 boys and 187 girls, from 36 to 71 months old of randomly selected seven nurseries in Iksan city. The prevalence of maxillary primary anterior teeth was cross-analyzed with gender, age, breast feeding or bottle feeding, length of feeding, sweet snack intake frequency, beginning of toothbrushing, and toothbrushing frequency per day. The prevalence was 43.0% in boys and 26.7% in girls, and there was significant association between the prevalence and gender in cross analysis(P<0.01). The prevalences of the shorter than 2 years of feeding group, the from 2 to 3 years group, and the longer than 3 years group were 31.0%, 43.2%, and 63.2%, respectively, and there was significant association between the prevalence and the length of feeding(P<0.01). Daily intake of sweet snacks had a significant association with the prevalence(P<0.05). There was no significant association between the prevalence and the variables of age, breast feeding or bottle feeding, beginning of toothbrushing, and toothbrushing frequency per day(P>0.05).