• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.699-703
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• 2006

The purpose of this study was to analyze the parental consultations, patients' age and consulters. Also it was to improve the tendency of consultation homepage The subjects were 2485 questions on Korean Academy of Pediatric Dentistry Homepage except deleted questions which were not related with consultations. The examined contents were categorized into patients' age, counseling contents, consulters. The results were as follows: 1. Patients mostly belonged to preschool children(64.29%). 2. In the subjects, questions were mostly about growth and development, restorative and pulp treatment. 3. In the subdivided subjects, great part of questions were about tooth eruption, restorative and pulp treatment and trauma. 4. The 93.72% of consulters were mothers. 5. We should reinforce with FAQ about growth and development, restorative and pulp treatment and trauma. Also we should improve on quality of information and childcare related contents and Homepage related pediatric dentistry.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.38-42
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• 2014

Purpose: Gastroschisis and omphalocele are major anterior abdominal wall defects. The purpose of this study was to analyze the clinical differences and mortalities of gastroschisis and omphalocele in Asan Medical Center. Methods: A retrospective review of the medical records was conducted of 103 cases of gastroschisis and omphalocele from September 1989 to February 2013 in Asan Medical Center in Korea. Results: There were 43 cases (41.7%) of gastroschisis and 60 cases (58.3%) of omphalocele. There was a female predominance in both gastroschisis (60.5%) and omphalocele (58.3%). The average gestational age at delivery was $36.7{\pm}0.4$ weeks for both groups. The mean birth weights were $2,381.9{\pm}80.6g$ for gastroschisis and $2,779.4{\pm}82.8g$ for omphalocele (p=0.001). Mean maternal ages in the gastroschisis and omphalocele groups were $27.5{\pm}0.7$ years and $30.5{\pm}0.7$ years, respectively (p=0.002). Associated malformations were documented in 13 infants (30.2%) with gastroschisis and 46 infants (76.7%) with omphalocele (p<0.001). All of gastroschisis patients except one underwent surgery including 31 primary repairs and 11 staged repairs. Fifty-two infants with omphalocele underwent surgery-primary repair in 41 infants and staged repair in 11 infants. Among 103 cases, 19 cases (18.4%) expired. Mortality rates of gastroschisis and omphalocele were 23.3% (10/43 cases) and 15.0% (9/60 cases), respectively (p=0.287). The main causes of death were abdominal compartment syndrome (6/10 cases) in gastroschisis, respiratory failure (4/9 cases) and discharge against medical advice (4/9 cases) in omphalocele. Conclusion: Gastroschisisis was associated with younger maternal age and lower birth weight than omphalocele. Associated malformations were more common in omphalocele. The mortality rates did not make a statistical significance. This might be the improvement of treatment of cardiac anomalies, because no patient died from cardiac dysfunction in our study. Furthermore, abdominal compartment syndrome might be the main cause of death in gastroschisis.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.134-142
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• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.240-247
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• 2013

Purpose: Regurgitation is known to peak at the age of 3-4 months, with a sharp decrease around the age of 6 months. Little is known about the natural evolution of infants who still regurgitate after the age of 6 months. Methods: Hundred thirty-one infants older than 6 months regurgitating more than once a day were followed for a period of 3 months. Results: According to our data, gastroesophageal reflux disease (GERD) is seldom at this age. Most of the infants regurgitated 3 or more times/day and spit up an estimated volume of more than 15 mL. Eighty-five parents were educated regarding frequency of feeding. There were only 6 infants that still had frequent regurgitation (>3 times/day) despite an appropriate feeding schedule. The Infant GER Questionnaire score reached a score of 0 in 50% of the infants after one month of follow-up and in 81.9% at the third month of follow-up. There was an increase of the "weight for age z-score" trends in infants that still regurgitated at the end of follow-up and a declining z-score in infants that no longer regurgitated. An explanation may be that infants that regurgitate drink larger volumes than infants who do not regurgitate. Conservative treatment (reassurance, dietary treatment, behavioral advice) resulted in a significant better outcome than natural evolution. Conclusion: Regurgitation that persisted after the age of 6 months, strongly decreased during a 3-month follow-up with conservative treatment. GERD is rare in this age group; therefore, anti-reflux medication is only seldom needed.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.469-485
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• 1994

The present study was undertaken to examine the relationship between time required for each step in the treatment process for pedodontic patients. and age of the patients, and experience of special training for pedodontics and career of dental practitioners. Information of these matters was gained from 580 questionnaires collected from 69 practitioners (62 male and 7 female). The questionnaires included questions about the patients' sex(303 male and 207 female) and age. The patients were categorized into 5 different age groups : Group 1, age $1{\sim}3$-year ; Group 2, $4{\sim}6$-year ; Group 3, $7{\sim}9$-year ; Group 4, $10{\sim}12$-year ; Group 5, $13{\sim}15$-year. The questions about the dental practitioners were the years of experience in private dental practice(5 years or more than 5 years) and whether or not they took the special training for pedodontics in the authorized institutes. The practitioners were asked to answer the questions about Frankl scale of the patients' behavior during the treatment, and time spent for managing the patients to be subjected to local anesthetic injection (the first behavior control), time for the injection, and time for the subsequent treatment. The results obtained by analyzing the information collected from the questionnaires were as follows : 1. The younger the patients, the lower the Frankl scale was counted at the time of the first behavior control, injection, and the subsequent treatment(p<0.001). 2. The lowest Frankl scale was scored during the injection regardless of the age of the patients. 3. Time for management and treatment was decreased in the order of age Groups 1 and 2< Group 3 < Groups 4 and 5. 4. The patients showed a more positive frankl scale in response to the treatment performed by those who were more-experienced in dental practice as compared with those were less-experienced. 5. Pedodontic training experience of the practitioners did not appear to influence the patients with respect to the treatment time and Frankl scale.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.35-43
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• 2008

Jaundice is common in breast-fed infants. Any infant noted to be jaundiced at 2 weeks of age need to be evaluated for cholestasis with measurement of total and direct serum bilirubin. The most common causes of cholestatic jaundice in infants are biliary atresia and neonatal hepatitis. Genetic causes of the neonatal hepatitis syndrome are increasingly recognized and idiopathic neonatal hepatitis is decreasing. Cholestasis should be investigated using a structured protocol. Early detection and timely, accurate diagnosis is important for successful treatment and a favorable prognosis. In particular, a Kasai portoenterostomy for biliary atresia has the best outcome if performed before the infant is 8 weeks of age. The management of cholestasis is mainly supportive, including nutritional support and alleviation of symptoms to improve the quality of life. Specific treatments are available for some causes of neonatal hepatitis syndrome and should be started as soon as possible. For decompensated liver disease, liver transplantation yields a better outcome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.44-49
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• 2008

The prevalence of symptomatic Hepatitis A has inclined significantly during the last several years in Korea. The average age at infection has increased, resulting in more clinically severe infections. Efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection. Hepatitis A vaccination is recommended for all children at age 1 year, for persons who are at increased risk for infection, for persons who are at increased risk for complications from hepatitis A, and for any person wishing to obtain immunity.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.85-94
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• 1995

Precocious puberty is difficult to define because of the marked variation in the age at which puberty begins normally, onset of puberty before 8 years of age in girls and 9 years in boys may be considered precocious. The etiology of precocious puberty in boys is usually idiopathic, but can result from adrenal and testicular tumors. The hepatoblastoma that produces hCG is a very rare functioning tumor known to cause precocious puberty in boys. Recently, author experienced one case of virilizing adrenal cortical adenoma in 22 month-old boy, one case of adrenal cortical carcinoma in 28 month-old boy, and one case of virilizing hCG-producing hepatoblastoma in 7 year-old boy and reviewed literatures.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.703-709
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• 2006

Since the advent of growth hormone(GH), children with a wide variety of growth disorders have received GH treatment. In GH deficiency(GHD), Turner syndrome, chronic renal failure, children born small for gestational age, Prader-Willi syndrome, and idiopathic short stature, the therapeutic effects and safety profile of GH are reviewed. GH therapy has been clearly shown to improve height velocity and final adult height in a variety of pediatric conditions in which growth is compromised irrespective of GHD. Early initiation and individualization of GH treatment has the potential to normalize childhood growth. The supra-physiological doses of GH have been shown to increase height velocity during childhood and final height in non-GHD conditions. Adverse events during GH therapy are uncommon and often not drug related. However continued surveillance into adult life is crucial, especially in children receiving supra-physiological doses or whose underlying condition increases their risk of adverse effects.

• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.149-156
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• 2021

Neurofibromatosis type 1 (NF1), a prevalent genetic disease that is transmitted in an autosomal dominant manner, is characterized by multiple cutaneous cafe-au-lait spots and neurofibromas as well as various degrees of neurological, skeletal, and neoplastic manifestations. The clinical features of NF1 increase in frequency with age, while the clinical diagnosis can remain undetermined in some pediatric patients. Importantly, affected patients are at risk for developing tumors of the central and peripheral nervous system. Therefore, adequate counseling for genetic testing, age-appropriate surveillance, and management are important. This review suggests several issues that should be considered to help general pediatricians provide adequate clinical care and genetic counseling to patients with NF1 and their families.