• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.494-498
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• 2009

Purpose : Applicability of transcatheter closure of atrial septal defect (ASD) has been expanded by accumulation of clinical experiences and evolutions of the device. This study was performed to evaluate the safety and efficacy of transcatheter closure of ASD with Amplatzer septal occluder (ASO) in young children less than 3 years of age. Methods : From May 2003 to December 2005, 295 patients underwent transcatheter closure of ASD with ASO in the Severance Cardiovascular Hospital, Yonsei University Health System. Among them, 51 patients less than 3 years of age were enrolled in this study. We investigated procedural success rate, rate of residual shunt, frequency of complications, procedure/fluoroscopy time, and need of modified techniques for device implantation. Results : The median age was 2.1 years and median body weight was 12 kg. Implantation of device was successful in 50 patients (98%). Seven patients (15%) showed a small residual shunt 1 day after the procedure, but complete occlusion had been documented at 6 month follow-up in all patients (100%). The pulmonary to systemic flow ratio (Qp/Qs), peak systolic pulmonary artery pressure, and peak systolic right ventricular pressure had decreased significantly after closure of ASD. There were 2 complications including device embolization (1, 2%) and temporary groin hematoma (1, 2%). Conclusion : Transcatheter closure of ASD with ASO can be performed with satisfactory results and acceptable risk even in young children less than 3 years of age. We could suggest that even in very young children with ASD, there is no need to wait until they grow to a sufficient size for the transcatheter closure.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.234-246
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• 2007

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and $N_2O/O_2$ inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and $N_2O/O_2$ in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of $30{\pm}8$ months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more $N_2O/O_2$ administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by only oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and $N_2O/O_2$ using tine, but no correlation between weight and $N_2O/O_2$ using time. There was no statistically significant difference among variables of treatment duration, $N_2O/O_2$ administration and adverse event.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.607-617
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• 2002

The purposes of this study were to evaluate the timing of tooth calcification and the change of tooth position with tooth developmental stage on the mandibular teeth. Seven hundred seventy two children(male:446, female:326), 3 to 12 years of age were examined radiographically with panoramic film. Dental development was determined by inspecting radiographs and assigning a rating according to consecutive stages defined by Moorrees, and tooth cusp position and root terminus position were measured from the lower border of mandibular body and calculated the position index to evaluate the movement of tooth with developmental stage. The results were as follows. 1. There were no significant differences between boys and girls in the timing of calcification until crown completion, but timing of calcification tend to be faster in girls than in boys after root initiation stage. 2. In terms of mean age, crown completion of central incisor in boys and girls occurred at the age of 3.71, 4.05 years, at 4.44, 4.60 years for the lateral incisor, at 5.35, 5.11 years for the canine, at 6.62, 6.36 years for the first premolar, at 7.36, 7.17 years of second premolar, at 3.51, 3.69 years of first molar, and at 7.90, 7.64 years for the second molar respectively. Apex 1/2 closed stage of central incisor occurred at the age of 8.70 in boys, 8.18 in girls, at 9.55, 8.99 years for the lateral incisor, at 12.48, 11.60 years for the canine, at 12.30, 12.01 years for the first premolar, at 12.19, 12.26 years of second premolar, at 9.12, 8.87 years of first molar, and at 12.59, 12.45 years for the second molar respectively. 3. There was no noticeable movement of cusp tip until crown completion (Crc), but showed rapid movement toward occlusion plane after root initiation(Ri) and again maintain stable position after root completion stage(Rc). 4. Root terminus position was stable until root 1/4 formation stage(R1/4), followed by rapid movement toward occlusal plane and was stable again after root 3/4 formation stage(R3/4). 5. Developmental stage at the time of alveolar bone penetration by cusp tip varied with each of the permanent teeth. 6. Canine tooth follicle was at the lowest position in the mandibular body during the early stage of calcification, followed by second premolar, first premolar, lateral incisor, second molar, first molar and central incisor in order.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.2
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• pp.109-119
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• 2020

This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N₂O/O₂ in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables. The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects. It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.657-665
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• 2017

The aim of this study was to develop and distribute a dedicated program that can easily calculate the effective dose of a patient undergoing nuclear medicine examinations, and assist in the study of dose of nuclear medicine examinations and information disclosure. The program produced a database of the effective dose per unit activity administered (mSv/MBq) of the radiopharmaceuticals listed in ICRP 80, 106 Report and the fourth addendum, was designed through Microsoft Visual Basic (In Excel) to take the effect of 5 different (Area, Clark, Solomon(=Fried), Webster, Young) of pediatric dose calculation methods and 7 different body surface area calculation methods. The program calculates the effective dose (mSv) when the age, radionuclide, substance, and amount injected in the human body is inputted. In pediatric cases, when the age is entered, the pediatric method is activated and the pediatric method to be applied can be selected. When the BSA (Body Surface Area) formula is selected in the pediatric calculation method, a selection window for selecting the body surface area calculation method is activated. When the adult dose is input, the infant dose and the effective dose (mSv) are calculated automatically. The patient effective dose calculation program of the nuclear medicine examinations produced in this study is meaningful as a tool for calculating the internal exposure dose of the human body that is most likely to be obtained in nuclear medicine examinations, even though it is not the actual measurement dose. In the future, to increase the utilization of the program, it will be produced as an application that can be used in mobile devices, so that the public can access it easily.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.237-243
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• 2011

The purpose of study is for the certified correlations of hand-wrist radiograph with cervical vertebrae for skeletal maturation in children. Normal evaluation devices of growth stage is sexual feature, biological age, tooth development stage, height and weight. Evaluation of growth potential is very important for childhood and puberty. The skeletal developmental stages were evaluated by using the hand-wrist radiograph and cephalometric radiograph that obtained from 6 to 18 years old children. 1. Chronologic age was not more suitable indicator of skeletal development compared to Skeletal Maturity Indicators(SMI) and Cervical Vertebrae Maturation(CVM) stages. 2. SMI and CVM stages for females occurred earlier than that for male. 3. SMI 1 and 2 stages were corresponded to CVM 1; SMI 3,4 = CVM 2; SMI 5,6 = CVM 3. 4. Reproducibility and reliability of observer for SMI and CVM were excellent. This results suggest CVM stage is comparable to SMI stage in terms of evaluating the skeletal development.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.607-612
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• 2009

The malignant tumor in childhood is one of the main causes of children s death due to disease. The traditional treatment for the malignancy is known for the radiation therapy and the chemical therapy or both. However, the treatments tend to induce intraoral complications. Different from adults, almost all children on cancer therapy are expected to have dental complications, because their permanent teeth are on the developmental stage. The degree of dental complication depends on the patient's age, type of chemical and other factors-radiation dose and frequency. In this report, 3 children who had experienced the anti-cancer therapy on their age between 1 and 4 years were selected and dental complications were examined. The children have chance for the various oral complications including the developmental problems such as agenesis, microdontia and hypoplasia of the teeth. Therefore, it's important to understand the side-effects of anticancer therapy during the permanent teeth had been developmental stage in young patients. Also, oral health care specialists, including pediatric and hospital dentist can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment undergoing anticancer treatment.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.137-146
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• 2009

In pediatric dentistry, sedation therapy is one of methods for managing children's behavior, and various types of sedation therapy are being used. Thus, this study surveyed the awareness of and satisfaction with sedation therapy in 204 parents who visited the Pediatric Dentistry using a self-administered questionnaire during the period from June to December 2008 in order to get information necessary in behavior management for pediatric patients, and obtained results as follows. 1. The most common path of learning about sedation therapy was dentistry (49.5%), and the most common reason for choosing sedation therapy was 'The child was young'(42.3%), which was followed by 'The child is too afraid'(18.8%), 'There are many teeth to be treated'(16.0%), 'To adjust the number of visits'(11.3%), and 'For behavior management'(3.1%). 2. Most of the parents felt anxiety about sedation therapy, and the reasons for the anxiety were 'The child was young'(33.0%), 'Worry about side effects'(31.3%), 'Worry about recovery of consciousness'(25.7%), 'Worry about the blunting of intellectual abilities'(7.6%), and others (2.4%). 3. Satisfaction with sedation therapy was higher in men than in women, and was high in order of 'Stationing of an anesthetist', 'One time completion of treatment', and 'Cautions'. Statistically significant difference was observed between men and women only in question "Have you ever heard about sedation therapy?"(p=0.018). 4. According to age, satisfaction with sedation therapy was highest in parents whose child was less than 48 months old. Satisfaction was high in order of 'Stationing of an anesthetist', 'One time completion of treatment', and 'Cautions', 'Choice of sedation therapy', and statistically significant difference was observed according to age only in question "Have you ever heard about sedation therapy?"(P=0.005). 5. Positive correlation was observed among questions on satisfaction with sedation therapy. In the survey on the awareness of and satisfaction with sedation therapy in parents visiting the dentistry, awareness and satisfaction were generally high with regard to the parents' choice of sedation therapy, but many of the parents answered that they chose sedation therapy and felt anxiety because their child was young. The results of this study need to be considered for behavior management in pediatric dentistry and there should be systematic education and promotion of sedation therapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.200-206
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• 2005

Cemento-ossifying fibroma of the jaws is well circumscribed, generally slow-growing, benign lesions which enlarge in an expansile manner. Clinically it presents as a slowly enlarging lesion commonly in the premolar-molar area of the mandible and only occasionally in the maxilla and other locations. It occurs twice as often in females and primarily in the 20 to 30 year age group. Differential diagnosis should be peformed, preferably with other fibro-osseous lesions such as fibrous dysplasia. A faster growing and more destructive variant of cemento-ossifying fibroma sometimes occurs in patients under age 15 and is termed juvenile (aggressive) ossifying fibroma. Treatment is surgical removal with the extent depending on the size and location of the individual lesion. Recurrence is considered rare. A case involving a 12-year-old male patient with delayed eruption of right mandibular canine is discussed. Following an incisional biopsy, the histopathologic diagnosis established was cemento-ossifying fibroma. After the surgical enucleation of the lesion, no sign of recurrence was detected.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.150-156
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• 2005

Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to analyze our experience and develop conclusions regarding the presentation, diagnosis and treatment of urachal anomalies. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month). There were 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6 %), 10 urachal cyst (31.3 %), and 9 patent urchus (28.1 %). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a physical examination and an appropriate radiographic test. Ultrasound was the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and the rare development of carcinoma.