• The Journal of Pediatrics of Korean Medicine
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• v.16 no.2
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• pp.69-81
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• 2002

The Purpose of this study was to collect statistics of pediatric problems, and so to investigate the new effective oriental medicine treatments in pediatric disease and its clinical applicability. The Study was composed of 698 new patient who had been treated at the pediatric unit in th Dong Sea Oriental Medical Hospital for 1 year, from 1 September 2001 to 31 October 2002, and aged between 0 and 18 years. The Chief complaints and their care-givers. Result: 1. In the study, male children are 403 and female children are 295. So the sex ratio between male and female is 1.37 : 1. 2. In age distribution, 0-3 years : 317(45.4%), 4-6 years : 148(21.2%). 7-9 years 98(14.0%), 10-12 years: 66(9.5%), 13-15 years : 40(5.7%), 16-18 years 29(4.2%). 3. The chief complaint according to systemic division was Respiratory diseases covers 30.1%, Digestive diseases covers 20.8%, Physique diseases covers 10.6%. 4. The Respiratory diseases tended to increase in autumn and appeared mostly in the age group between 0 and 9 years. The Digestive diseases increase in summer and appeared mostly in the age group between 10 and 12 years. The physique diseases increase in winter and appeared mostly in he age group between 13 and 18 years. 5. Most of patient came to the hospital from diseases such as common cold, weakness, dyspepsia, atopic dermatitis, rhinitis, take a easy cold, short stature, sweating, Bell's palsy, abdominal pain, etc. Conclusion : 1. The chief complaint In pediatric diseases that needed an oriental medical treatment was mainly the disease that tends to take long time and the weakness, and appeared frequency in respiratory and digestive disease. 2. The oriental medical treatment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. in particular, the study shows that the oriental medical treatment should be emphasized in terms of preventing the disease. 3. The new disease, which were developed with change of human life and environment, should be investigated as a new fie of oriental medical treatment.

• Clinical and Experimental Pediatrics
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• v.61 no.7
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• pp.205-209
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• 2018

Kidney transplantation (KT) is the gold standard for renal replacement therapy in pediatric patients with end-stage renal disease. Recently, it has been observed that the outcome of pediatric KT is nearly identical to that in adults owing to the development and application of a variety of immunosuppressants and newer surgical techniques. However, owing to several differences in characteristics between children and adults, pediatric KT requires that additional information be learned and is associated with added concerns. These differences include post-KT complications, donor-recipient size mismatch, problems related to growth, and nonadherence to therapy, among others. This review was aimed at elucidating the clinical characteristics of pediatric KT that differ from those observed in adults.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.227-232
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• 1999

Crohn disease is a chronic transmural inflammatory disease that may involve any portion of the gastrointestinal tract. An increased incidence of Crohn disease in the general population has been reported, along with a greater than threefold increase of Crohn disease in children under the age of 16 years noted in a recent study. Crohn disease may be seen as early as infancy, but the most common pediatric age of onset is during the teenage period. We experienced a case of Crohn disease in 6 year old male child complained abdominal pain, oral aphthous ulcers, arthralgia, anorexia, and growth failure. A brief review of related literature is also presented.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.41-46
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• 2017

Purpose: Vitamin D deficiency is common in Crohn disease (CD). The aim of the study was to examine the prevalence of vitamin D deficiency and evaluate the association between vitamin D status and growth outcome in Korean pediatric CD patients. Methods: In this retrospective study, 17 children younger than 18 years old diagnosed with CD were enrolled and their serum 25-hydroxy vitamin D (25[OH]D) was checked between 2011 and 2015. We categorized the patients into two groups, Group 1 and Group 2. Group 1 included patients with serum 25(OH)D levels below 10 ng/mL, and Group 2 was for patients with a 25(OH)D serum levels between 10 ng/mL and 30 ng/mL. The z-scores for height (Htz), weight (Wtz), and body mass index (BMIz) were measured at baseline, 6 months, and 12 months. Results: The mean serum 25(OH)D levels of the total 65 CD patients and 17 enrolled patients were $15.64{\pm}6.9ng/mL$ and $13.1{\pm}5.1ng/mL$, respectively. There was no correlation at the beginning of the study between vitamin D level and growth parameters (Htz, Wtz, BMIz) or other variables including laboratory data and Pediatric Crohn Disease Activity Index. The Htz, Wtz, and BMIz in Group 1 showed no significant improvement at 6 months and 12 months follow-up. In Group 2, Wtz and BMIz showed significant improvements sustained until 12 months of follow-up. Htz showed no significant improvement at 6 months but there was significant improvement at 12 months. Conclusion: It seems that baseline vitamin D status affects growth outcome in pediatric CD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.152-161
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• 2019

Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.2
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• pp.154-163
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• 2021

Purpose: In children overlap of autoimmune hepatitis (AIH) and primary sclerosing cholangitis is labelled as autoimmune sclerosing cholangitis (ASC). The only prospective pediatric study showed a high prevalence of ASC by using endoscopic retrograde cholangiopancreatography. Aims of our study were to find the prevalence of ASC by using magnetic resonance cholangiography (MRC) in AIH and in non-AIH cirrhosis and to compare clinical presentation and outcome of AIH and ASC. Methods: Prospectively we did MRC in 38 children with AIH (cases) and 19 disease controls (Wilson disease). Multiple biliary strictures with proximal dilatation on MRC were taken as definitive changes of ASC. Detail clinical, laboratory parameters, liver histopathology and treatment outcome were recorded. Results: The median age of cases was 11.5 (3-18) years, 22 (57.9%) were girls and 28 (73.7%) were diagnosed as type 1 AIH. MRC was done in 11 children (28.9%) at the time of diagnosis and in 27 (71.1%) after a median follow-up of 2.5 (0.3-10) years. Abnormal MRC changes were seen in 14/38 (36.8%) of AIH and 8/19 (42.1%) of controls. However, definite changes of ASC were present in four (10.5%) children in AIH and none in controls. None of the clinical, laboratory, histological parameters and treatment response were significantly different between ASC and AIH groups. Conclusion: The prevalence of ASC in children with AIH was just 10.5%. We suggest MRC in select group with cholestatic features, inflammatory bowel disease and in those who showed poor response to immunosuppression instead of all children with AIH.

• Advances in pediatric surgery
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• v.13 no.1
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• pp.61-65
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• 2007

Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was $14.56{\pm}8.77$ days and the average weight at operation was $3.26{\pm}0.66kg$. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was $88.57{\pm}22.80$ minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.6
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• pp.548-557
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• 2020

Purpose: To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media. Methods: We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation. Results: Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team. Conclusion: Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.853-862
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• 2021

Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn's disease. Methods: A 15-year-old female Korean patient with Crohn's disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital. Results: Decreases in the Pediatric Crohn's Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn's disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.80-84
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• 2014

Clostridium difficile infection has been increasing since 2000 in children and in adults. Frequent antibiotics use, comorbidity, and the development of hypervirulent strains have increased the risk of infection. Despite the high carriage rates of C. difficile, infants rarely develop clinical infection. Discontinuing antibiotics and supportive management usually leads to resolution of disease. Antibiotics use should be stratified depending on the patient's age and severity of the disease.