• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.300-311
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• 2022

Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

• Advances in pediatric surgery
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• v.19 no.1
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• pp.14-21
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• 2013

Pediatric liver transplantation has evolved into a definite and effective therapeutic modality for various liver diseases in the pediatric patient. During the last 25 years, liver transplant outcomes in Korea have reached international standards and Korea has become the leader in living-donor liver transplantation. This review will present the cumulative outcomes of pediatric liver transplantation performed in Korea and will focus on other issues of interest involving pediatric liver transplant recipients, especially in the field of immunosuppression and post-transplant lymphoproliferative disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.14-21
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• 2017

Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients. Surgery can affect a patient's clinical course, especially for pediatric CD patient who are growing physically and mentally, so the decision should be made by careful consideration of several factors. The complex and diverse clinical conditions hinder development of a systemized treatment algorithm. Therefore, timing of surgery in pediatric CD patients should be determined with individualized approach by an experienced and well organized multidisciplinary inflammatory bowel disease team. Best long-term outcomes will require proactive post-operative monitoring and therapeutic modifications according to the conditions.

• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.824-829
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• 2010

The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. The skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every aspect including patient and parent management and preparation, selection criteria for sedation and general anesthetic, bowel preparation, expected diagnoses, instrument selection, imperative for terminal ileal intubation, and requirement for biopsies from macroscopically normal mucosa. Investigation of inflammatory bowel disease, whether for diagnosis or follow-up evaluation, and suspected colonic polyps are the most common indication for pediatric colonoscopy. The child who presents with signs and symptoms of lower gastrointestinal disorder should undergo colonoscopy with biopsy to make the diagnosis, as well as to help determine the appropriate therapy. This review introduces practical information on pediatric colonoscopy, the author's experiences, and the role of colonoscopic examination in the diagnosis and treatment of pediatric lower gastrointestinal disorders.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.72-79
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• 2000

Background and Objectives : Adenotonsillar hypertrophy is the most common disorder in pediatric otolaryngology, which should be suspected as a possible cause of obstructive sleep apnea syndrome (OSAS). In the past, most of the adenotonsillectomy were performed because of recurrent infection, but now OSAS is the most common indication in many centers. Materials and Method : A review of 1,945 adenotonsillectomy performed between 1990 and 1998 is presented. We classified into two categories of indication for adenotonsillectomy and analyzed changing trends of indication for adenotonsillectomy. Results : Although recurrent infection remains the predominant indication for surgery, there has been a rise in OSAS as a significant indication from 13.67% in 1990 to 24.26% in 1998. Conclusion : An increase has occurred in the percentage of adenotonsillectomy performed for OSAS due to adenotonsillar hypertrophy. This trend promises to continue as physicians become increasingly aware of the prevalence and seriousness of adenotonsillar hypertrophy as a cause of sleep apnea.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.282-288
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• 2017

A variety of complications in endoscopic third ventriculostomy have been reported, including neurovascular injury, hemodynamic alterations, endocrinologic abnormalities, electrolyte imbalances, cerebrospinal fluid leakage, fever and infection. Even though most complications are transient, the overall rate of permanent morbidity is 2.38% and the overall mortality rate is 0.28%. To avoid these serious complications, we should keep in mind potential complications and how to prevent them. Proper decisions with regard to surgical indication, choice of endoscopic entry and trajectory, careful endoscopic procedures with anatomic orientation, bleeding control and tight closure are emphasized for the prevention of complications.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.73-78
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• 1995

Torsion of the wandering spleen is a rare condition especially in children. Unfortunately, splenectomy was the advocated treatment of choice for wandering spleen in many children up to 1985 in spite of the well-known possibility of overwhelming postsplenectomy sepsis. Because of the conclusive evidence of the vital function of the spleen in infection, indication of splenectomy have been revised and more attention has been paid to preserving the spleen where possible. We are presented a girl with splenic torsion, seen as a migratory abdominal mass and intermittent vague abdominal pain. Splenopexy by fixation of the spleen to the diaphragm and posterolateral peritoneum and the use of Avitene in the splenic bed was successfully performed. Complete fixation of the spleen was confirmed by ultrasound a year after this procedure was carried out. The clinical presentation, etiology, diagnostic procedures and management are discussed also.

• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.336-343
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• 2019

Epilepsy surgery revealed dramatically improved seizure outcomes over medical therapy in drug-resistant epilepsy patients. Children with epilepsy, however, have multiple epileptic focuses which require multilobar resection for better seizure outcome. Multilobar resection has not only the several severe surgical complications, such as hydrocephalus and shunt-related craniosynostosis, due to intracranial volume reduction. Isolation method (disconnection surgery) was progressively studied over epileptic focus removal (resective surgery) for seizure control. This concept was first introduced for functional hemispherotomy, and its primary principle is to preserve the vital vascularized brain that is functionally disconnected from the contralateral healthy brain. Currently in most epilepsy centers, the predominant disconnection surgical methods, including functional hemispherotomy, are continually being refined and are showing excellent results. They allow the functional isolation of the hemisphere or multi-lobe, affected by severe epilepsy. This review describes recent findings concerning the indication, surgical technique, seizure outcome and complications in several disconnection surgeries including the functional hemispherotomy for refractory pediatric epilepsy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.1-14
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• 2024

Probiotics are live microorganisms that confer health benefits to the host when administered in adequate amounts. Although recommendations for probiotic use should be strain-specific, many systematic reviews, including recommendations from different societies, recommend probiotic use in general, providing no relevant information for healthcare professionals regarding which probiotic to recommend for which clinical indication, at what dose, and for how long. This narrative review aimed to present the available evidence on the use of probiotics in the prevention and treatment of common gastrointestinal diseases in children, considering the strain and dose used. Furthermore, this study summarizes the evidence on the possible side effects and quality of products containing probiotics.

• Child Health Nursing Research
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• v.7 no.4
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• pp.461-473
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• 2001

The purpose of this study was to identify nursing interventions performed by pediatric care unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification (NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The 419 nursing interventions were selected by panel group, which consist of pediatric clinical experts and nursing scholars. The data were collected 104 nurses of pediatric care unit. There were 158 nursing interventions identified as being used at least monthly 50％ or more of the nurses. The 32 nursing interventions were used at least daily, indication a set of core interventions unique to pediatric care unit practice. The most frequently used nursing interventions were 'Medication administration: intravenous' & 'Medication administration: oral'. The 27 nursing interventions were rarely performed by 90％ or more of the nurses. The rarely used interventions were 'Ostomy care' & 'Rectal prolaps management'. The domain received the highest mean score was Health System, followed by Physiolocal: complex, Physiolocal: Basic, Safty, Community, Family, Behavior domain. These findings will help in building of a standardized language for the pediatric care units and enhance the quality of nursing care.