• Childhood Kidney Diseases
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• v.6 no.1
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• pp.37-47
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• 2002

Purpose: We reviewed the clinical manifestations, responsiveness to treatment, and prognosis in children with nephrotic syndrome. Methods: Medical records of 159 children with idiopathic nephrotic syndrome who were admitted to the pediatric department of Chonbuk National University Hospital from January 1979 to December 2000 w ere retrospectively reviewed. Results: There were 32 females and 127 males. The most common age group was between 3 and 5 years of age among the 159 children with nephrotic syndrome. Generalized edema ($75.5\%$), scrotal edema ($20.1\%$), upper respiratory infection ($19.5\%$), and ascites ($28.3\%$) were frequently observed. After the initial steroid therapy, diuresis occurred within tile first two weeks in 138 children, and proteinuria disappeared within the first two weeks in 105 children. Among 159 patients who received initial daily steroid therapy, 110 children were in complete remission, 29 children were in partial remission and 20 children were in poor response state. Hematuria, hypertension and elevated serum creatinine were more frequently observed in the partial and the poor response groups than in the complete remission group. Among 107 children who were followed up for more than one year, 78 children were in complete remission and 55 children were relapsed within the first one year after steroid therapy. Renal biopsy was undertaken in 76 children and 53 children had minimal change nephrotic syndronm. Conclusion: Our study showed that illost children with idiopathic nephrotic syndrome have a good responsiveness to steroid therapy and even most children show frequent relapse during 1st year after remission, long term prognosis is excellent.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.100-108
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• 2001

Purpose : We investigated the incidence and predisposing factors of pulmonary embolism in minimal change nephrotic syndrome(MCNS). Methods : Lung perfusion scan using 99mTC-MAA were done on 14 patients who were diagnosed to minimal change nephrotic syndrome. Group h: Five patients who had perfusion defects on scan, Group B; Nine patients who had no perfusion defect on scan. Between the two groups, the differences of platelet number, hematocrits, albumin, cholesterol, triglyceride, proteinuria were evaluated. Results : Five patients were found to have perfusion defect consistent with pulmonary embolism($35.7\%$). However, there were minimal or no respiratory symptoms and signs. In our laboratory studies, the mean proteinuria on admissions was $676{\pm}31\;mg/m2/hr$ in the group with pulmonary embolism, and $313{\pm}28\;mg/m2/hr$ in the group without pulmonary embolism. There were more severe proteinuria in group with pulmonary embolism(P<0.05). The mean platelet count at early stage of remission after steroid treatment was $746,600{\pm}280,000/mm3$ in the group with pulmonary embolism, $511,890{\pm}90,000/mm3$ in the group without pulmonary embolism. There were significant difference of platelet count between the two groups(P<0.01). In patients with pulmonary embolism, there were more higher and sustained increasement of platelet count. All cases of pulmonary embolism were treated with dipyridamole(5 mg/kg). In 4 cases the perfusion defects were improved in two weeks, however, one case showed persistent perfusion defect after 1 month. Conclusion : Our study suggested that pulmonry embolism might be one of tile major complications in childhood MCNS The occurrence rate was correlated with severity of proteinuria before treatment and sustained increasement of platelet counts in early remission state after steroid treatment. Therefore, the scintigraphic pulmonary perfusion study is mandatory in childhood MCNS, especially in the high risk patients, such as the patients with severe proteinuria and sustained increasement of platelet count. (J Korean Soc Pediatr Nephrol 2001;5 : 100-8)

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1248-1252
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• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Journal of Oral Medicine and Pain
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• v.33 no.3
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• pp.257-267
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• 2008

The mentophysical disease causes diseases in digestive, respiratory, circulating systems, including chronic pain, through combined reactions from different individual characteristics, mental stress and temperamental factors. The most common symptom related to orofacial area is pain and the contributive factors include biological, behavioral, environmental, social, emotional, recognitive factors. These factors affect the course of the symptom according to individual's character and human nature. In pain, sleep acts as a contributive factor, and pain could bring about sleep disturbance and vice versa. Deterioration of sleep quality would act as a factor that aggravates mental stress. Therefore, relatively accurate and simple mental examinations and sleep quality test should be carried out for the patients with symptoms related to orofacial area. This study evaluated the mental state in relation to the sleep quality which could affect orofacial pain. The number of poor sleeper was 18 in male subjects, and 1 in female subjects and PSQI global index was higher in male($6.11{\pm}2.38$) than female($4.67{\pm}2.18$). SCL-90-R index showed no sex difference. Poor sleeper showed significantly high value in SOM, O-C, I-S, ANX, PHOB, PSY, GSI, PST. When SCL-90-R T scores were compared according to sleep quality, higher the subjective sleep quality score, O-C and I-S showed significant increase. As sleep disturbances score increased, PAR, PSY, PST showed statistically significant increase. In comparison of SCL-90-R T score according to daytime dysfunction, statistically significant increase in DEP, ANX, HOS, PHOB, PAR, GSI was observed. Therefore, the quality of sleep and psychological status have a high correlation. This is likely to influence chronic pain in the orofacial field. As a result, clinicians treating orofacial pain should evaluate the sleep quality and psychological status of the patient. Further studies of larger sample sizes including various age, occupation, and pain groups are necessary in order to apply the results to clinical practice.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.292-298
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• 2007

In order to thoroughly understand change patterns and to set up an appropriate approach the direction of future treatment towards children in Chonbuk area, we carried out this research. we could draw below conclusions from the studies based on researches of distribution of new patients visited Dept. of Pediatric Dentistry, Chonbuk Nat' university from 1998 to 2005 and current changes in dental treatment. 1. There was an increase in the number of patients until 2004 but it decreased in 2005. Boys took higher portion. 2. Number of patients increased during school holidays. 3. 97.7% of patients were urbanites. 4. An age group from 31 months to 6 years showing 48.2% was the highest, each percentage of $7{\sim}13$ years, $13{\sim}30$ months showed 31.3%, 17.2%. 5. 33.8% of patients were referred from local dental clinics and among them, an age group from 31 months to 6 years showing 49.5% was the highest, each percentage of $7{\sim}13$ years, $13{\sim}30$ months showed 35.2%, 12.9%. 6, 5.5% of patients who had systemic diseases, among them, each percentage of cardiovascular disease, mental retardation, respiratory disease showed 21.8%, 13.6%, and 11.0%. 7. According to the distribution of chief complaints, dental caries showing 42.9% was the highest. 8. Root canal treatment, restoration, prosthesis showing 42.6% were the highest of all treatments.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.443-448
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• 2007

Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.139-146
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• 2013

Objective: As per the requirement of Korean Food and Drug Administration, this post-marketing surveillance was conducted in Korea to evaluate the safety and reactogenicity of Poliorix$^{TM}$ following its introduction in 2006. Methods: In this open, multicenter study, the vaccine was administered as per the current practice of Korean doctors and in reference to the guidebook by the Korean Pediatric Society and as indicated in the Korean label which was as follows - for primary vaccination three doses were given to infants at ages 2, 4 and 6 months whereas, for the booster dose a single dose was given to children aged 4-6 years. Safety data during this six year surveillance was collected using diary cards which were distributed to the parents to record adverse events. Results: A total of 639 subjects were enrolled into the study. Of these, 617 subjects and 22 subjects received the vaccine as a primary and booster dose, respectively. At least one unsolicited symptom was reported in 11.4% (73/639) of the subjects during the 7-day follow-up period; upper respiratory tract infection (2.5%;16/639) was the most frequently reported unsolicited symptom. One subject reported at least one unsolicited symptom (gastroenteritis) of grade 3 intensity within the 31-day post-vaccination period. Approximately 1.7% (11/639) of subjects reported 13 serious adverse events (SAEs). All SAEs were resolved by the end of the study. Conclusion: In Korea, primary and booster vaccination with Poliorix$^{TM}$ was well-tolerated in healthy subjects when administered according to the prescribing information as part of routine clinical practice.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.48-52
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• 2013

Purpose: Bed, living a long time is required in adult patients with brain lesions such as stroke, traumatic brain injury, and Parkinson's disease, causing pneumonia and respiratory diseases may be due to aspiration of food or saliva. In patients with recurrent pneumonia or pulmonary symptoms, there is a need to determine the possibility of pulmonary aspiration due to aspiration of saliva. Materials and Methods: Saliva due to aspiration pneumonia diagnosis in patients with brain lesions request for inspection to the Department of Nuclear Medicine, 10 patients (male 6, female 4) were included in this study. Patients were fasted before the test, $^{99m}Tc_{O4}$ 185 MBq (5 mCi) of less than 1 mL of solution was administered in the oral cavity. Administration and 20 minutes of dynamic imaging acquisition, and immediately after that the static images were acquired. Delayed scan after 2-4 hours if necessary. Results: Positivity rate of all 10 patients was 60%. In 4 patients showed positive reactions after the administration of oral cavity in a 20-minute dynamic imaging were able to confirm whether the aspiration. In the remaining 2 patients, four hours of additional delay tests were able to confirm whether the aspiration. Conclusion: Does not require changes in patient posture compared to the other checks that can be diagnosed with aspiration pneumonia. A simple test and takes less time. Therefore be useful in providing information for the diagnosis and treatment modality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.116-121
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• 2008

Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.186-192
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• 2003

Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.