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Clinical Study of Acute Pyogenic Osteomyelitis in Children (소아 급성 화농성 골수염의 임상적 고찰)

  • Park, Ji Sook;Yeom, Jeong Suk;Hwang, Sun Chul;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.731-736
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    • 2005
  • Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Clinical Evaluation and Diagnosis of Children with Chest Pain (흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사)

  • Shin, Su A;Kim, Yong Joo;Lee, Jae Whan;Kim, Nam Su;Moon, Soo Ji
    • 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.

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children (과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계)

  • Kim, In-Kyoung;Kang, Jae-Heon;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.736-744
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    • 2007
  • Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Relation Between Oral Health Knowledge and Behavior of Mother and a Oral Health Condition of Children (일부 어머니의 구강건강 지식 및 행동과 초등학교학생들의 구강건강상태와의 관련성)

  • Choi, Sung-Suk
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.245-250
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    • 2005
  • This study was executed from June first to 30th. 2005. The target was first and second graders of Bok-Hyun elementary school and their mothers. The total of participants was 275 persons and the component ratio was 135 first graders and 140 second graders, also 82 boys and 193 girls. They answered to the question sheet by writing out with their own hands. Among the 300 question sheets that were answered, 275 sheets were analyzed, excepting 25 sheets that got poor answer. The results were as follows; (1) About the behavior of mothers and their children for oral health, In mothers' case, 68.8% of them answered that they brush teeth more than 3 times a day and 31.3% answered that they brush teeth less than 2 times a day, so those who brush teeth more than 3 times were more than those who brush teeth less than 2 times In children's case, on the contrary, 14.2% of them answered that they brush teeth more than 3 times a day and 85.8% answered that they brush teeth less than 2 times a day, so those who brush teeth less than 2 times were more. (2) In 7 questions for researching mothers' knowledge level about fluorine, 55.3% of them answer 3~4 questions correctly. In 7 questions for researching mothers' knowledge level about Periodontal disease, 47.3% of them answer 3~4 questions correctly and it was highest. (3) In a case of the relation between oral health knowledge and behavior of mother and frequency of brushing teeth of children, statistical similarity on frequency of brushing teeth was shown(p < 0.05). (4) In a case of the relation between social-anthropological features of mother and frequency of brushing teeth of children, there was no statistical similarity on age, mothers' educational level, monthly income. However, statistical similarity was shown about existence of mothers' occupation(p < 0.05).

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Analysis of Gene Expression in Helicobacter pylori-associated Nodular Gastritis in Children Using Microarray (소아의 Helicobacter pylori 감염에 의한 결절성 위염의 유전자 발현 양상 분석)

  • Yang, Hye-Ran;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.7-22
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    • 2010
  • Purpose: Nodular gastritis is a characteristic finding of Helicobacter pylori infection in children. The aim of this study was to evaluate the difference in gene expression in the gastric mucosa of H. pylori-infected and non-infected children, and to analyze the difference in gene expression using cDNA microarray analysis of nodular gastritis caused by H. pylori infection. Methods: Twelve children (6 boys and 6 girls; mean age 9.8 years) who underwent upper gastrointestinal endoscopy and biopsy at Seoul National University Bundang Hospital were included in the study. The subjects were divided into three groups according to the presence of H. pylori infection and nodular gastritis on endoscopic examination. Gastric mucosa tissue was kept at $-70^{\circ}C$ and RNA was extracted to perform cDNA microarray analysis in each patient. Results: cDNA microarray analysis in children revealed a clear distinction between H. pylori-infected and non-infected gastric mucosa. Specifically, 182 over-expressed genes and 29 under-expressed genes were identified in H. pylori-infected gastric mucosa compared to non-infected mucosa. H. pylori-infected nodular gastritis revealed different gene expression patterns from H. pylori-infected normal gastric mucosa; five genes were over-expressed and five genes were under-expressed. Conclusion: In the presence of H. pylori infection, gastric mucosa shows distinct differences in gene expression, and nodular gastritis with H. pylori infection in children may be associated with over- or under-expression of some genes. Further studies are required to clarify the host response and the pathogenesis of nodular gastritis in children.

AN INVESTIGATION OF TRAUMATIC DENTAL INJURIES IN CHILDREN (소아의 치아와 지지조직 외상에 관한 분석)

  • Baik, Byeong-Ju;Yang, Yeon-Mi;Yang, Cheol-Hee;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.600-612
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    • 2001
  • The purpose of this study is concerned with an investigation of the actual condition of traumatic injuries of teeth and supporting structures in children to set up possible criteria for prevention and treatment of injured teeth. The materials consisted of the clinical records of 431 traumatically injured teeth of 212 children, accumulated during two years from the first of April in 1998 to the end of March in 2000, supplied from the Dept. of Pediatric Dentistry, Chonbuk National University Hospital. The incidence of injuries in boys was extremely high for permanent teeth, twice as high as in girls. Accidents to primary teeth were most common from 1 to 2 years of age and to permanent teeth were most from 8 to 9 years of age. The most common cause of trauma was a fall for both primary and permanent teeth, followed by collision. The anterior teeth in maxilla was most frequently affected by trauma in both the primary and permanent teeth. The most common type of trauma were loosening for the primary teeth, followed by luxation types which included the intrusion, displacement and extrusion and complete avulsion types. For the permanent teeth, the most common type of trauma were tooth fracture. The most common trauma of soft tissue was laceration of upper lip, lower lip and gingiva of maxilla Concerning treatment at the first visit, primary teeth with only loosening and concussion were not usually treated. Permanent teeth were often treated by crown restorations for crown fractures and by endodontic procedures for pulpal exposure. Though we could elucidate actual condition of traumatic injuries of teeth in children, we should make a follow-up survey to ensure the prognosis of injured teeth and establish the most desirable criteria for traumatized teeth in children.

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Teachers' Importance Perception of the Contents in Housing Unit of Middle School Technology and Home Economics Subject (중학교 기술 가정 교과의 주생활단원 내용에 대한 교사의 중요도 인식)

  • Jun, Kyung-Sook
    • Journal of Korean Home Economics Education Association
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    • v.20 no.4
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    • pp.223-237
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    • 2008
  • The purpose of this research was to provide the information needed for improving the contents in housing unit of middle school technology and home economic textbook. For this purpose, a survey questionnaire was developed to examine teachers' importance perception of 48 contents in housing unit. A direct survey and an e-mail survey were used to collect data from teachers, and a total number of 233 data were analyzed. Conclusions were summarized as following: 1. Among the 48 contents in housing unit, the average score of teachers' importance perception of the 18 contents on 'interior environment and equipments' was 3.94; the average score of teachers' importance perception of the 15 contents on 'living space plan and use' was 3.78; and the average score of teachers'importance perception of the 15 content on 'housing maintenance and repair' was 3.42. Therefore, the 15 contents on 'housing maintenance and repair' must be revised. 2. Teachers' importance perception of 25 contents, among the 48 contents in housing unit, were significantly differentiated by gender, age, teaching experience, scholastic attainment, subject in charge(technology, home economics, technology and home economics), school type(boys' middle school, girls' middle school, coeducation), and region(city, county). Therefore, the 25 contents, of which importance perception were influenced by teachers' characteristics, must be revised in order to maintain the consistent importance perception. Suggestions were that the team teaching of technology and home economic textbook was more recommendable; that the local situations must be considered in the contents of housing unit and; that the contents of housing unit must be segmented into a minimum unit for the accurate evaluation.

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A study on the status of dietary behavior and nutrient intakes according to the gender and the level of physical activity of adolescents: using the 7th (2017-2018) Korea National Health and Nutrition Examination Survey (청소년의 성별과 신체활동 수준에 따른 식행동 및 영양섭취실태: 제7기 2,3차년도 (2017-2018년) 국민건강영양조사 자료 이용)

  • Seo Yeon Kim;Sun A Choi;Jeong Ok Rho
    • Journal of Nutrition and Health
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    • v.56 no.6
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    • pp.683-701
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    • 2023
  • Purpose: The purpose of the study was to analyze the status of dietary behavior and nutrition intakes according to the gender and the level of physical activity of adolescents. Methods: Data from 659 adolescents aged 13 to 18 years who participated in the Korea National Health and Nutrition Examination Survey (2017-2018) were analyzed. Collected data were analyzed using complex sampling data analysis with SPSS v. 27.0. Results: The adolescents were categorized into three groups based on their physical activity as follows: The first group with high physical activity (8.9%), a second group with normal physical activity (29.7%), and a third group without physical activity (61.4%). Boys showed significantly higher physical activity than the girls. Adolescents with high physical activity had a significantly lower body mass index than adolescents without physical activity, but their meal regularity, subjective health status, and recognition of body image were significantly higher. In terms of biochemical factors, adolescents with high physical activity had lower triglycerides and cholesterol than adolescents without physical activity, while hemoglobin and hematocrit were significantly higher. In addition, the intakes of energy, carbohydrates, proteins, fat, vitamin B1, niacin, calcium, phosphorus, sodium, potassium, iron increased significantly as adolescents' physical activity increased. Conclusion: The physical activity of adolescents had a positive effect on dietary behavior, lifestyle, and nutritional factors. Therefore, it is necessary to increase participation in physical classes in schools and develop various programs considering the level of physical activity among adolescents.

Analysis of Children with Unilateral Multicystic Dysplastic Kidney(MCDK) (편측성 다낭포성 신이형성증 (Unilateral multicystic dysplastic kidney)의 임상 경과)

  • Yoo Ji Hyung;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Han Sang Won;Kim Myung Joon
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.63-68
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    • 2000
  • Purpose: MCDK is regarded as a common cause of abdominal masses in children. And the presentation of the MCDK is usually a unilateral flank mass in the a newborn. Bialteral disease results in either fetal demise or necessity fer renal replacement therapy at birth. This study is designed to assess the clinical features and natural history of the unilateral multicystic dysplastic kidney. Patients and Methods: From January 1987 to January 2000 data were obtained retrospectively on 57 patients (28 boys and 29 girls, age ranged 1day-11years) who had a diagnosis of multicystic dysplastic kidney. The diagnosis of multicystic dysplastic kidney was confirmed by a combination of ultrasonography and radionuclide scan. Voiding cystourethrogram study in 31 patients were done to determine the condition of the contalateral kidney. Restllts: $84\%$ of the patients were diagnosed before birth by antenatal ultrasonography Clinical manifestations of children with postnatal diagnoses were palpable abdominal mass($3.5\%$), abdominal distension($17\%$), and incidental($10.5\%$). The abnormalities in contralateral kidney were hydronephrosis($21\%$), compensatory hypertrophy($12\%$), simple cyst($2\%$), bifid pelvis($2\%$). Surgical management was performed in 20 patients($35\%$) due to recurrent infection, for diagnostic purpose to differentiate from malignancy and abdominal distention. Follow-up in the remaining 37 patients continued (mean 18 months) and results of sonogram findings were involution change in 23 patients($40\%$) and no interval changes in 13 patient($23\%$). Conclusions : The apparent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rather than operative intervention except in associated severe complications such as urinary tract infection or rupture of cysts.

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Evaluation of cardiac function by tissue Doppler imaging in children with cancer (Tissue Doppler imaging을 이용한 소아 종양 환자에서의 심기능 평가)

  • Kim, Yeo Hyang
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.417-423
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    • 2006
  • Purpose : The objectives of this study were to assess ventricular function by tissue Doppler imaging in children who were receiving chemotherapy or who had received chemotherapy, and to apply repeated tissue Doppler imaging to make an early assessment in cardiac toxicity studies. Methods : This study was conducted on 23 oncology patients on-treatment or off-treatment from April 2005 to July 2005 at Dongsan Medical Center, Keimyung University. All patients(group 1) were divided into two groups, fractional shortening(FS) over 29 percent(group 2) and FS under 28 percent (group 3) in the first category. These same patients were also divided into the following groups : group treated with anthracyclin(group 4) and group treated without anthracyclin(group 5). Deceleration time(DT), isovolumic relaxation time(IVRT), FS, peak early diastolic(E), and peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic(Sm), peak early diastolic(Em), and peak late diastolic(Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated a modified Tei index, E/A, E/Em ratio by using measured values. Results : Twenty three patients were enrolled : 12 boys and 11 girls. The average age of patients was 8 years and 4 months. Thirteen out of 23 patients were in the group treated with anthracyclin (group 4) and 6 had FS under 28 percent(group 3). E/Em ratio showed a significant difference between group 1 and control group($6.46{\pm}1.85$ vs $7.06{\pm}1.64$, P<0.05). Other parameters had no difference statistically. Conclusion : This study showed that the change of cardiac function developed earlier in diastolic function than in systolic function, as E/Em ratio reflecting the mean LV diastolic pressure showed a significant difference between the control group and chemotherapy groups. Echocardiography using tissue Doppler imaging is a non-invasive, comfortable and reliable method for post-chemotherapy follow up.