• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1120-1125
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• 2002

Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.152-160
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• 1998

Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically. Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed. Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{\pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$\%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50\%$, each. 4) Resolution rates in relation to the age at diagnosis were $100\%$ for below 1 mo, $48\%$ between 1 mo to 1 yr, $56\%$ between 1 to 6 yr, and $13\%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93\%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32\%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up. Conclusion: The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.376-381
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• 2002

The purpose of this study was to analyse the color of natural deciduous teeth in Korean children and to compare with that of composite resin specimens. The subjects were 148 children (80 boys and 68 girls) with good general condition and normal teeth color, aged between 3 and 6 years. The color of middle third of maxillary central incisor in deciduous teeth was examined with shade guide and then measured by means of the colorimeter CV300 which can be measured by CIELAB system. The data were analyzed statistically by SPSS program. The results were summerized as follows; 1. Over 90% of the color for the deciduous anterior teeth was in A1, A2, B1, B2 and P shade. 2. The means of deciduous teeth color were $L^*=58.72,\;a^*=-1.18,\;b^*=-0.63$ by colorimeter CV300. 3. $L^*,\;a^*\;and\;b^*$ prices for A1, A2, B1, B2, P were $L^*=52.52,\;a^*=-1.90,\;b^*=1.18$ in A1 specimen, $L^*=54.90,\;a^*=-1.87,\;b^*=1.60$ in A2 specimen, $L^*=59.80,\;a^*=-2.70,\;b^*=-0.63$ in B1 specimen, $L^*=56.90,\;a^*=-1.70,\;b^*=1.63$ in B2 specimen, $L^*=52.93,\;a^*=-2.33,\;b^*=1.10$ in P specimen. The means of B1 color specimen were most similar to those of deciduous teeth color. The A1 color values were similar to the P color values. 4. The standard deviation of $L^*,\;a^*$ was small among colors, but that of $b^*$, in the yellowish color, was large.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.437-448
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• 2021

The purpose of this study is to analyze morphological characteristics of maxillary primary molar's root and root canal. 268 children aged 3 - 7 years (175 boys, 93 girls) who had CBCT (152 children) and 3D CT (116 children) taken in Seoul National University Dental Hospital from January 2006 to April 2020 were included. The number of roots and root canals were analyzed in 1002 teeth without any root resorption or periapical pathologies. Curvature, angulation, length of root and root canal, as well as cross-sectional shapes of the root canal were analyzed in 218 teeth. By using Mimics and 3-Matics software, volume, surface area, and volume ratio of root canal was analyzed in 48 teeth. More than half of maxillary primary molars have 3 roots and 3 root canals. The degree of symmetry of root canal type was about 0.63 (Cohen's kappa coefficient). The most frequent shape of roots and canals was linear in 1^st primary molars and curved in 2^nd primary molars. Angulation, length of root and root canals was the largest on palatal roots. Most teeth showed ovoid or round shapes at apex. The largest root canal volume, surface area, volume ratio was found in the palatal roots.

• Survey Research
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• v.6 no.2
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• pp.33-50
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• 2005

The purpose of this study was to investigate whether Korean children's being addiction to computer game had an effect on physical health(headache, insomnia, indigestion, cardivascular). We considered both direct effects of that addiction and indirect effects which caused an negative emotion(anxiety). For this study, we collected data from 800 students of grades and 6 in Daejeon, Korea. Among them, we analyzed the data of 572 students[408 boys(71.3%) and 164 girls(28.7%) respectively] who had played computer games for a long period of time(two years or more). Reliability of the scale used on this study was a proper level by $.64{\sim}.91$ and we operated an analysis of structural equation pattern to make relationships of variable causes clear. As a result of examining an index of fitness of each model, it was proved for the fitness of every model(all GFI >.931, all CFI >.939, all NNFI >.929, all RMSEA <.046) to be acceptable. Not only the computer game addiction affected(all ps<.001) directly on physical symptoms(headache ${\beta}$=.211, insomnia ${\beta}$=.289, indigestion ${\beta}$ =.214, cardivascular ${\beta}$=.349), but also it affected(${\beta}$=.458, p<.001) on anxiety. In addition, the effect of anxiety on physical symptoms(headache ${\beta}$=.419, insomnia ${\beta}$=.375, indigestion ${\beta}$=.498, cardivascular ${\beta}$=.328) was significant. As a result of yielding the indirect effects of computer game abuse mediated by anxiety, headache was measured up ${\beta}$=.192, insomnia ${\beta}$=.172, indigestion ${\beta}$ =.228 and cardivascular ${\beta}$=.151. The computer game addiction caused 21% of anxiety and this mediate model proved that the computer game addiction caused 30% of headache, 32% of insomnia, 39% of indigestion, and 34% of cardivascular symptom. As a result of this study, the computer game addiction has a negative effect on physical health both directly and indirectly. Especially, cardivascular was influenced most extremely, then insomnia, indigestion, and headache in order. The implications gleaned from this study were discussed with considerations for future study and practical aspect.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.183-192
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• 2005

Purpose : The long term disease course and prognostic factors were evaluated in childhood Henoch-$Sch{\ddot{o}}nlein$ puruura nephritis(HSPN). Methods : A total of 75 children(44 boys and 31 girls) with HSPN were included in this study. The onset age was $8.0{\pm}3.1$ years(2.3-l5.3 years), and the follow-up period was $4.3{\pm}3.6$ years(1.0-17.1 years). Kidney biopsy was done in 24 children(32$\%$). Initial clinical and laboratory findings were evaluated. In addition, polymorphisms of the renin angiotensin system(RAS) genes(insertion/deletion in intron 16 of ACE gene, M235T in AGT gene, and A1166C in AGTR gene) were analysed. The initial and last clinical states were classified into 4 groups as follows A, normal; B, minor urinary abnormalities; C, active renal disease (nephrotic-range proteinuria and/or hypertension with serum creatinine $\leq$1.5 mg/dL); D, renal insufficiency. Results : At the onset, the clinical states of the patients were B in 26(35$\%$), C in 46(61$\%$), and D, in 3(4$\%$). The distribution of the RAS gene polymorphism of HSPN were not different from that of 100 healthy control subjects. At the last follow-up, the clinical states of the patients were A in 23(31$\%$), B in 38(50$\%$), C in 9(12$\%$), and D in 5(7$\%$). A multiple logistic regression identified age at the onset and initial urine protein excretion as significant prognostic factors. Analysis of genotypes of the 3 RAS genes as prognostic values revealed no statistical significance. Conclusion : Older age at onset and severe proteinuria were identified as poor prognostic factors of childhood HSPN. Implication of the RAS gene polymorphism In HSPN could not be validated in this small-scale retrospective study. (J Korean Soc Pediatr Nephrol 2005;9:183-192)

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.764-772
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• 2002

Purpose : Obesity is closely related to insulin resistance, compensatory hyperinsulinemia and dyslipidemia in adults. We identified the effect of obesity measured by BMI and insulin resistance on dyslipidemia in children and adolescents. Methods : The fasting serum insulin, glucose, total cholesterol, triglyceride, HDL- and LDL-cholesterol were measured and insulin resistance(HOMA-IR) was calculated in 35 children with simple obesity(age :$10.6{\pm}2.8$ years; male 20, female 15; BMI : $27.1{\pm}5.4kg/m^2$). Results : The hypertriglyceridemia(37%), hyperinsulinemia(54%) and HDL-hypocholesterolemia(5.7%) were observed. HOMA-IR was well expressed by fasting insulin. As BMI increased, there was a statistically significant increase in insulin resistance and insulin level in both sexes. BMI was not related with lipid profile in both sexes. Triglyceride was correlated with only insulin level and insulin resistance index in boys. In girls, there was no correlation between triglyceride, HDL-cholesterol and insulin(insulin resistance). Conclusion : These results suggest that hypertriglyceridemia was dependent on insulin resistance in pre-adult males. Monitoring of insulin resistance and those risk factors known to become a part of insulin resistance syndrome should become part of routine medical care for obese children.

• Journal of Nutrition and Health
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• v.41 no.5
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• pp.414-427
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• 2008

The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.851-856
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• 2006

Purpose : The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants. Methods : Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase of premature infants with total parenteral nutrition induced cholestasis were measured for comparison and analysis of their correlation. Results : Changes of serum bile acid analysis after birth showed no significant difference between boys and girls, between premature infants and term infants without cholestasis. Serum bile acid levels are constant after two weeks after birth in neonates without cholestasis. In premature infants with total parenteral nutrition induced cholestasis, the increase of serum direct bilirubin over 2 mg/dL was $34.9{\pm}18.3$ days after birth, and the increase of serum bile acid was $28.1{\pm}18.3$ days. Its increase was about 1 week faster than serum direct bilirubin, however, there was no statistical significance(P=0.114). Comparing analysis of serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase, serum bile acid showed the highest correlation to serum direct bilirubin(r=0.487, P=0.000). Conclusion : Serum bile acid is an important parameter of total parenteral nutrition induced cholestasis in premature infants and will be useful for early diagnosis and treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.157-165
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• 2007

Purpose: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. Methods: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. Results: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. Conclusion: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.