• Journal of Korean Neurosurgical Society
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• v.51 no.2
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• pp.109-112
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• 2012

It is rare for low-grade gliomas to disseminate to the leptomeninges. However, low-grade gliomas with dissemination to the leptomeninges have been occasionally reported in children, and have generally been associated with local recurrence. A 16-year-old boy sought evaluation for diplopia and gait disturbance. A brain magnetic resonance imaging (MRI) revealed pontine mass, which was proved to be fibrillary astrocytoma on biopsy, later. Radiation therapy (5400 cGy) was given and the patient's symptoms were improved. He was followed-up radiologically for brain lesion. Seven months after diagnosis he complained of back pain and gait disturbance. A brain MRI showed a newly-developed lesion at the left cerebellopontine angle without an interval change in the primary lesion. A spinal MRI demonstrated leptomeningeal dissemination of the entire spine. Radiation therapy (3750 cGy) to the spine, and adjuvant chemotherapy with a carboplatin plus vincristine regimen were administered. However, he had a progressive course with tumoral hemorrhage and expired 13 months after diagnosis. We report an unusual case of a low-grade brainstem glioma with spinal dissemination, but without local recurrence, and a progressive course associated with hemorrhage.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.85-91
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• 2006

PFAPA syndrome is characterized by periodic fevers associated with aphthous stomatitis, pharyngitis, and cervical adenitis and is unusual in infants and children. We report on a case of PFAPA syndrome mimicking cyclic vomiting syndrome in a 42-month-old girl. She had experienced multiple episodes of cyclic vomiting with abdominal pain from age 20 to 30 months. When she was 30 months old, periodic fever with pharyngitis was combined with cyclic vomiting, and when 40 months old, aphthous stomatitis and cervical adenitis were added. These periodic symptoms and signs were not treated with prokinetics or antibiotics. Symptom duration of an episode was 3 days. After cimetidine therapy (150 mg three times daily for 6 months), her febrile and cyclic vomiting episodes ceased. At the time of writing she had not received therapy for 10 months and has remained well without periodic attack.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.213-216
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• 2016

Children with an intellectual disability often demonstrate lack of cooperation during dental treatment and require behavioral management. A child with mild intellectual disability can be managed adequately using restraints and medication. However, in cases of profound intellectual disability, dental treatment under general anesthesia is usually required. In cases where the patient is an intellectually disabled child who has intellectually disabled parents, it is difficult to evaluate the patient's preoperative condition and to obtain consent for treatment under general anesthesia. Furthermore, they are unable to respond to emergencies after treatment. Therefore, dental treatment should be performed under general anesthesia with hospitalization for children with an intellectual disability. This case presents the dental treatment of an intellectually disabled child, who has intellectually disabled parents, and who required general anesthesia and hospitalization.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.165-172
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• 2023

Pyogenic liver abscess is a rare condition in healthy children in developed countries, but it can have severe consequences if diagnosis and treatment are delayed. Staphylococcus aureus is the most commonly identified cause of pyogenic liver abscess worldwide, while Klebsiella pneumoniae is the predominant causative agent in Korea. However, cases of pyogenic liver abscess caused by anaerobic bacteria have also been rarely reported. A 14-year-old boy presented to the emergency room with fever and pain in the upper right abdomen. He exhibited tenderness in the right upper quadrant, elevated white blood cell count, anemia, and elevated liver enzyme levels. Abdominal computed tomography with contrast revealed pyogenic liver abscess. The patient underwent percutaneous catheter drainage for two weeks and received a 4-week course of antibiotic therapy. Prevotella intermedia, an anaerobic bacterium commonly found in the oral flora, was isolated from the drained pus. However, no evidence was found suggesting that the infection originated from a dental source. This case highlights the importance of considering the possibility of pyogenic liver abscess even in otherwise healthy children.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.57-67
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• 2001

Purpose : The purpose of this study was to identify attitudes of hospice volunteers toward care of for terminally ill patients. Method : This was a descriptive study with a sample of 84 adults who were registered for a hospice volunteer education program at Severence Hospice Center. The Frommelt (FATCOD) scale on attitudes toward the care of the dying (Cronbach alpha=.778) and an open ended questions on "what if you only have 6 months to live" were used to collect the data. The data was analyzed using SPSS/W and content analysis. Results : 1) The hospice volunteers were mostly female, with an average age of 45 years, half of them were college graduates and their religious preference was Protestant. 2) The participants of this study demonstrated positive attitudes to care for the dying which is in coherence with hospice philosophy and principles. However they indicated difficulties in maintaining close relationships with people who are dying, and in communicating and sharing, and encouraging those who are dying to express their feelings. In the open ended questions, they identified that their most important issues would be guilt feelings toward their children, family concerns, and the burden of unfinished business in their lives. They also identified the fear of pain in the dying process and fear of the afterlife. The care they would like to receive was to have peace of mind, have a good listener, spiritual counselling, and pain relief and to be respected as a human being. The source of strength would be faith in God and they would like to overcome their of dying. The FATCOD scale has limitation in describing and identifying the need and attitude toward the care of the dying revisions were made. Conclusion : We all are the potential clients for the hospice rare. In a hospice volunteer education program, communication and interpersonal skill are essential. The fear of dying, afterlife, concerns about family with children, and human dignity are major concerns in hospice and palliative care.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.126-133
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• 2010

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50 %) boys and 20 (50 %) girls. At the time of operation, 27 (67.5 %) patients were younger and 13 (32.5 %) were older than 1 year. Vomiting was seen in 20 cases (74.1 %) of the younger group compared to 2 cases (15.4 %) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4 %) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5 %) of the younger group and 1 patient (7.7 %) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.

• Korean Journal of Social Welfare
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• v.56 no.2
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• pp.195-213
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• 2004

The purpose of this study is to explore and understand the meaning of 'Good Death' that the Korean aged people are generally thinking based on their values and the sentiments. For this purpose, we carried out individual and in-depth interviews with 40 aged persons living in Seoul taking their genders and social-economic status into consideration from March to May 2003. We applied qualitative research method to this study. Eight graduate students were responsible for the interviews. They majored in gerontology or had experiences of field work with old persons. It took an average of one and a half hour and maximum of two hours for each of the interviews. All of the processes of each interview were tape-recorded under the agreement with each interviewee. The main and sub themes from the data can be classified to seven categories according to the Phenomenological Approach designed by Colaizzi(1978). The main theme of good death that most of the interviewees considered was 'Blessed Death', very similar to 'Death Fortune' in the five good fortunes found in Korean tradition and the Confucianism. Also, the main concept is classified to seven sub-themes: (1) Not seeing their children's death; (2) Dying in front of their children; (3) Not to be a burden of their children during their lives; (4) Dying after doing all of their duties as parents; (5) Dying with no pain; (6) Completing the natural span of their lives; and (7) Prepared death. Thus, 'Blessed Death' that Korean aged people consider seems to be very closely related with the lives, health, happiness and success of their children. Based on the findings, we concluded that both social policy makers and social service providers are required to keep in mind the meanings of 'Good death' that most of the Korean aged people consider in order to help them enjoy successful aging during their remaining lives.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.1
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• pp.41-48
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• 2013

Purpose: Meckel's diverticulum (MD) has various clinical manifestations, and diagnosis or selectection of proper diagnostic tools is not easy. This study was conducted in order to assess the clinical differences of MD diagnosed by scintigraphic and non-scintigraphic methods and to find the proper diagnostic tools. Methods: We conducted a retrospective review ofthe clinical, surgical, radiologic, and pathologic findings of 34 children with symptomatic MD, who were admitted to Gachon University Gil Medical Center, Inha University Hospital, and The Catholic University of Korea, Incheon St. Mary's Hospital between January 2000 and December 2012. The patients were evaluated according to scintigraphic (12 cases; group 1) and non-scintigraphic (22 cases; group 2) diagnosis. Results: The male to female ratio was 7.5: 1. The most frequent chief complaint was lower gastrointestinal (GI) bleeding in group 1 and nonspecific abdominal pain in group 2, respectively. The most frequent pre-operative diagnosis was MD in both groups. Red blood cell (RBC) index was significantly lower in group 1. MD was located at 7 cm to 85 cm from the ileocecal valve. Four patients in group 1 had ectopic gastric tissues causing lower GI bleeding. The most frequent treatment modality was diverticulectomy in group 1 and ileal resection in group 2, respectively. Conclusion: To diagnose MD might be delayed unless proper diagnostic tools are considered. It is important to understand indications of scintigraphic and non-scintigraphic methods according to clinical and hematologic features of MD. Scintigraphy would be weighed in patients with anemia as well as GI symptoms.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.187-191
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• 1998

Yersinia pseudotuberculosis, a gram-negative coccobacillus, is a member of the enterobacteriaceae family, and the illness has fever, abdominal pain, diarrhea, mesenteric lymphadenitis, terminal ileitis, arthropathy, erythema nodosum. Specially in children, it is known as an important cause of acute renal failure due to acute tubulointerstitial nephritis. It has been recognized in a worldwide distribution. For the first time, the cases of acute renal failure caused by this organism were reported in Japan in 1980's. In Korea, the first case accompanying with ARF was reported in 1988. Since that, many cases have been reported in Seoul area, but no case in other places. So we report 2 cases of Y.P. infection accompanying with ARF in Pusan area, for the first time in other place than Seoul area.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.3
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• pp.186-190
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• 2014

Lymphocytic gastritis (LG) is a rare subtype of chronic gastritis. It is defined as dense proliferation of intraepithelial lymphocytes (IELs) more than 25 lymphocytes per 100 epithelial cells. The known major causes of LG are celiac disease and Helicobacter pylori infection. H. pylori associated LG (HpLG) has more enhanced cytotoxic and apoptotic tendencies than chronic H. pylori gastritis. A 12-year-old girl with postprandial epigastric pain was diagnosed HpLG on endoscopic biopsy. After the 1st eradication therapy, H. pylori bacilli were still found, and urea breathing test was positive. Although the endoscopic finding was partially improved, clinical symptoms and histologic finding were persisted. We could achieve the improvement of clinical symptoms and disappearance of IELs after the 2nd eradication. The discordant of histopathologic and endoscopic improvement occurred after the 1st eradication therapy of HpLG. Therefore the clinical and histopathologic evaluation should be considered as well as endoscopic findings.