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Successful Transplantation of 3 Cases of Oligomeganephronia (신장이식 수술로 치험한 Oligomeganephronia 3례)

  • Bae Hyun-Chul;Kim Ji-Hong;Kim Pyung-Kil;Kim Yoo-Seon;Park Ki-Il;Jeong Hyun-Ju;Choi In-Jun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.189-194
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    • 1997
  • Oligomeganephronia is a rare congenital form of bilateral renal hypoplasia histologically characterized by reduction in number and hypertrophy of nephrons. Clinically, this condition is presented in early infancy with vomiting, polyuria, polydipsia and dehydration. The problems are readily corrected, but slowly progressive renal failure follows accompanied by failure to thrive, short stature, and renal osteodystrophy. We experienced three cases of oligomeganephronia. Case 1. : A 3 2/12 years old female child was incidentally diagnosed as renal failure at age of 2 months when she was hospitalized due to pneumonia. She had open renal biopsy and was diagnosed as bilateral dysplastic kidney. On OPD follow-up, she progressed to end-stage renal failure (BUN/Cr 114/4.6 mg/dl) and had renal transplantation. The specimen was shrunk remarkably and light microscopy showed oligomeganephronia. Case 2. : A 14 8/12 years old female child with proteinuria was detected in an annual urine screening program for school children, she was diagnosed as renal failure (BUN/Cr 33.9/4.1 mg/dl), and had $5{\times}4{\times}3\;cm$ sized mass on abdominal CT scan. She had renal biopsy, and the specimen showed oligomeganephronia. She had hemodialysis for six months, and renal transplantation along with bilateral nephrectomy was performed. Case 3. : A 14 8/12 years old male child was diagnosed having chronic nephritis and chronic renal failure at 3 years old, progressed to end-stage renal failure (BUN/Cr 87/9.6 mg/dl) on OPD follow-up, and had a rephrectomy and renal transplantation. The biopsy specimen showed oligomeganephronic hypoplasia, secondary focal segmental glomerolosclerosis, and chronic interstitial nephritis. We report 3 cases of oligomeganephronia that progressed to end-stage renal failure and had successful renal transplantation with a brief review of related literatures.

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A Clinicostatistical Study of 677 Mandibular Fractures (하악골 골절 667 증례의 임상통계학적 분석)

  • Lee, Sang-Han;Lee, Seoung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.50-62
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    • 1989
  • This is clinicostatistical study of mandibular fractures. This study was based on a series of 677 patients with mandibular fracture during the period of 1982 to 1987. This results obtained were as follows : 1. In respect of incidence, there were high frequency in May and September, and in large city(63%). 2. The age frequency was the highest in the 20s-year old group (38.7%), and the ratio of male to female was 4.64 : 1. 3. The most common etiologic factor was blow(31.5%), but in children that was traffic accident followed by fall down. 4. The most common site of bone fractures was symphysis, followed by angle, condyle. In comparison of right and left sides, left side was more frequently involved(364 cases) than right side(257 cases). 5. The patients arrived in hospital immediately within 24 hours after accident were 62.9% of all, and 42.4% was arrived via private medical and dental clinic. 6. In respect of treatment, open reduction was 55.5% of all, closed reduction was 37.2%. In children, closed reduction was done in 50.6%.

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Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center

  • Jeong, Hyung Joo;Ahn, Yo Han;Park, Eujin;Choi, Youngrok;Yi, Nam-Joon;Ko, Jae Sung;Min, Sang Il;Ha, Jong Won;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.86-93
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    • 2017
  • Purpose: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. Methods: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. Results: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. Conclusion: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.

The Clinical Characteristics of Recurrent Kawasaki Disease (재발한 가와사끼병의 임상적 특징)

  • Jo, Hyuk;Kim, Seong Hyun;Kim, Ki Hwan;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.188-194
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    • 2008
  • Purpose : The purpose of this study is to investigate the clinical characteristics of recurrent Kawasaki disease (KD). Methods : From January 2004 to December 2007, the medical records of 20 children with recurrent KD in Severance Children's Hospital were retrospectively reviewed. The clinical characteristics, laboratory findings, treatment and complications of these patients were compared between the initial episode and the second episode. Results : At the initial episode of the recurrent KD group, the gender ratio was 1.2:1 (male:female) and the mean age was $37.2{\pm}19.9$ months. The interval between the two episodes in the recurrent KD group was 3.3 months. The febrile period before admission was shorter for the second episode (P=0.034). The skin rash was less developed in the second episode. But there were no differences in the laboratory results and complications between the initial episode and the second episode. Three patients (15%) among those with a second episode failed to respond to the initial intravenous immunoglubulin treatment. On comparison between the initial episodes of the recurrent group and the nonrecurrent group, the erythrocyte sedimentation rate was higher in the first episode of the recurrent KD group. Conclusions : For recurrent KD, it tends to present more atypical features than the KD that occurs for the first time. Physicians should consider these characteristics when making the diagnosis and treating recurrent KD.

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Comparison of the Estimations of Body Fat by Bioelectrical Impedence Analysis(BIA) and Anthropometric Measurements of Elementary School Students in Daejeon (대전 시내 초등학생의 생체 전기 임피던스치와 신체계측치에 의한 체지방율 비교 연구)

  • Wang, Soo-Gyoung;Lee, Na-Young
    • Korean Journal of Human Ecology
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    • v.16 no.4
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    • pp.849-854
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    • 2007
  • Body fat proportion is a major issue in health. The prevalence of obesity in childhood has been increasing on thesedays. A series of indirect estimates of body fat have been developed. There are hydrodensitometry, BIA and anthropometry equation for body fat. Hydrodensitometry has been regarded as a common criterion method. BIA made it possible to analyze body fat mass more related to hydrodensitometry than anthropometry. The purpose of this unvestigation were to compare body fat and other body composition between boys & girls and to know which anthropometry equation for body fat was most closely associated with BIA in boys & girls respectively. The subjects were 148 4th grade elementary school students(male:70, female:78). They underwent BIA(InBody 3.0, Biospace Korea)to determine body fat and other body composition. Anthropometric measurements were taken of height, weight, skinfolds and circumferences. The results obtained are summarized as follow: 1) Weight, BMI and Rohrer index were $39.9{\pm}7.2kg$, $20.5{\pm}8.0$, $138.2{\pm}17.0$ for boys and $35.9{\pm}6.7kg$, $18.2{\pm}2.6$, $96.6{\pm}13.6$ for girls. 2) Total body fat and percent body fat determined by BIA were $10.3{\pm}4.3kg$, $25.4{\pm}6.6%$ for the boys group and $9.3{\pm}3.8kg$, $25.1{\pm}6.0%$ for girls. 3) Mean triceps skinfold thickness was $20.5{\pm}6.1mm$ in boys, $17.0{\pm}5.1mm$ in girls and mean WHR was $0.88{\pm}0.4$ in bodys, $0.82{\pm}0.4$ in female and the values were significantly different by sex. 4) Correlational nanlyses showed that estimation of body fat by BIA measurement seemed to be closely associated with Rohere index(boys r=0.854, girls r=0.909). Kim's equation was highly correlated with the body fat in girls(r=0.910) but less correlated in boys(r=0.710). We need to develop specific anthropometric equations based on age and sex to determine body fat for children.

Effects of Maxillary Lateral Incisor Agenesis on Skeletodental Characteristics in Mixed Dentition (상악 측절치 결손이 어린이 안면골격과 치열궁 형태에 미치는 영향)

  • Nam, Siyeon;Shin, Jonghyun;Kim, Jiyeon;Jeong, Taesung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.147-157
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    • 2019
  • This study aimed to evaluate skeletodental characteristics of patient with maxillary lateral incisor agenesis (MLIA) in mixed dentition. It involved the children in early mixed dentition who visited Pusan National University dental hospital for orthodontic purposed and had intact primary canines. 38 children with MLIA and 38 controls with the same chronological age satisfying the inclusion criteria were selected. The craniofacial structures and dental arch dimensions of the MLIA were evaluated using model & cephalometric analysis and compared to controls. The rate of unilateral MLIA was high in male and the rate of bilateral MLIA was high in female. In model analysis, the width / length ratio of maxillary anterior portion of the MLIA group were higher and arch perimeter of the maxilla of the MLIA group were smaller than those of the control group (p = 0.003, 0.04). Cephalometric analysis showed that there were no significant differences in terms of skeletal, dental analysis. In soft tissue profile, nasolabial angle was larger in MLIAs than in controls (p = 0.039). Considering these skeletodental characteristics of MLIA, early diagnosis and proper management is highly recommended to minimize the possibility of functional defect.

The Comparison on Illustrations of Elementary Science Textbooks in Koaea and Japan (한.일 국민학교 자연 교과서 삽화 비교 연구)

  • Park, Si-Hyoun;Woo, Jong-Ok
    • Journal of The Korean Association For Science Education
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    • v.14 no.1
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    • pp.58-69
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    • 1994
  • In this study, with the problem of "What is the desirable illustrations?", the problem points of the existing textbooks were analyzed, and the opinions of experts concerning desirable illustrations were examined through questionaire survey, and by developing 'Analysis Framework of Illustrations', and Korean-Japanese 'science' textbooks were analyzed and compared with. The conclusions for the direction of korean 'science' textbooks are summarized as follows : 1) The numbers of korean illustrations should be more about two than one of per one page of the existing textbooks. 2) The korean illustrations for the 6th grade should be more largely inserted. 3) The more econmic space utilizing measure should be groped for looking at from the such side. 4) Though the kinds of Korean illustrations are mostly composed of photographs, pictures, illustrations, cartoons, etc. should be positively utilized. and the shapes of photographs should be diversified by such as square, round shape,omissions of background and others. 5) The distribution of players by sex should be considered envenly for male and female from the ascendency of male (1.5: 1). 6) It was found that it is desirable for the formation of role of illustrations of 20% for motive inducement, 45% for guidance for experimentation, 30% for presentation of data, and 5% for presentation of the results of experimentation. 7) The illustrations for guidance for experimentation should present important stages of experimentation process regardless the number of illustration. 8) It would be advantageous for motive induction to find the subject matters as possible as from the children's close actual life. 9) It is necessary to induce more freely method in utilizing Printing plate for inserting illustrations. 10) It is the result of research that the existing Korean textbooks are not suitable in inducing interest, and the positive strategy to induce interest is demanded. 11) It is required to select their location freely in accordance with the content regardless the. 12) In order to develop such illustrations, it is required to cultivate expert illustrators, and more economic investment is required for development of illustrations. The emphasis matters of revision of the 6th educational process of 'Inducement of study motive and emphasis on interest' is the change of presenting form and method of illustrations, which is expected to be rewarded with much good fruits.

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The Use of Nafamostat Mesilate as an Anticoagulant during Continuous Renal Replacement Therapy for Children with a High Risk of Bleeding (출혈성 경향이 높은 소아환자의 지속성 신대체 요법시 사용되는 항응고제로서 Nafamostat mesilate의 사용)

  • Lee, Sang Taek;Cho, Heeyeon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.98-105
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    • 2014
  • Purpose: Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has been investigated as an anticoagulant for adult patients with a high risk of bleeding, who need chronic renal replacement therapy (CRRT). However, little is known about the use of NM as an anticoagulant in pediatric CRRT. The aim of this study was to evaluate the ideal dosage, efficacy, and safety of NM in pediatric CRRT. Methods: We conducted a retrospective study of 40 pediatric patients who had undergone at least 24 h of venovenous CRRTs between January 2011 and October 2013. We divided the patients according to risk of bleeding. Those at high risk received no anticoagulation (group 1) or NM as an anticoagulant (group 2), while those at low risk received heparin (group 3). Results: Forty patients (25 male and 15 female; mean age, $8.2{\pm}6.6$ years) were enrolled. The mean duration of CRRT was 13.0 days, and the survival rate was 57.5%. The mean hemofilter lifespan was 39.3 h in group 1 and 11.3 h in group 3. In group 2, hemofilter lifespan was extended from 7.5 h to 27.4 h after the use of NM (P =0.001). The mean hemofilter lifespan with NM was greater than with heparin (P =0.018). No patient experienced a major bleeding event during treatment with NM. Conclusion: NM may be a good alternative anticoagulant in pediatric patients with a high risk of bleeding requiring CRRT, and is not associated with bleeding complications.

A Study on Childbrith in Late Maternal Age (노령출산에 관한 연구)

  • Han Yea Young
    • Journal of Korean Public Health Nursing
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    • v.8 no.2
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    • pp.101-113
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    • 1994
  • Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

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Comparison of Methods of Peer Relation Subgroup Classification on the Basis of Cooccurence of Perception Data and Psychological Preference Data (지각 자료의 공유인접수와 심리적 선호도에 의한 또래관계 하위집단의 분류 방법에 대한 비교)

  • Ahn, Ie-Hwan
    • The Korean Journal of Elementary Counseling
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    • v.11 no.2
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    • pp.153-169
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    • 2012
  • The purpose of this study is to investigate the most rational method of grouping peers to understand the impact of peer relationship on individual development of elementary school students. For the study, students at a class of the 3rd year(male) and a class of the 4th(female) year at elementary schools in Busan and Ulsan were surveyed to see the differences between various methods of classification of peer relation subgroup on the basis of cooccurence of perception data and psychological preference data. Two questionnaires were used; a questionnaire of perception and a questionnaire of psychological preference. With the perception data, value of sharing relationship was applied to classify peer relation subgroup and with the psychological preference data, interest relationship was expanded to classify peer relation subgroup of more than third party relationship. The result of this study showed that in the case of girls, there was high congruency between the classifications of peer relation subgroup by perception data and by preference data, whereas in the case of boys, there was difference between the classifications of peer relation subgroup by perception data and by preference data, which implies that boys can form a peer group even if there is psychological difference among members but girls can form a peer group only when there is psychological preference among them. Such a result shows that there is difference between boys and girls in the process of forming peer relationship. It is suggested that comparison of fitness be made between classification of peer relation subgroup by a homeroom teacher, by perception data and by psychological preference for rational classification of peer relationship among male children.

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