• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.236-246
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• 2010

Purpose: The purpose of this study was to develop and evaluate a Korean questionnaire to measure resilience in children with chronic illness. Methods: Item construction was drawn from an extensive review of the literature, existing questionnaires and interviews with parents. Content validity was tested by experts. To further refine the questionnaire and test its reliability and validity, data were collected from the 202 children with asthma, diabetes mellitus or nephrotic syndrome. Corrected items were used to total correlation coefficient and test-retest reliability. Questionnaire testing was conducted using factor analysis, Cronbach's $\alpha$, and correlation coefficients. Validity of the questionnaire was tested using internal consistency, construct validity, and criterion-related validity. Results: Components of the questionnaire were in three domains; interpersonal characteristics, characteristics of coping, and intrapersonal characteristics. Factor analysis is showed five factors; positive self-understanding, self-reliance, resourcefulness, perception of positive family relationships, and intimacy. The questionnaire showed a high internal consistency. A significant positive correlation with the Numerical Rating Score and negative correlation with the Child Depression Inventory support the validity of the questionnaire. Conclusion: This instrument demonstrated high reliability and validity. Therefore, this instrument can contribute to the evaluation of resilience of chronically ill children and to any subsequent intervention as well as to develop a theory for resilience.

• Child Health Nursing Research
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• v.12 no.2
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• pp.223-232
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• 2006

Purpose: The purpose of this study were to describe of resilience in children with chronic illness and family resilience, and to identify their correlations. Method: Data was collected from 108 children and their families, being treated by hospitals C and K in Seoul, who are diagnosed with nephrotic syndrome, IgA nephritis, diabetes, asthma at least six months ago. Descriptive, t-test, One-way ANOVA, and Pearson's Correlation were done. Result: The mean score of resilience in children was 101.31 and family resilience was 60.14. The variable which showed a statistically meaningful difference in the resilience in children according to a general characteristic was the gender of a child (t=6.209, p<.05), diagnosis (F= 6.315, p<.01), age of a mother (t=2.237, p<.05), and school grade (F=12.838, P<.01). In terms of the family resilience according to a general characteristic, the variable showing a statistically meaningful difference was the order of sibling (F=13.468, p<.01). There was significant positive resilience in children between family resilience (r=.356, p<.01). Conclusions: In this study we proposed the implement programs for the increase of the resilience in children with chronic illness. In order to give a positive effect on the resilience in children, implement for the increase of the family resilience is also proposed.

• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.242-245
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• 2016

Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia. We report of a 33-month-old girl with bilateral iliac and popliteal arterial thrombosis associated with steroid-resistant NS due to focal segmental glomerulosclerosis. Her treatment involved thrombectomy and intravenous heparinization, followed by oral warfarin for 8 months. Herein, we report a rare case of spontaneous iliac and popliteal arterial thrombosis in a young child with NS.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.627-632
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• 1986

This report describes our 17-years experience with intracardiac repair in 123 patients older than 15 years with tetralogy of Fallot. Major clinical manifestation was cyanosis and clubbing [102 Pts], but other minor associated manifestation were infective endocarditis, pulmonary tuberculosis, brain abscess, congestive heart failure, nephrotic syndrome, and tuberculous spondylitis. Prior palliative shunts had been performed in 10 patients. Preoperative hemoglobin ranged from 9.7 gm/dl to 25 gm/dl [mean 19 gm/dl]. The type of ventricular septal defect were typical perimembranous type, and total canal defect [13%]. The right ventricular outflow tract obstruction was due to combined [58.5%], infundibular [35%], and valvular stenosis [6.5%]. Transannular patch was used in 17% of patients. Hospital mortality was 9.8% in overall, but decreased to 1.7% since 1982. There was two late death [12 year actuarial survival [97%] due to fulminant hepatitis, residual abnormalities [PS, VSD]. Ninety two percent of survivors at follow-up are asymptomatic and leading an active normal life. Residual ventricular septal defect was detected with radionuclide single pass study in 15.3% of patients but almost cases were Qp/Qs less than 1.5, and only two patients had been candidates for reoperation.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.73-76
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• 2003

A girl aged 21 months with $Henoch-Sch\"{o}nlein$ purpura(HSP) developed heavy proteinuria with hematuria 8 days after the appearance of purpuric rash, swelling and tenderness of both ankle joints. Her clinical and laboratory features demonstrated nephrotic and nephritic syndrome. The percutaneous renal biopsy revealed diffuse mesangial proliferative glomerulonephritis. Unlike usual HSP nephritis, immunoglobulin A deposition was not detected in the mesangium or the capillary of the glomeruli. Instead, numerous subepithelial electron-dense deposits('humps') mimicking acute poststreptococcal glomerulonephritis were found.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.535-538
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• 2014

An eight-year-old intact male Beagle had anorexia, vomiting, depression for two days. The dog had hypoalbuminenia and mild azotemia on hematologic and clinical chemistry examinations. Severe proteinuria was identified on urinalysis. On abdominal ultrasonographs, there were small amount of ascites and bilateral renomegaly with severe hyperechoic renal cortex and hyperechoic medullary rim sign. Renal biopsy and histopathology revealed renal amyloidosis. The quality of life in this dog was satisfactory with aggressive supportive care for three months. Euthanasia was performed due to deteriorated azotemia and nephrotic syndrome.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.198-208
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• 2002

Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.157-165
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• 2003

Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.17-24
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• 2000

Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.495-509
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• 2009

Objective : Membranous nephropathy(MN) is an organ-specific autoimmune disease and a relatively common cause of nephrotic syndrome in adults worldwide. But treatment of MN is not defined. This study was to evaluate the effects of Acasia Catechu extract(ACE) on the MN induced by cBSA in mice. Methods : Mice were divided into 4 groups. The normal group was injected with a saline solution. The control group was treated with cBSA(10 mg/kg i.p.) only. The third group was treated with cBSA (10 mg/kg i.p.) and ACE (250 mg/kg, p.o.). The fourth group was treated with cBSA (10mg/kg i.p.) and ACE (500mg/kg, p.o.). After cBSA and ACE treatment for 6 weeks, we measured change of body weight, 24hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN, creatinine, TNF-$\alpha$, IL-6, IL-$1{\beta}$, IFN-$\gamma$, IgA, IgM and IgG levels. The morphologic changes of renal glomeruli were also observed with a light microscope. Results : The levels of 24 hrs proteinuria, total cholesterol, triglyceride, IgG, IgM, IgA, TNF-$\alpha$, IL-6, IL-$1{\beta}$, IFN-$\gamma$ significantly decreased in both ACE groups. The level of albumin significantly increased in both ACE groups. The mRNA expression of IL-$1{\beta}$ in splenocytes considerably decreased in the ACE-500 group. In histological findings of kidney tissue, thickening of GBM decreased in both ACE groups. Conclusions : This study shows that ACE might be effective for treatment of MN. More clinical data and studies are to be done for efficient application.