• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.6-10
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• 2016

Esophageal atresia is the abnormal development of the esophagus that connects the mouth to the stomach. This birth defect results in the incomplete connection of the esophagus to the stomach causing an inability to swallow properly and breathing difficulties. Surgery is the only treatment for esophageal atresia. Patients undergone an esophageal reconstruction usually suffer from gastroesophageal reflex. A 5-year old boy with congenital esophageal atresia and Sciwitar syndrome visited Seoul National University Dental Hospital because generalized excessive loss of tooth structure. The patient had history of multiple operations for reconstruct esophagus. He had little food intake experience thought oral and had difficulty to swallowing. The patient was generalized severe erosive and decayed state. For patient, the dental procedure under general anesthesia was scheduled due to the multiple caries with erosion and poor cooperation. Under general anesthesia, pulpectomy and restoration as well as extraction was performed. Gastroesophageal reflex is potentially serious condition, with various extraesophageal adverse effects such as dental erosion. To prevent progression of dental caries, dietary counselling and oral hygiene instruction should be reinforced. Also, restorations to erosive teeth will maintain esthetics and function and preserve pulp vitality.

• Journal of dental hygiene science
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• v.1 no.1
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• pp.21-27
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• 2001

The purpose of this study was to explore some of the right directions for school dental-health education, by examining nursing students' knowledge on and attitude to the two major oral diseases in our country, dental caries and periodontal disease, as they will take charge of dental-health education and care for children in school dental-health center as sole expert health personnels after graduation. As a result of making an analysis of their knowledge and attitude, the following findings were acquired: (1) The students investigated perceived their oral cavity to tend to be healthy(36.8%) or in moderate situation(36.3%), although they had a subjective symptom for hot or cold food. (2) They thought dental caries is attributed to poor dental hygiene care(90.4%). Among them, 94.1% found toothbrushing effective for the prevention of dental caries, but just 40.2% agreed that toothbrush should be straight. (3) Those who considered fluoride effective for dental caries prevention thought the best way to use fluoride is taking fluoride-containing tap water(2.00). The second best way was fluoride mouth rinse(2.40), followed by the topical application of fluoride(2.70), use of fluoride dentifrice, and intake of fluoride(4.30) in the order named. (4) The regular examination and toothbrushing were mentioned as a way to prevent dental caries, but just toothbrushing was put in action for dental health. So their knowledge and actual attitude weren't the same. (5) They brushed their teeth for oral health(94.3%). Toothbrushing was done after breakfast(71.9%) or before bedtime(65.8%). Just 40.3% performed toothbrushing after lunch. That was implemented twice(35.7%) or three times(37.6%) a day. (6) Out of those who pointed out toothbrushing as a way to prevent periodontal diseases(84.7%), the effect of toothbrushing on the prevention of periodontitis wasn't supported by 7.1% of those who completed the course of study for the teaching profession and by 17.0% of the others who didn't. The two groups weren't of the same opinion. The above-mentioned findings suggest that the dental knowledge of the nursing students wasn't good enough to be properly responsible for school children's dental health care. In particular, there was a gap between knowledge and attitude. To improve children's poor dental health and help their oral cavity stay healthy, there is a need to activate school dental-health center, which is now in model operation, and to make the most of dental hygienists, who are educated to be a dental-health specialist, for more successful dental-health care for school children.

• Journal of Nutrition and Health
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• v.4 no.4
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• pp.47-56
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• 1971

The incidence of diabetes mellitus among Koreans as shown an increasing tendency recently, probably due to the various factors such as the improving living conditions. The majority of people are ignorant or indifferent to the nature, progress and prognosis of diabetes mellitus in Korea. 107 cases of diabetes mellitus which had been admitted to Severance Hospital between January and August, 1971 were Studied. Of these 107 cases, 22 cases were interviewed thoroughly during their hospital stay and the response to their diet therapy was carefully checked. 1) Of the 107 cases 69 cases were male and 38 cases were female; the sex ratio was 18:1. The age of the onset of the disease was as follows: 2 cases were under 20 years of age; 20 cases (18.7%) were under 40 years of age and 85 cases (79.5%) were over 40 years of age. Juvenile diabetes was less frequent when compared with developed countries. 2) Patients complaints and symptoms on admission, complications of sickness, and duration of sickness until the female discharge were also studied. We found that the incidence of tuberculosis complication in diabetes melltius was alarming (13. 8%). 3) In most cases, the control of diabetes was inadequate and diet practisis by the patients was also very poor even when they had known of the diabetes mellitus for a considerable period of time. During hospitalization 75 cases (70.0%) were controlled by diet and oral medications alone. Only 16 cases (15.0%) needed insulin injection, the remaining 16 cases required both diet control and insulin injection. 4) In general, patients received hospital diet satisfactorily. Only a few cases complained of difficulties with milk intake because of no previous dietary experience or of excessive meat orfish because they preferred vegetables and fruit. 5) Patients responded well to the dietitians interviews in the hospital but follow up study and care were poorly organized after discharge from the hospital. 6) The diet exchange 1ist published by the Korean Diabetic Association was not well received by the patients or the general puplic because it is not inexpensive and detailed instructions were not given at the time of discharge from the hospital.

• Clinical and Experimental Pediatrics
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• v.57 no.11
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• pp.496-499
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• 2014

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.257-260
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• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.3
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• pp.140-146
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• 2014

Purpose: The etiology of acute gastroenteritis (AGE) has changed since the introduction of the rotavirus vaccination. The aim of this study was to clarify which common pathogens, both bacterial and viral, are currently causing AGE in infants. Methods: Infants with acute diarrhea were enrolled. We tested for 10 bacterial pathogens and five viral pathogens in stool specimens collected from infants with AGE. The clinical symptoms such as vomiting, mucoid or bloody diarrhea, dehydration, irritability, and poor oral intake were recorded, and laboratory data such as white blood cell count and C-reactive protein were collected. The clinical and laboratory data for the cases with bacterial pathogens and the cases with viral pathogens were compared. Results: Of 41 total infants, 21 (51.2%) were positive for at least one pathogen. Seventeen cases (41.5%) were positive for bacterial pathogens and seven cases (17.1%) were positive for viral pathogens. Staphylococcus aureus (13 cases, 31.7%) and Clostridium perfringens (four cases, 9.8%) were common bacterial pathogens. Norovirus (five cases, 12.2%) was the most common viral pathogen. Fever and respiratory symptoms were common in the isolated viral infection group (p=0.023 and 0.044, respectively), whereas other clinical and laboratory data were indistinguishable between the groups. Conclusion: In our study, S. aureus (41.5%) and norovirus (12.2%) were the most common bacterial and viral pathogens, respectively, among infants with AGE.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.1
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• pp.66-70
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• 2014

X-linked adrenoleukodystrophy (ALD) is a uncommon metabolic disorder which derived by peroxismal ${\beta}$-oxidation and elevation of serum very long chain fatty acid (VLCFA). VLCFA is mainly accumulated in the myelin of the central nervous system and adrenal cortex, by which the expressed symptoms of this disease are mainly neurologic and endocrinologic (such as adrenal insufficiency). The mutations in the ABCD1 gene causes X-linked ALD, nevertheless its phenotypes and genotypes are poorly coordinated. We report the case of a 12-year-old boy with X-linked ALD who developed vomiting, fatigue and poor oral intake. Severe dehydration and hyponatremia were found in initial physical examination and laboratory test, but his motor/sensory nerve function and mental status were completely normal. We diagnosed ALD with diffuse high-intensity signal in both parietotemporal cerebellar white matter in brain MRI and elevated serum VLCFA. Later, we confirmed a novel c.1635-1G>A (IVS6-1G>A) mutations of the ABCD1 gene. With the discrepancy between its phenotypes and genotypes, various phenotypes could be seen in X-ALD patient. Careful examination and further studies for these patients will be needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.98-103
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• 2007

An 8-year-old boy presented with abdominal pain and poor oral intake for two months. Serum amylase and lipase levels were elevated. CT of the abdomen and chest X-ray showed two pseudocysts at the pancreatic uncinate process, pancreatitis with a parenchymal defect, a large amount of ascites, and a right pleural effusion. MR cholangiography and endoscopic retrograde cholangiopanreaticography revealed a pancreatic duct disruption. The patient was successfully treated with a chest tube placement and percutaneous drainage. After surgery, his general condition improved; the serum level of amylase normalized and the pleural effusion resolved. Pancreatic injuries are rare in pediatric blunt trauma; however, diagnostic difficulty is common with isolated blunt trauma. Therefore, a high index of suspicion should follow such an injury. We report the case of an 8-year-old boy with pancreas transection, ductal disruption, ascites, and pleural effusion who was successfully treated.

• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.161-165
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• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

• Laboratory Medicine Online
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• v.7 no.2
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• pp.83-87
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• 2017

Pseudohypoparathyroidism (PHP) is a rare disorder caused by genetic and epigenetic aberrations in the GNAS complex locus resulting in impaired expression of stimulatory G protein ($Gs{\alpha}$). PHP type Ib (PHP-Ib) is characterized by hypocalcemia and hyperphosphatemia due to renal resistance to the parathyroid hormone, and is distinguished from PHP-Ia by the absence of osteodystrophic features. An 11-yr-old boy presented with poor oral intake and cramping lower limb pain after physical activity. Laboratory studies revealed hypocalcemia, hyperphosphatemia, and increased parathyroid hormone levels. The GNAS complex locus was evaluated using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. Gain of methylation in the NESP55 domain and loss of methylation in the antisense (AS) transcript, XL, and A/B domains in the maternal allele were observed. Consequently, we present a case of PHP-Ib diagnosed using MS-MLPA.