• Clinical and Experimental Pediatrics
• /
• v.53 no.2
• /
• pp.184-189
• /
• 2010

Purpose : Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods : Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results : Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case.Conclusion : PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.

• Clinical and Experimental Pediatrics
• /
• v.45 no.12
• /
• pp.1519-1527
• /
• 2002

Purpose : Although influenza virus is one of the most important causes of acute respiratory tract infections(ARTIs) in children, virus isolation is not popular and there are only a few clinical studies on influenza in Korea. We evaluated the epidemiologic and clinical features of ARTIs by influenza virus in children. Methods : From February 1995 to August 2001, nasopharyngeal aspirations were obtained and cultured for the isolation of influenza virus in children admitted with ARTIs. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Respiratory viruses were isolated in 997(22.0%) out of 4,533 patients examined, and influenza virus was isolated in 164 cases(3.6%). Influenza virus was isolated year after year mainly from December to April of next year. The ratio of male and female was 1.9 : 1 with a median age of 15 months. The most common clinical diagnosis of influenza virus infection was pneumonia, and fever and cough developed in most patients. There was no difference between influenza A and B infection in clinical diagnoses and symptoms. All patients recovered without receiving antiviral treatment except for one patient diagnosed with pneumonia who had underlying disease of Down syndrome with ventricular septal defect. Conclusion : ARTIs caused by influenza virus developed every winter and spring during the period of study. Because fatal complication can develop in the high risk group, prevention, early diagnosis and proper management of influenza should be emphasized.

• Pediatric Infection and Vaccine
• /
• v.6 no.2
• /
• pp.210-218
• /
• 1999

Purpose : As several epidemics of aseptic meningitis had been reported in Korea since 1990, the need of epidemiologic study about enteroviral infections was recognized. We studied epidemiologic and clinical features of enteroviral infections in children. Methods : We analyzed the seasonal occurrence of enteroviral infections and age, sex and clinical diagnosis of the children admitted to five branch hospitals of Hallym University and diagnosed to have enteroviral infections by culture from January 1996 to December 1998. Results : Enterovirus was isolated in 126 out of 245(51.4%) stools, 15 out of 89(16.8%) nasopharyngeal aspirates and 195 out of 1,835(10.6%) cerebrospinal fluids. There were 273 echoviruses(Echo)(197 Echo 30, 46 Echo 9, 17 Echo 6, 13 unclassified), 24 coxsackieviruses B(CB)(11 CB 2, 2 CB 5, 11 unclassified), 7 coxsackieviruses A 24 and 32 unclassified enteroviruses. Yearly number of isolates was 65(46 Echo 9) in 1996, 239(197 Echo 30) in 1997 and 32(15 CB: 9 CB 2) in 1998. Epidemics of enteroviruses occurred mainly during the months May to October. The mean age of the infected children was $62.1{\pm}38.0$ months and 74.6% of the patients were younger than 7 years of age. There were 203 boys and 100 girls and 79.3% of the patients were diagnosed as aseptic meningitis. Conclusions : We confirmed that enteroviral infections occurred in epidemics from late spring to fall during the study period. Enteroviral infections occurred predominantly in boys and the preschool children. Aseptic meningitis was the main illness in the hospitalized children.

• Journal of Chest Surgery
• /
• v.32 no.4
• /
• pp.341-346
• /
• 1999

Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

• Korean Journal of Heritage: History & Science
• /
• v.50 no.3
• /
• pp.110-125
• /
• 2017

The purpose of this study is to investigate the constructional facts and the operational features of Hamchunwon(含春苑), a wonyu(苑?, a royal garden) constructed in Dongbu(Eastern District) of the capital city of Hanyang. As the living quarters of the queen dowagers were scheduled for relocation after the construction of Changgyeonggung Palace(昌慶宮) during the reign of King Seongjong(成宗), it is presumed that the screening tree planting project discussed around tongmangcheo(通望處, a place allowing open view) was the original form of Dongbu Hamchunwon. Dongbu Hamchunwon was a longitudinal royal garden built in the area across the section from Wolgeunmun Gate(月覲門) to Seoninmun Gate(宣仁門), which were both attached to the east side walls of Changgyeonggung Palace. The area corresponds to the west side area of the newly built main building of Seoul National University Hospital today. During the Joseon Dynasty, only royal gardens built within a palace were referred to as geumwon(禁苑, a palace garden). But Dongbu Hamchunwon which was built outside a palace was recognized as a symbolic and hierarchical space comparable to geumwon. The site location of Donbu Hamchunwon was an important place that corresponded to Naecheongnyong(內靑龍) according to Hanyang's geomancy, and large-scale public works were prohibited in order to protect the vein of Naecheongnyong. During the reign of King Injo(仁祖), part of Dongbu Hamchunwon was partitioned as a ranch. The area around the ranch was called Madongsan(馬東山) and Bangmawon(放馬苑) and was an open space used for rest and pleasure (amusement). In the early days of Hamchunwon's construction, fast growing trees were planted to screen the view to Changgyeonggung Palace. However, after the construction of Gyeongmogung Shrine(景慕宮), a broad scale tree planting project was undertaken to complement Naecheongnyong's vapor of the earth. In particular, after the construction of Yugeunmum Gate(?覲門) and Yucheommun Gate(?瞻門) during the reign of King Jeongjo(正祖), Dongbu Hamchunwon functioned as a key point on the King's progress for paying respects to the ancestors, which followed the route of Palace(Changgyeonggung)-Wonyu(Hamchunwon)-Ancestral Shrine(Gyeongmogung).

• Korean Journal of Heritage: History & Science
• /
• v.42 no.1
• /
• pp.88-99
• /
• 2009

This study was conducted to formulate management guidelines for Natural monumental old trees in Korea through survey of tree vigor and analysis of growing environments. A total of 20 old trees designated as natural monuments in Seoul, Incheon, and Gyeonggi Province were surveyed. The biological characteristics were surveyed with 4 items of species, ages and height of trees. The surrounding environments were surveyed with 2 items of location types and surroundings. The root conditions were surveyed with 2 items of denudation and molding depth. The health conditions were surveyed with 5 items of withering rate, cavity size, bark breakaway rate, damages by blight and insects, and growing tips. The soil conditions were surveyed with 6 items of PH, organic contents, valid phosphoric acid, transposal cations(K, Ca) and soil compaction. On the basis of outcomes of these research items, mutual relations among locations, growings and soil conditions of old trees were analyzed by carring out cross tabulation, correlation, and simple and multiple regression. Management guidelines were presented searching the factors effecting on the health of the monumental old trees. On the biological characteristics, the old trees designated as natural monuments were Pinus bungeana(4 trees), Juniperus chinensis(3 trees), Ginkgo biloba(3 trees), Poncirus trifoliata(2 trees). Actinidia arguta, Wisteria floribunda, Thuja orientalis, Quercus mongolica, Sophora japonica, Fraxinus rhynchophylla, Zelkova serrata, and Pinus densiflora. The tree height ranged from 4.2 to 39.2m, and root collar rounds ranged from 1.01 to 15.2m. On the surrounding environments, The location types ; Gardens(4), historical sites(5), residental sections(3) open agricultural fields(3), mountain hills(3), and near ocean beaches(1) and stream site(1). The surroundings ; 75% denudation of roots, molded more than 10cm except 4 trees(25%). On the health conditions, 1)Withering rate ; Ginkgo biloba(20%) in Yongmoon temple, (5%) in Saki-ri, kanwha-gun, and others had no withering rate. 2) Cavity size ; all subject had $5{\sim}100cm^3$ of cavity. 3) Bark breakaway rate ; Pinus bungeana in Soosong-dong, in the shrine of Confucius, in Samchung-dong, especially high rate of cavity(5~50%) in Seoul area and in Saki-ri, Kangwha-gun were high 45% brakeaway rate. 4) Damages by blight and insects was slight due to managements. 5Growing tips ; In cases of Juniperus chinensis in Changdeok palace and SunnogDang, seoul, growing tips were 1/2, presumably cause by air pollution, and in cases of Fraxinus rhynchophylla in Paju city and Pinus densiflora in BacksaDorip-ri, Icheon city, growing tips were fine, presumably because there were no moldings. On the Soil conditions, Soil pH ranged from 5.2 to 8.3, organic matter contents from 12% to 56%, phosphorus contents from 104 to 618ppm, soil compaction ranged from 7 to 28mm( among them, Denudation was severe with 21~28mm soil compactions in cases of Pinus bungeana in Soosong -dong, Thuja orientalis in Samchung -dong, Ginkgo biloba in the shrine of Confucius and in Yongmoon temple.) Results of cross tabulation, correlation, and regression analysis showed that molding depth was the most serious factor to deteriorate the tree vigor and cambium conductivity. In addition, soil acidity, organic matter contents, disease and insect damages and cambial detachment were also related to the tree vigor. Additional research of these relationships will be needed to conduct more detailed studies. Based on the relationships between the tree vigor and growing environments, it is considered that old trees should be managed to give them more growing spaces and less abuses. Also, molded soils should be removed and further soil-molding around the tree collar should be prohibited. For the construction of systematic management and removal of harmful factors, appropriative management according to spices, persistent monitering of damaged cases and construction of management system through the accumulation of data on the relationships of soil conditions are required.