• Clinical and Experimental Pediatrics
• /
• v.52 no.2
• /
• pp.256-260
• /
• 2009

Idiopathic pulmonary hemosiderosis (IPH) is a rare disease affecting mostly children. This disorder is characterized by recurrent episodes of hemoptysis, bilateral diffuse pulmonary infiltrates, and iron-deficiency anemia. An acute fulminant alveolar hemorrhage can be fatal due to respiratory failure, while chronic hemorrhage leads to hemosiderin-laden macrophages and pulmonary fibrosis. Genetic, autoimmune, allergic, environmental, and metabolic mechanisms of pathogenesis have been suggested, but the etiology of IPH remains unknown. We report on a 9-year-old girl with idiopathic pulmonary hemosiderosis who showed seasonal recurrences without cause.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.4
• /
• pp.837-842
• /
• 1998

Rett syndrome is a progressive neurological disorder that occurs exclusively in females. The syndrome is characterized by regression of language, motor development, and stereotypic hand movement. Autistic behavior, breathing irregularities, gait dyspraxia, scoliosis, and seizure are also accompanied. The cause of Rett syndrome is unknown, however, it is believed that the X-chromosome might playa significant role in the development of the syndrome. Patients with this syndrome have unusual oral and/or digital habits such as abnormal chewing pattern, bruxism, hypersalivation, micrognathia, high vaulted palate, tongue protrusion with lower posture of tongue, hand biting, digit-hand sucking. Dentists who are aware of distinct manifestations of Rett syndrome will be able to aid in early diagnosis and treatment of the syndrome. Prior to dental treatment for a patient with the Rett syndrome under sedation or general anesthesia, one should assess the degree of hypersalivation, apnea, severity of autism, expected life span. Early recognition of the syndrome and also dental treatment with established strict preventive guidelines for patients with the Rett syndrome may obviate the necessity of sedation or general anesthesia. Two cases with the Rett syndome were reported. Both patients had most of the above mentioned typical manifestations of the syndrome. Dental treatment for the case 1(8-year-old) including caries control, stainless steel crown, sealant application was performed under general anesthesia. The case 2 could not be undergone the dental treatment due to poor general conditions.

• Clinical and Experimental Pediatrics
• /
• v.52 no.1
• /
• pp.119-123
• /
• 2009

Renal cell carcinoma (RCC) arising from epithelial cells of the renal tubules is a highly aggressive and malignant tumor in all ages; however, it rarely occurs in children. the standard treatment for RCC is radical nephrectomy with lymph node dissection when the tumor is localized and can be completely resected. Adjuvant chemotherapy, radiotherapy, and immunotherapy are used for pediatric patients with advanced RCC involving lymph nodes or metastatic lesions. Sorafenib is an oral, multikinase inhibitor that has recently been approved for use in metastatic RCC. Common toxicities that have been reported include dermatologic changes such as rash or desquamation and hand-foot skin reaction, diarrhea, fatigue, alopecia, and hypertension. In particular, hand-foot syndrome (HFS) an erythematous skin lesion of the palms and solesis most often caused by cytostatic chemotherapeutic agents. In this report, we have studied a 14-year-old female patient with hand-foot syndrome that occurred in association with sorafenib for the treatment of metastatic RCC. Furthermore, this case demonstrates that reversal of complications can be achieved by discontinuing the drug and intervention with topical steroids, vitamin E, and high-dose pyridoxine.

• Journal of the Korean Society of School Health
• /
• v.3 no.1
• /
• pp.85-100
• /
• 1990

This study is an attempt to give basic information for sex maleducation, which is the integration of emotional, moral and social aspects as well as generative and physiological ones. It is concerned with both students and parents' sexual knowledge, attitude and need for sex education. The participants for this study are consisted of 193 parents, and 492 boys and girls high school students in Seoul. The main results of this study are as follows: 1. General Characteristics 66.5 percent of students is the girl and 38.8 percent of students is christian. Regarding parents age, 73.6 percent of them is 40~49 year old and 30.6 percent of them is Buddhist. 50.5 percent of them is graduated from high school, almost of them are keeping on being married(90.9%). 2. Sexual Knowledge: The boys score higher grade(average 8.98) than the girls. (average 7.51) (p<0.001) The Parents appear to record average 11.5, higher than the students' 8.01(p<0.01). However, there is no difference between them depending on their age, educational level or marital condition. 3. Sexual Attitude: The boys have more affirmative and positive feelings on the generative and physiological sides than girls. They also have a positive attitude to usual sides such as marriage, sexual intercourse and pregnancy, compared with girls. The girls have negative and irrecipient attitude to unusual sides like divorce, premarital sex or extramarital sex, while the boys are recipient(p<0.01). The parents' sexual attitude is positive feelings on the generative and physiological sides, and they also have a positive attitude to usual sides but they have a negative attitude to unusual sides. 4. Correlation between sexual knowledge and attitude Both the students and parents have positive correlation between sexual knowledge and attitude to generative and physiological sines and usual sides. The higher scores. of the sexual knowledge are, The more positive attitude they have. But parents only have positive carrelation between sexual knowledge and attitude to unusual sides. The lower scores of the sexual knowledge are, The more negative attitude they have. 5. More than half of the parents educate their high school children in sex: menstruation(75.0%), sexual hygiene (59.1%). intersexual fellowship(69.7%). marriage(62.0%) and chastity(51.9%) 6. Need for sexual education The students and the parents have almost the same opinions on this subject. Regarding pregnancy. delivery, family planning, dilatation and currettage and divorce, however, the students want to learn in high school. while the parents expect sex education later in high school.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.4
• /
• pp.580-585
• /
• 2009

Pediatric dentists often meet children with abnormal in number of tooth. Presence of supernumerary teeth is frequent cause of malocclusion. Etiology for supernumerary teeth is not yet clearly defined, but it is thought to be caused by excessive proliferation of dental lamina by hereditary and environmental factors. Supernumerary teeth occur in the maxilla nine times more frequently than in the mandible. Most common supernumerary tooth is the mesiodens in the maxilla, and some are observed in the maxillary molar and mandibular premolar. It occurs rarely in the mandibular incisor region with the incidence of 1-2% among all supernumerary teeth. A six-year old boy visited the department of the pediatric dentistry, Yonsei University Dental Hospital, with the chief complaint of crowded supernumerary teeth on the mandibular incisor region. Clinical and radiographic examinations revealed six permanent mandibular incisors similar in size, shape, and length. Further investigation using computed tomography(CT) was proceeded on the mandible to measure and compare morphologic features and positions of the six incisors. Then, we decided to remove two incisors which were already erupted. Periodic check-up was followed to monitor the dental development and spontaneous positional enhancement of the remaining four incisors in the mandible.

• Pediatric Infection and Vaccine
• /
• v.11 no.1
• /
• pp.126-130
• /
• 2004

Neisseria meningitidis is a leading cause of meningitis and septicemia in children and young adults. Meningococcemia, the most severe form of infection, represents a part of the various spectrum of the illness, and its clinical manifestations varied from mild fever and occult bacteriemia to fulminant catastrophic events(e.g., sepsis, shock, and death) within a few hours after onset of symptoms. Complement deficiencies, either congenital or acqired, increase the risk for invasive meningococcal disease. Since C3 plays a critical role in the complement cascade, congenital C3 deficiency or conditions that decrease C3(e.g., systemic lupus erythematosus, cirrhosis, nephritis, C3 nephritic factor) increase the risk for invasive disease due to pyogenic bacteria including N. meningitidis. We had experienced a case of meningococcemia and meningococcal meningitis presenting with mild fever, petechiae, and purpura. The patient was a 7-year old male. He had mild fever, vomiting, headache, nuchal rigidity, petechiae and purpura on both lower extremities, which spreaded to the whole body. His blood culture grew Neisseria meningitidis. The diagnosis of meningococcal meningitis was confirmed by examination of cerebrospinal fluid. The clinical symptoms of the illness were improved after treatment of antibiotics(cefotaxime) for 12 days. However the patient had developed generalized edema, microscopic hematuria & proteinuria on the third day after admission. High ASO titer and low serum C3 level were also noted. The microscopic hematuria returned to normal about 2 months after discharge. The C3 level returned to normal range about 3~4 months after discharge. we report a case of combined acute poststreptococcal glomerulonephritis and acute invasive meningococcal disease with reference review.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.4
• /
• pp.442-448
• /
• 1993

Foreign body aspiration, although not an uncommon problem in children, is unusual in adults and is overlooked as a cause of airway obstruction. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Especially in the cases of otherwise healthy subjects, even though manifested overt respiratory symptoms, diagnosis can be delayed due to lack of history of aspiration or unnoticed aspiration. A 57-year-old male was admitted to Yonsei University College of Medicine Severance hospital due to left upper chest pain for five months. on the past history he had been diagnosed as bronchiectasis about 20 years ago. He showed radiologically bead-like bronchostenosis and a calcific density protruding into the lumen of left upper lobar bronchus. Bronchoscopically broncholith was revealed with the finding of endobronchial obstruction of each upper and lingular division of left upper lobar bronchus due to mucoid impaction and surrounding inflammed bronchial mucosa. The preoperative diagnosis was broncholithiasis due to chronic inflammatory process. Lung perfusion scan shows absence of perfusion in left upper lobe. So left upper lobectomy was performed. But from the pathologic specimen an incisor tooth was emerged. Later a history of tooth extraction thirty years ago at dental clinic was found. We report a case of bronchial obstruction due to occult aspiration of a tooth with a review of the literatures.

• Research in Community and Public Health Nursing
• /
• v.15 no.4
• /
• pp.587-599
• /
• 2004

Purpose: The purpose of this study is to compare abdomen-fat rate, life style and social-support between normal weight women and obese women. Method: 304 women objectives from their 30 to 59 years of age were selected living in Je-chon city, Chung-Buck province and their height and weight were measured from April 1st to June 30th, 2003. Data were classified into low-weight group ($18.5kg/m^2$), normal-weight group ($18.5{\sim}22.9kg/m^2$), over weight group ($23{\sim}24.9kg/m^2$), and obese group ($25kg/m^2$) following the Korean Conference of Obesity, 2001. in which 119 people in the normal weight group and 91 people in the obese group, i.e. total 210 people were analyzed in sequence. Using SPSS Win 10.1 Program, frequency and percentile, and by ANOVA, $X^2-test$ and t-test were treated. Results: The average age of obese women was 46.68 distributing 40.7% of forties and 39.6% of fifties while normal-weight women were average 41.73-year old distributing 53.8% of forties and 34.5% of thirties, which revealed aged in obese women. The body fat rate of obese women averaged $37.52{\pm}4.17%$, in which 98.9% of obese women and 21.0% of normal weight women with a more than 30% of body-fat rate resulted in a higher body-fat rate in obese women. The waists of obese women averaged $88.37{\pm}8.22cm$, in which more than 85cm showed in obese women of 68.2% and normal weight women of 7.6% indicating a higher waist-fat rate in obese women. The abdomen-fat rate of more than 0.85 of waist vs hip-fat showed 74.7% in obese women and 58.4% in normal weight women, indicating a higher abdomen-fat rate in obese women. Obese women and normal weight women showed significant differences in education level, number of children, religion, menstrual status, and mother's weight. Especially, obese women ate hotter or saltier food than normal weight women preferring meat. However, no significant differences appeared in marital status, social economic status. occupation. eating habits. smoking. drinking and physical exercise. Social support levels showed a lower rate in obese women than in normal weight women, indicating a statistically significant difference (p<.05). Observing areas of social support, obese women showed lower rates in attachment/intimacy, social integrity, opportunity of foster and confidence in value except help and instruction, which indicated a statistically significant difference (p<.05). Social support for obese women showed significant differences in age, education level, social hierarchy, religion and menstrual status. Obese women were more negative than normal weight women in health recognition, indicating a statistically significant difference (p<.01). Normal weight women showed higher health recognition when provided high social support and significantly low (p<.01) health recognition when provided low social support. However, there was no significant difference in health recognition in obese women whether high or low social support was given. The health recognition of obese women showed significant differences in age, education level, social hierarchy, number of children, menstrual status, physical exercise, eating habits, eating taste and preference of food. Conclusion: Obese women showed elder than normal-weight women, higher body-fat rate and abdomen-fat rate, lower social support, and a tendency to more negative health recognition. Therefore, providing weight-control programs for the treatment of obesity and prevention of recurrence for obese women to prevent progressing to adult disease and promote a healthy life, we suggest that better eating habits and the encouragement of regular physical exercise should be included, as well as total approachment on change of health recognition and social support would be needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.13 no.1
• /
• pp.139-152
• /
• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

• Journal of Radiation Protection and Research
• /
• v.40 no.2
• /
• pp.118-123
• /
• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.