• Childhood Kidney Diseases
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• v.3 no.1
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• pp.80-87
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• 1999

Purposes : Renal involvement is a potentially serious complication of systemic lupus erythematosus (SLE). There have been only few studies of lupus nephritis in pediatric age. In this study, the clinical manifestations, pathologic findings, response to treatment, and clinical course of lupus nephritis in children were analyzed. And the results will provide basic data for future nation-wide prospective multi-center study. Methods . The medical records of 46 children clinically and pathologically diagnosed to have lupus nephritis at Seoul National University Children's Hospital during 1986 to 1997 were analyzed retrospectively. Results : 1) The median age of diagnosis of lupus nephritis was 12.8 years ($2\;years\~\;15year$ 8months), and the sex ratio was 1:2.5. 2) FANA($85.7\%$), anti-ds-DNA antibody ($78.0\%$), and malar rash ($60.8\%$) were the most common findings among the classification criteria by ARA Decreased C3 was detected in $88.9\%$ of patients. 3) Hematuria ($87.0\%$) was the most common renal symptom, and WHO class IV lupus nephritis was identified in 41 cases by renal biopsy. 4) In most of patients, the disease activity was controlled relatively well with a single or combined therapy of prednisolone, azathioprine, or cyclophosphamide. The response revealed no difference according to the mode of treatment. 5) Infection, especially of Varicella-Zoster virus and candida, was the most common complication during the disease course. Conclusion : The renal involvement was noted in $87.0\%$ of childhood SLE, and $89.1\%$ of renal lesions was WHO class IV lupus nephritis known to associated with poor long-term prognosis. So, aggressive treatment using immunosuppressants in the early disease course may be helpful to increase long-term prognosis of lupus nephritis. A prospective multi-center study is necessary to analyze the therapeutic efficacy of various treatment modalities.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.42-50
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• 2003

Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

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

• Journal of Music and Human Behavior
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• v.5 no.2
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• pp.67-92
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• 2008

The purpose of this study is to give an overview of the clinical process of songwriting with pediatric patients undergoing cancer treatment. Many literatures have proved that music therapy aids patients during their cancer treatment to relax, reduce anxiety and feelings of isolation, and promote self-esteem and quality of life and so on. However, among music therapy methods, I found songwriting proved to be very effective method. By using songwriting as therapy with pediatric patients undergoing cancer treatment, songwriting helped patients express difficulties of dealing emotionally with their illness and ongoing aggressive and invasive treatments. Also the process of songwriting established trust and relationship between therapist and patient which promoted normalization of hospital environment. In my case study, patient N has expressed her feelings and thoughts through writing songs about her current life which revolved around treatment of her brain tumor. Moreover, patient N found her creativity and developed ways of getting touch with her inner strength.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.228-231
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• 2005

Atypical teratoid/rhabdoid tumor may arise at any central nervous system location, but it is most commonly located in the cerebellum(60 percent). The incidence of this tumor remains unclear but it occurs most commonly in children less than 2 years of age. This highly malignant tumor shows a rapid progression and nonspecific radiologic findings. We report a case of primary intracranial atypical teratoid/rhabdoid tumor arising from the supratentorial area in early infancy. The diagnosis was made based on distinctive light microscopy and immunohistochemical findings. Despite aggressive surgical treatment with adjuvant chemotherapy, he died six months after his second operation.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.533-537
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• 1999

Pulmonary lymphangiomatosis is a very rare pulmonary lesion with an aggressive potential that occurs mainly in newborns, infants and young children of both sexes. It is characterized by pulmonary abnormalities of lymphatic system, showing an increased number of complex anastomosing lymphatic channels in the pleura, in the subpleural interlobular septa, and along the bronchovascular lymphatic route and uniformly fatal. We report a case of lymphangiomatosis behaving like lymphangioleiomyomatosis in a 26-year-old woman.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.83-90
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• 2005

Focal segmental glomerulosclerosis(FSGS) has been detected in approximately 10% of cases of Idiopathic nephrotic syndrome in children, and exhibits a poor response to initial steroid therapy, as well as a higher rate of progression to chronic renal failure and relapse after kidney transplantation. We describe a case of an eleven year-old boy with steroid-resistant FSGS who exhibited a response to a second trial of cyclosporin h(CsA) therapy. At the age of 26 months, this patient was diagnosed with steroid-resistant FSGS. For 9 years, he had undergone a gauntlet of therapies to induce remission; oral steroids, cyclophosphamide, methylprednisolone(mehyIPd) pulse therapy, CsA, and ibuprofen therapy. Although these therapies failed to induce remission, the patient's renal function remained In the normal range during the nine years of treatment. At the age of ten years, the patient's proteinuria decreased, and complete remission was attained with a second administration of CsA, coupled with a low dose of oral steroids. This patient continues to receive CsA without relapse. Therefore, our major concern involves the possibility of relapse after the discontinuation of CsA therapy Our findings in this case suggest that, in cases of refractory FSGS, if renal insufficiency does not emerge, aggressive therapy for the amelioration of proteinuria should be continuously pursued.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.63-66
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• 2011

Purpose: Cranial fasciitis is a rare type of benign tumor that occurs mostly in children younger than 6 years. It arises from the deep fascia, periosteum, or fibromembranous layer that covers fontanelles. The etiology is unknown, although prior trauma has been postulated to be an underlying cause. There is a 2:1 male predominance. Despite its rapid growth, this tumor has a benign clinical course and can be cured by total excision. Methods: A 16-year-old male presented with a 3 cm-sized palpable mass in the left lateral eyebrow region that he first noticed 4 months before presentation. The mass had grown rapidly since it was first noticed. Preoperative brain computed tomography showed a well-demarcated mass approximately 3 cm in size extending from the subcutaneous layer to the periosteum. Preoperatively, the presumed diagnosis was a dermoid cyst. An operation was performed with the patient under general anesthesia. The subcutaneous mass was completely excised by periosteal dissection. Results: Histological diagnosis revealed the presence of cranial fasciitis. After 20 months of follow-up, there have been neither complications nor evidence of local recurrence besed on clinical examination. Conclusion: Although cranial fasciitis is quite rare, it should be considered in the differential diagnosis for lytic skull lesions in patient whose clinical presentation suggests this possibility. This condition could be occasionally mistaken for malignant or locally aggressive lesions. To prevent local recurrence, curettage of the underlying bone is recommended for patients with bone involvement.

• Nutrition Research and Practice
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• v.12 no.6
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• pp.521-526
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• 2018

BACKGROUND/OBJECTIVES: Although a lot of effort has been put into increasing fruit and vegetable intakes in preschool children, vegetable intake in this group is still low. This study investigated whether nutrition education focusing on fruit and vegetable intakes can affect preschoolers' fruit and vegetable intakes as well as their behavioral outcomes. SUBJECTS/METHODS: Thirty-five preschoolers (54.3% boys, n = 19) aged 4-6 years residing in Seoul underwent weekly nutrition education intervention (8 sessions) between May and July 2016. Intakes of fruits and vegetables were measured during pre and post-intervention. At snack time, fresh fruit (150 g) and vegetable (120 g) snacks were distributed to each child by teachers. The remaining portions of the snacks were weighed and recorded for each child. Behavioral outcomes were measured by applying Child behavior checklist 1.5-5 and the Diagnostic and statistical manual of mental disorders. RESULTS: During post intervention, vegetable intake increased from $36.15{\pm}30.64g$ to $48.01{\pm}31.23g$ (P = 0.010). Among the emotional and behavioral problems measured by parents, levels of total problems (P = 0.001), internalizing (P = 0.004), externalizing (P = 0.003), anxiety and depression (P = 0.001), and aggressive behavior (P = 0.005) decreased. Anxiety (P = 0.026) score, as measured by teachers, also decreased. CONCLUSIONS: Nutrition education of preschoolers regarding the intakes of fruits and vegetables had a positive effect on preschoolers' vegetable intake as well as on their emotional and behavioral outcomes. A long-term, large-scale study with a broader study design is warranted to further investigate the role of fruit and vegetable intake in cognitive development and behavior of preschoolers.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.17 no.1
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• pp.99-113
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• 2006

As society has more interest in reading activities, it has become possible to secure social value of libraries through the promotion of reading. In this regard, the study aimed to analyze social tasks that the libraries face and suggest concrete methods through bibliographical examination. Currently, various regions of the nation have an increasing interest in libraries, particularly, children's libraries. The public libraries can expand their social roles by meeting these social requests. As a variety of activities by the public libraries to promote reading have helped people recognize the importance of libraries, more aggressive reading promotion activities are considered to help expand the roles of the public libraries and secure social base. Accordingly, the libraries need to take the initiative in implementing various measures by establishing a committee to adjust various reading promotion activities in the government and the public and private sectors, coming up with legal base, pursuing development of voluntary reading promotion programs, establishing an information network for reading and books, publishing book reviews, leading campaign for reading and reading promotion activities, supporting reading at home and expanding award system with regard to the promotion of reading.