• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.277-283
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• 2007

Purpose : Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. Methods : A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. Results : Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. Conclusion : Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

• Clinical and Experimental Pediatrics
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• v.54 no.3
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• pp.117-122
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• 2011

Purpose: Natural history and consequences of the novel 2009 influenza A H1N1(2009 H1N1) infection in immunocompromised pediatric patients are not yet fully understood. In this study, we investigated the clinical features and outcomes of the 2009 H1N1 infection in pediatric patients with hematological and oncological diseases. Methods: We retrospectively reviewed the medical records of 528 patients who had hematological and oncological diseases and who were treated at 7 referral centers located in the Yeungnam region. Among the 528 patients, 27 with definite diagnosis of 2009 H1N1 infection were the subjects of this study. All patients were divided into the following 3 groups: patients who were receiving chemotherapy (group 1), patients who were immunosuppressed due to a nonmalignant hematological disease (group 2), and patients who were off chemotherapy and had undergone their last chemotherapy course within 2 years from the influenza A pandemic (group 3). Results: All 28 episodes of 2009 H1N1 infection were treated with the antiviral agent oseltamivir ($Tamiflu^{(R)}$), and 20 episodes were treated after hospitalization. Group 1 patients had higher frequencies of lower respiratory tract infection and longer durations of fever and hospitalization as compared to those in group 2. Ultimately, all episodes resolved completely with no complications. Conclusion: These results suggest that early antiviral therapy did not influence the morbidity or mortality of pediatric patients with hematological and oncological diseases in the Yeungnam region of Korea after the 2009 H1N1 infection. However, no definite conclusions can be drawn because of the small sample size.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.2
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• pp.317-322
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• 2006

Dental caries in children has declined over the past few decades. However, Certain populations of children experience high levels of dental disease. To perform the highest quality dental care for the pediatric patient, the practitioner may need to use pharmacological means to obtain a quiescent, cooperative patient. Furthermore, complex treatment can impose high demands on the very young, making use of general anesthesia the preferred approach for some patients. General anesthesia is widely used to provide comprehensive dental treatment for children in USA and Europe and Scandinavia etc. Parental and patient satisfaction following completion of dental care under general anesthesia is reportedly high. Dental general anesthesia has disadvantage that it is expansive and carries a small but significant risk of mortality. However, It has the advantage of permitting treatment at a single visit, allowing immediate relief of pain and requiring little or no cooperation from the child. Rampant caries was the major indication for use of general anesthesia in the youngest age group or medically compromised patients. This study describe the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chonbuk National University Hospital in Jeonju, Korea in the 4year period between December 2001 and April 2005.

• Korean Journal of Microbiology
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• v.53 no.1
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• pp.1-8
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• 2017

Measles virus is a highly contagious, exanthematic virus, preventable by the use of an effective live-attenuated vaccine. However, measles virus remains endemic in many area of the world causing nearly 200,000 deaths per year and still a major cause of child mortality, mostly in developing countries. In March 2014, Republic of Korea was certified as a 'national measles elimination' by the WHO as a result of a high-quality case-based surveillance system and population immunity, which was achieved by a high vaccination rate (>95.0% since 1996). But, since the beginning of 2014, the Gyeonggi province has experienced a resurgence of measles cases. In this study, we investigated the characteristics of measles viruses isolated from confirmed measles in Gyeonggi province during January 1, 2014 ~ July 31, 2014, 60 isolates were obtained from 72 confirmed measles specimens. Genotypic distributions and genetic diversities of isolated measles virus were analyzed by sequencing of nucleoprotein (N) gene. 58 (96.7%) imported cases were identified. The predominant genotype was B3, which reflects the circulating measles virus in adjacent countries. The sequences of nucleoprotein (N) gene of isolated MeV were showed that the strains characterized showed the highest degree of identity (99%) with the Philippine related strains in 2013-2014. Therefore, infected traveler returning from the Philippines transmitted secondary infection in Korea.

• Pediatric Infection and Vaccine
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• v.30 no.1
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• pp.47-54
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• 2023

With the widespread use of broad-spectrum antibiotics in clinical practice, the emergence of multidrug-resistant (MDR) gram-negative bacteria has become a global problem. The MDR Pseudomonas aeruginosa infection is especially difficult to treat and increases mortality in critically ill patients. Ceftolozane-tazobactam (Zerbaxa^TM) is a fifth-generation cephalosporin and beta-lactamase inhibitor that has proved to be effective for treating complicated urinary tract infections and complicated intra-abdominal infections caused by MDR P. aeruginosa. Herein, we report the first case of pediatric hematologic cancer in Korea that was successfully treated for MDR P. aeruginosa bacteremia with Ceftolozane-tazobactam.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.40-46
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• 2022

Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.536-545
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• 2007

Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.659-664
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• 2006

Purpose : To evaluate the morbidity and mortality of children with status epilepticus(SE) as an initial seizure and to compare these according to age groups. Methods : The 78 cases(38 cases <2 years and 38 cases ${\geq}2$ years) with SE as an initial seizure admitted to the Chonnam national university hospital from Jan. 2000 to Jan. 2004 were reviewed. Developmental profiles, laboratory findings, etiologies and seizure types of SE and outcomes were compared in between two age groups, under and over 2 years. Results : SE occurred predominantly in less than 5 years old. Febrile causes were the most common, which is significantly more in those under 2 years than over 2 years(P<0.05). whereas idiopathic and acute symptomatic causes were more common in those over 2 years(P<0.05). Generalized tonic-clonic seizures was the most common type. The mortality rate was 6.4 percent(5 cases : 1 case <2 years and 4 cases ${\geq}2$ years). The estimated occurrence of epilepsy after SE was 24.4 percent(19 cases : 8 cases <2 years and 11 cases ${\geq}2$ years). The neurologic sequelae after SE in cases that had developed normally before SE(62 cases : 32 cases <2 years and 30 cases ${\geq}2$ years) were observed in 20 cases(32.3 percent), and were more frequent over 2 years(21.9 percent vs. 43.3 percent, P<0.05). Conclusion : In this study death was less common and the neurologic sequelaes of SE as an initial seizure were less severe in children under 2 years of age. The reason seemed to be the difference in the etiology of SE with age.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.324-329
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• 2009

Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.