• Title/Summary/Keyword: Korean Children

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A Seroepidemiologic Study on Hepatitis A in Phohang, Korea (포항 지역 소아 및 성인의 A형 간염의 혈청학적 역학조사)

  • Bae, Soon Ho;Kwon, Young Dae;Kang, Ho Seok;Oh, Sei Ho;Lee, Sun Ju;Hong, Ji Yeon
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.61-66
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    • 2005
  • Purpose : Since hepatitis A virus almost is transmitted by fecal-to-oral route, individual and public sanitation affects the prevalence and ages of hepatitis A infection. We researched the positivity rate of hepatitis A antibody at Pohang to make the basic data for subclinical infection and vaccination schedule. Methods : From January 2004 to February 2005, a total of 603 patients who were admitted at Hangdong University Sunlin Hospital, Dongguk University Hospital, and Christianity Hospital without any hepatic disease and vaccination of hepatitis A were enrolled. IgG antibody to hepatitis A virus were measured by electrochemiluminescence immunoassay(ECLIA). Results : Among 603 patients, 523 patients were less than 15 year of age and 80 patients were in above 15 years. The prevalence rate was 19.3%(101/523) in pediatric group and 70.0%(56/80) in above 15 years. In detail, the prevalence rate was 73.2%(52/71) in 0~5 months, 14.9%(11/74) in 6~11 month, 8.9%(7/79) in 12~17 month, 7.3%(6/82) in 18~23 month, 5.5%(4/72) in 2~3 years, 12.1%(9/74) in 4~8 years, 16.9%(12/71) in 9~14 years, 52.5%(19/40) in 15~29 years, and 92.5%(37/40) in group aged over 30 years. The prevalence rates in male and female showed no significant differences. Conclusion : The prevalence rate of hepatitis A in the group of 4~8 years and 9~14 years at Pohang was lower comparing with previous reports of other cities in Korea. We can postulate that the sanitation of children living at Pohang is at least not bad than other cities. And for the prevalence rate of hepatitis A is increased after 3 years, we should recommend that the vaccination of hepatitis A may be finished until 3 years.

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Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea

  • Yang, J.M.;Bang, S.;Song, S.W.;Youn, B.B.
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.51-66
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    • 1968
  • During a period of about one year(November '66 to December '67), the Yonsei University College of Medicine conducted a field trial of the oral contraceptive(Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang county. We can summarize the outstanding findings from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Most of the reasons for not wanting to use it(352 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs if still in need of a contraceptive methods are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25 of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took one or more tablets we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5 th day as directed for the first three cycles, but the percentages rose sharply to about 80% in later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among acceptors who did not quit between cycles, 80 to 90% were regular users, missing two or less tablets in each cycle. 5) More than 60% of the users felt well and sometimes lost their pre-acceptance symptoms. especially dysmenorrhea. However, 27.4% (58 women) had side effects attributable to the pill compund as nausea, vomiting, indigestion, breast tenderness, decreased lactation or breakthrough bleeding. 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 49.2% (212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months, 6 months and one year, respectively. These rates are lower than in the U.S. studies. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.

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Eosinophilic Peritonitis (EP) Complicated with Continuous Ambulatory Peritoneal Dialysis (CAPD) (지속적 외래 복막투석 직후 발생하는 비감염성 호산구성 복막염)

  • Paek Kyung-Hoon;Jeon Yun-Ae;Min Jae-Hong;Park Kyung-Mi;Kim Jung-Su;Ha Il-Soo;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.117-122
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    • 1997
  • Purpose : To clarify the clinical findings, laboratory findings and disease course of EP complicated with CAPD and to find out possible predisposing factors to EP. Methods : The medical records of 34 children who underwent CAPD at our hospital between Jan. '94 and Dec. '96 were retrospectively reviewed. The clinical features and laboratory findings of EP were analyzed, and several parameters were evaluated as predisposing factors of EP. Results : EP developed in 7(21%) out of 34 patients. The major symptom of EP was turbid peritoneal fluid without fever, abdominal pain or disturbance of drainage in all cases. The microbiologic culture studies of the peritoneal fluid resulted negative in all cases. Patients with peripheral blood eosinophilia before insertion of CAPD catheter had higher risk of EP than those without eosinophilia (P=0.002). And peripheral blood eosinophilia, noted after insertion of hemodialysis catheter in cases with previous hemodialysis before CAPD, showed significant correlation with the occurrence of EP (P=0.016), too. However, there was no significant correlation between peripheral blood eosinophilia noted after insertion of CAPD cathter and the occurrence of EP. Identification of eosinophils in peritoneal fluids was more accurate with cytospin analysis. Conclusions : An early and accurate diagnosis of EP in patients with CAPD can prevent unnecessary treatment of antibiotics. Peripheral blood eosinophilia before insertion of CAPD catheter is one of the predisposing factors of EP. And, cytospin analysis of peritoneal fluid is an accurate method for diagnosis of EP.

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Cystic Diseases of the Kidney in Children (소아의 낭포성 신질환)

  • Lee Ji-Suk;Rho Kwang-Sik;Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.144-150
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    • 1997
  • Purpose : The kidney is one of the most common sites of cyst formation. Cystic diseases of the kidney are a diverse group of clinicopathologic entities and variable prognosis. They span a wide range of both age of presentation and severity of the renal disease. And many of them are systemic disorders, sharing similar process of cyst formation in other organs. Recently, development of imaging studies has been contributing widely to the diagnosis of the diseases. Treatment, however, is not established satisfactorily. We performed this study to evaluate the occurrence and treatment of cystic diseases of the kidney. Methods : We reviewed retrospectively the medical records of 44 patients with cystic diseases of the kidney in the Department of Pediatrics, during last 11 years. Results : In the 44 patients with cystic diseases of the kidney, 31 patients(71%) had multicystic dysplastic kidney and 11(35%) of them received nephrectomy due to differentiation from neoplasms or severe abdominal distension. Seven patients(16%) had polycystic kidney disease, and all of them were infantile type. Five patients(11%) were diagnosed as having a simple renal cysts. Progression to renal failure was noted in none of the cases. In 14(32%) out of total 44 patients, the diagnosis was made in neonatal or infantile pelted. Conclusion : The incidence of cystic diseases of the kidney appeared very low, but further investigation on their pathogenesis, classification, and indication of treatment is needed.

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Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients (야뇨증 치료반응 예측에 관계하는 평가지표)

  • Lee, Kang-Gyoon;Lee, Hyun-Jung;Lim, Yun-Ju;Kwon, Duck-Geun;Kim, Eun-Jin;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.272-279
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    • 2007
  • Purpose : We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. Methods : Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none(<50%), partial(50-90%) and complete(90%) response groups. We also compared the 'initial responders' who showed improvement(${\ge}50%$) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. Results : Parameters mentioned above showed no significant relation to the treatment out-come. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3% (2/151), partial in 29.6% (47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73) (P<0.05). Conclusion : We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

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Should Voiding Cystourethrography be Performed for Infants with Urinary Tract Infection? (요로감염 영아에서 배뇨성방광요도조영술이 필요한가?)

  • Woo, Mi-Kyeong;Kim, Mun-Sub;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.54-61
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    • 2008
  • Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.

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A Survey on the Conception and Cognition about Enuresis of Primary Care Physicians in Daegu City (대구 지역 일차 진료를 담당하는 의사의 야뇨증에 대한 인식 평가)

  • Choi, Jung-Youn;Kim, Sae-Yoon;Lee, Kyung-Soo;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.78-87
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    • 2008
  • Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.

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The Effect of Growth Hormone and the Factors Influencing Growth in Pediatric Chronic Peritoneal Dialysis Patients (만성 복막투석 환자에서 성장호르몬 치료의 효과와 성장에 영향을 주는 요인에 대한 연구)

  • Kim, Su-Jin;Park, Sung-Won;Sohn, Young-Bae;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.38-46
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    • 2008
  • Purpose: Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods: Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total $CO_2$, calcium, phosphate and iPTH during GH treatment were compared between the growth group (increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=l1) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results: The mean age at the start of dialysis was 7.7${\pm}$5.2 years and the mean age at the start of GH treatment was 8.5${\pm}$4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048) and residual renal Kt/Vurea was better (1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion: GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.

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Influence of Anatomy, Associated Anomalies, Age, and Surgical Methods on the Surgical Results of Aortic Coarctation (대동맥교약증 환아의 해부학적 형태, 동반심기형, 연령, 수술방법등이 수술결과에 미치는 영향)

  • 이정렬;김혜순
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.363-372
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    • 1997
  • One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

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Aortic Valvuloplasty in Pediatric Age (소아연령군에서의 대동맥판막성형술)

  • 임홍국;박천수;황호영;김웅한;이정렬;노준량;김용진
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.652-659
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    • 2004
  • Background: In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. Material and Method: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1$\pm$61.5 (1∼223) months. The mean follow up was 50.8$\pm$30.2 (3∼121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0$\pm$33.0 mmHg, and the mean grades of AR were 3.1$\pm$0.9. Result: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5$\pm$21.0 mmHg (p < 0.05), and AR improved with mean grades of 1.9$\pm$0.8 (p < 0.05). At mean follow up of 35.0$\pm$23.0 months, AS maintained with mean peak pressure gradients of 31.5$\pm$24.0 mmHg, but AR progressed with mean grades of 2.8$\pm$1.3 (p < 0.05). Reoperation was required in 6 patients 38.3$\pm$21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9$\pm$3.1%, 79.5$\pm$5.5%, and 56.8$\pm$11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR. Conclusion: Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.