• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.593-601
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• 2006

Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Clinical and Experimental Pediatrics
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• v.54 no.4
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• pp.146-151
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• 2011

Streptococcus pneumoniae remains a leading cause of invasive infections including bacteremia and meningitis, as well as mucosal infections such as otitis media and pneumonia among children and adults. The 7-valent pneumococcal conjugate vaccine (PCV7) was licensed for use among infants and young children in many countries including Korea. The routine use of PCV7 has resulted in a decreased incidence of invasive pneumococcal disease (IPD) by the vaccine serotypes among the vaccinees and substantial declines in IPD among unvaccinated populations such as older children and adults as well. In addition, there are increasing evidences to suggest that routine immunization with PCV7 is changing the epidemiology of pneumococcal diseases such as serotype distribution of IPD, nasopharyngeal colonization, and antibiotic resistance patterns. In contrast, there is an increase in the number of IPDs caused by nonvaccine serotypes, though it is much smaller than overall declines of vaccine serotype diseases. Several vaccines containing additional serotypes have been developed and tested clinically in order to expand the range of serotypes of Streptococcus pneumoniae. Recently two new pneumococcal protein conjugate vaccines, 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13), have been approved for use in several countries including Korea. This report summarizes the recommendations approved by the Committee on Infectious Diseases, the Korean Pediatric Society.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.19 no.2
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• pp.180-191
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• 2006

Objectives : The purpose of this clinical report was to investigate the general characteristics of the patients with nasal polyps and estimate the efficacy of the oriental medical treatment on nasal polyps. Methods : We performed a clinical analysis of 50 patients who visited Kabsan oriental clinic due to nasal polyps. We inquired into distribution of age, sex, operation history related to nose, grade of nasal polyps, efficacy of treatment, etc. Results and Conclusions : 1. The sex ratio was 2.3 : 1. The average age was 40.02 years. 2. In the nasal operation history, inexperienced patients were 35 cases and experienced patients were 15 cases. 3. In the region of nasal polyps, there were 35 cases of bilateral types of nasal polyps, which is mon than in unilateral types. In the number of nasal polyps, multicentric types of 26 cases were similar in the number with solitary type of 24 cases. 4. In the predisposing or concomitant diseases, chronic sinusitis was the most frequent followed by allergic rhinitis, chronic rhinitis, septal deviation chronic otitis media, asthma, tonsilitis and allergic dermatitis. 5. In the main symptoms, nasal obstruction was the most important. In the concomitant symptoms, patients had frequent rhinorrhea, smell disturbance, postnasal drip, headache, etc. 6. The average treatment period was 3,58 months and the average number of treatment was 12.94 sessions. 1. In the amount of herbal medicine, 2 and 3 Ji(劑) were the most. The most frequently used herbal medicine to treat was Hyangbujamogeuntanggagam(香附子茅根湯加減) 8. In the change of grade after treatment, Grade I was the most. In the efficacy of treatment, 'good' was the most, followed by 'excellent' and 'uneffective'.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.151-155
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• 1996

Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

• The Journal of Pediatrics of Korean Medicine
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• v.11 no.1
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• pp.249-273
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• 1997

Hyunggyeyungyotang has been used for treatment of sinusitis and otitis media in oriental medicine since ancient times. It is reported that Hyunggyeyungyotang has good effects on inflammatory and allergic diseases of otorhinolaryngology in clinical medicine. Kamihyunggyeyungyotang was made by adding several herbs to Hyunggyeyungyotang which has such good effects. To investigate the effects of Hyunggyeyungyotang and Kamihyunggyeyungyotang on inflammatory, algesic and allergic diseases, the author examined the analgesic effect by acetic acid reaction, studied the anti-inflammatory effect through the experiments of the protein thermo-denaturation and circumscribed edema. Besides researched the anti-allergic effect through the vascular permeability response to Chemical Mediator and the delayed type hypersensitivity response to Picryl Chloride. The obtained results were as follows ; 1. In the analgesic effect of Hyunggyeyungyotang and Kamihyunggyeyungyotang extract by acetic acid method, both of the sample groups showed the analgesia, but didn't show useful effect. 2. In the anti-inflammatory effect on the protein thermo-denaturation, the sample groups revealed the inhibitory effect in proportion to concentration as compared with the control group. 3. In the inhibitory action on circumscribed edema induced by Caraggeenin, both of Hyunggyeyungyotang and Kamihyunggyeyungyotang administration showed the significant effect after 4 hours in comparison to the control group. 4. In the delayed type hypersensitivity response to Picryl Chloride, both of the sample groups revealed the significant effects. 5. Both of the sample groups decreased the vascular permeability induced by Histamine in comparison with the control group, but the significancy was admitted in only Hyunggyeyungyotang administration. According to above results, Hyunggyeyungyotang and Kamihyunggyeyungyotang are considered to be used for treament of the inflammatory diseases including sinusitis.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.1-9
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• 2004

Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchul-san on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchul-san, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san, san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaekchul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.11-11
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• 2004

Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchulsan on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchulsan, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaeichul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.15-19
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• 1998

Objectives: It is expected that the combined cisplatin and radiation therapy for nasopharyngeal carcinoma produces more sensory neural hearing losses compared to radiation therapy alone. The purpose of this study was to evaluate the incidence of sensory neural hearing losses after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. Materials and Methods: From Jun. 1994 to Mar. 1997, 10 patients were available for this study with the following eligibility criteria: 1) The patients received concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. 2) There was no pre-existing auditory disease except serous otitis media due to nasopharyngeal carcinoma. 3) They had normal sensorineural hearing function on the pretreatment pure tone audiogram. 4) Pure tone audiograms were performed at least one time after treatment between 6months to 1 year follow-up without local recurrence. Results: At 1 year follow-up, 3 patients complained of decreased hearing capacity. Sensorineural hearing losses were developed in 15 ears out of 20(75%) and were more frequent and severe in high frequency area on pure tone audiogram. Conclusion: The concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma may produce sensorineural hearing losses more frequently compared to historical data of radiation therapy alone and close evaluations with regular audiograms are necessary even in patients without symptoms and signs of hearing impairment.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.601-608
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• 1996

Robinow syndrome or fetal face syndrome is a rare inherited disorder characterized by short stature, mesomelic brachymelia, hypoplastic genitalia, and a typical facial appearence ("fetal face") with frontal bossing, hypertelorism, ear abnormalities, a short upturned nose, long philtrum, micrognathia, and macrocephaly. Intraoral features have included quite a few dental cavities, crowding, hypoplastic uvula, cleft lip or/and cleft palate, gingival hyperplasia, alveolar hyperplasia, enamel hypoplasia, delayed eruption, and congenital missing of the permanent teeth. We report on a 10 years old girl with Robinow syndrome. The patient had most of the typical anomalies of the syndrome and negative family history but, in addition, had mental retardation, hearing loss, and serous otitis media. Intraoral findings included dental cavities, crowding, hypoplastic uvula, repaired cleft palate, and mouth breathing. Dental treatment and V-tube insertion(by dept. of ENT) were performed under general anesthesia. In all cases of Robinow syndrome, thorough evaluation and united treatments with medical specialists should be performed.