• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1120-1125
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• 2002

Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.476-483
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• 2007

Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.16-23
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• 2004

Purpose: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. Methods: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. Results: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. Conclusion: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.129-137
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• 2007

Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.138-146
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• 2007

Purpose: Ischemic enterocolitis (IEC) is the total or partial infarction of the intestine in the absence of occlusion of a major mesenteric blood vessel. The purpose of this study was to evaluate the clinical features of IEC in children. Methods: A clinical analysis of 6 patients with IEC who were admitted to the Department of Pediatrics at Pusan National University Hospital, between 1996 and 2005 was conducted retrospectively. Patients were diagnosed with IEC based on clinical characteristics, including radiologic, endoscopic, histopathologic, and intraoperative findings. Results: Four boys and 2 girls between the age of 6 weeks and 6 years were included in this study. Most of the patients were born at term and had a birth weight that was appropriate for their gestational age. The major symptoms of IEC observed included hematochezia or hematemesis (5 cases), vomiting, diarrhea, abdominal pain or irritability (4 cases), as well as abdominal distension and fever (3 cases). IEC occurred in thecolon in 5 cases (2 descending colon, 1 descending and sigmoid colon, 1 sigmoid colon, 1 whole colon) and the duodenal bulb and gastric antrum in 1 case each. The type of the lesions observed includedulcera, which were found in 3 cases, perforation, which was pbserved in 2 cases, necrotic patches, which were observed in 2 cases, stricture, which was observedin 1 cases, and massive membranous desquamation of the epithelium, which was observed in 1 case. Two of the patients received surgical treatment and the remaining four were treated conservatively. None of the patients died. Conclusion: The presentation of IEC varies, and the findings of this study will be helpful in managing patients with IEC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.157-165
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• 2007

Purpose: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. Methods: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. Results: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. Conclusion: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.369-379
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• 1993

The bone mineral density(BMD) of the lumbar spine (L2-L4) was measured by using dual energy x-ray absorptiometry(Norland XR26 DEXA) in 80 children aged between 2months and 15years (group 1 : 2month-1years, group 2 : 1year-5years, group 3 : 6years-10years, group 4 : 11years-15years). The correlation coefficient of BMD with age, body weight, height and Tanner stage were 0.696, 0.693, 0.717 and 0.636 respectively. There were significant difference in BMD($g/cm^2$) between group 1(BMD : $0.335{\pm}0.175$) and group 2(BMD : $0.627{\pm}0.200$). and group 3(BMD : $0.714{\pm}0.189$) and group 4(BMD : $0.873{\pm}0.163$)(P<0.05). There was no significant difference of BMD between boys and girls(P<0.05). BMD also increased significantly with development of Tanner stages(Tanner stage 1 : $0.547{\pm}0.234$, Tanner stage 2 : $0.783{\pm}0.136$, Tanner stage 3 : $0.998{\pm}0.080$ )(P<0.05). These data indicate that the BMD was correlated with age, body weight, height and Tanner stage significantly and BMD increased significantly during growth spurt occured in 1 to 4years of age and puberty.

• Journal of agricultural medicine and community health
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• v.40 no.4
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• pp.206-220
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• 2015

Objectives: The purpose of this study was to investigate the association between practice and infectious diseases in elementary, middle and high school students. Methods: In 16 metropolitan cities and province of the Korea, the students who from fourth grade of elementary school to third grade of high school were surveyed by personal interviews and an web-based online survey from 5 to 25 September, 2014. We analyzed data with chi-square test and logistic regression analysis. Results: Common cold, diarrhea, and eye infections were more prevalent among students in higher grade than lower grade. In particular, common cold was more prevalent among girls than boys, using hand sanitizer than washing with soaps, and students who wash the dorsal side of hand than not wash the dorsal side of hand. Conclusions: Higher-grade students showed low status of hand washing practice. Hand washing was determined as the fact which influences to increase the prevention of communicable disease such as common cold. Considering the fact that youth groups have higher risk of being infected due to their group life, schools are recommended to provide adequate educations regarding proper hand washing practice with soap.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.2
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• pp.245-255
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• 2001

Objectives：This study was conducted to investigate variables related to children's depression, and also the relationships between children's depression and parents' depression. Methods：258 5th and 6th grade elementary school students in Taegu, and their parents were asked to complete self-report questionnaires including the children's depression Inventory(CDI) and the Beck's depression Inventory(BDI). Correlation analysis, T-test, One-way ANOVA were used for the statistical analysis and the statistically significant level is p<0.05. Results：1) CDI mean for total children is $13.5{\pm}6.77$, BDI mean for their mother is $13.3{\pm}7.25$, and BDI mean for their father is $11.6{\pm}7.03$. 2) There are significant differences in CDI for children variables related to sex, health, school achievement, economic status. 3) Mother's health slightly affect children's depression, but there are no significant differences in CDI for parents' education, religion, father's health. 4) Children's school achievement and economic status among variables related to children affect mother's BDI scores and children's school achievement affect father's BDI scores. 5) For CDI item analysis, there are significant differences in 10 items for children's sex, in 8 items for health, and in 6 items for economic status. Especially, there are significant differences in 20 items among 27 items for children's school achievement. 6) There is significant correlation between parents' BDI scores and children's CDI scores, and especially high correlation to mother for both boys and girls. Conclusion：Children's depression are significantly affected by children's sex, health, school achievement, economic status. And especially school achievement affect grossly children's depression and their mother's depression, so we know that children and their mother have much burden about school achievement. There is high correlation between children's depression and parents'(especially mother) depression. Therefore, these result imply that in the therapy for children's depression, we must include not only children's problems but also parents' depression and parent-children relationship.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.21-33
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• 1999

The clinical assessment for preschool children who are known to have problems in selfreporting tends to be dependent on outsiders' reporting. Thus, the direct assessment of children's inner experience, thoughts and feelings is difficult. MacArthur Story-Stem Battery(MSSB) developed to learn more about preschool children's mental representation in play is used in this study to help assess clinical preschool children through developmental study of normal children's mental representation. Fifty five children(32boys and 23girls) who performed MSSB, IQ Test, Peabody Picture Vocabulary Test-Revised(PPVT) were videotaped and were analyzed. The results of this study were as follows：1) Children frequently displayed negative mental representation such as atypical negative response, reparation/guilt, punishment, personal injury and so on during emotionally laden play situation. 2) Mental representation of parent appeared positive, disciplinary, and negative in respective. 3) As a result of factor analysis of MSSB content themes, aggressive, prosocial, and oppositional content theme composites were generated. Aggressive content included atypical negative response, aggression, personal injury, and exclusion. Prosocial content included affection, affiliation, and reparation/guilt. Oppositional content included punishment and non-compliance. 4) Mental representation of parent and content themes showed significant correlation. Positive, negative, and disciplinary representation were significantly correlated for prosocial(r=0.40), aggressive (r=0.52), and oppositional(r=0.75) content theme respectively. 5) Among the correlations between parental mental representations and emotional responses, positive parental representation and anxiety showed significant negative correlation(r=-0.43). 6) Among the correlations between content themes and emotional responses, there were significant positive correlations between aggressive(r=0.28) and oppositional content themes(r=0.29) and distress, and were significant negative correlations between prosocial content theme and concern(r=-0.29) and anxiety(r=-0.43). According to the above results, preschool children frequently displayed negative mental representation in emotionally conflictual play situation. Children with more prosocial themes in their stories exhibit more positive parental mental representation. Also, children with more aggressive themes tend to display more negative parental representation and negative emotional responses.