• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.174-182
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• 2003

Purpose: Non-alcoholic fatty liver disease (NAFLD) has been recognized as an important childhood liver disease, especially where the prevalence of childhood obesity is increasing. The purpose of this study is to clarify the usefulness of elevated serum aminotransferase activities and their ratio for predicting the presence of fatty liver and its severity in obese children. Methods: Forty-four children (M/F 29/15, age 4 to 16 years) with obesity (weight excess>20%) were analyzed retrospectively with medical records based on degree of obesity, bioelectrical impedence, serum aminotransferase activities, lipid profiles and ultrasonography. Results: 1) Ultrasonography was carried out in 34 cases. Elevated serum ALT was found in 89.7% (26/29) of the patients diagnosed as fatty liver by ultrasonography and decreased AST/ALT ratio (<1) was found in 96.6% (28/29). There was a strong correlation between elevated serum ALT (>45 IU/L) or decreased AST/ALT ratio (<1) and the fatty liver in obese children (p<0.05). 2) There was no significant correlation between the serum ALT or AST/ALT ratio and the degree of fatty liver (p>0.05). 3) There was a significant correlation between total cholesterol, triglyceride and fatty liver (p<0.05). Conclusion: Serum ALT activity and AST/ALT ratio were useful to predict the presence of fatty liver diagnosed by ultrasonography in obese children, whereas they were not useful to predict the degree of fatty liver. Therefore, to prevent fatty liver progressing to advanced liver disease, it is necessary to manage and monitor the obese children continuously, especially those who have predicting factors of fatty liver.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.147-155
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• 2001

Purpose : IgA nephropathy(IgAN) and thin glomerular basement membrane disease(TGBMD) are common glomerular diseases that cause hematuria in childhood. IgAN has characteristics of IgA deposit as the sole or predominantly localized to the mesangium Recently, it has been reported that thinning of glomerular basement membrane(GBM) is commonly accompanied with precipitation of electron dense deposits in IgAN. We performed this study to examine the frequency of thinning of GBM among children with IgAN and to analysis tile correlation between urinary abnormalities and GBM thickness and furthermore to conduct comparative analysis of the clinical and pathological features of IgAN and TGBMD. Methods : This study summarizes data collected from Department of Pediatrics, Busan Paik Hospital, Inje Medical College. Data include 51 cases who were diagnosed as IgAN from 1995 to 2000, and 26 cases who were diagnosed as TGBMD from 1990 to 2000 by percutaneous renal biopsy. Results : Males accounted for 29/51($56.9\%$) patients with IgAN and 8/26($30.8\%$) of those with TGBMD. The clinical and laboratory features between IgAN and TGBMD were significantly different regarding the incidence of proteinuria(IgAN vs TGBMD: $43.1\%\;vs\;3.8\%$, p=0.001), the incidence of co-appearance of proteinuria with hematuria ($41.2\%\;vs\;3.8\%$, p=0.001), total amount of protein in 24 hours collected urine ($808{\pm}\;mg\;vs\;251{\pm}200.7\;mg$, p=0.001) and the incidence of proteinuria more than 1 gm in 24 hours collected urine ($23.5\%\;vs\;3.8\%$, p=0.01). On the contrary, there were no significant differences in the levels of serum albumin, creatinine, BUN, and Ccr between two groups. The mean thickness of GBM in patients with IgAN was $293.0{\pm}79.2\;nm$(139.7-461.9 nm) and $180.9{\pm}35.8\;nm$(110.5-229.5 nm) in patients with TGBMD. The mean GBM thickness revealed significantly thinner in TGBMD compared than those with IgAN (P=0.0001). The frequency of thickness being less than 250 nm was $37.4{\pm}34.4\%$ in IgAN and $93.0{\pm}7.0\%$ in TGBMD (P=0.0001). But there were no correlations between urinary abnormalities and GBM thickness in patients with IgAN. Conclusion : The thinning of GBM would be one of the common pathological findings in IgAN Moreover, there is no significant correlations between urinary abnormalities and GBM thickness in patients with IgAN, However, patients with IgAN tend to have significantly higher possibilities of proteinuria, co-appearance of proteinuria with hematuria and higher total amount of protein in 24 hours collected urine compared those with TGBMD. These differences might be play all important role as progressive prognostic indicators in patients with IgAN. (J Korean Soc Pediatr Nephrol 2001;5 : 136-46)

• The Journal of Korean Society of Virology
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• v.26 no.2
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• pp.215-225
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• 1996

Aseptic meningits, an acute inflammation of the meninges, is a common illness during childhood. Virus is the most important cause of aseptic meningitis. Especially enterovirus causes approximately above 85% of all cases of aseptic meningitis. In 1993, there was a big epidemic of aseptic meningitis by ECHO 9 and ECHO 30 viruses. And ECHO 3 virus was isolated as a causative agent of aseptic meningitis in 1994. This study was aimed to detect the causative agent of aseptic meningitis in 1995 and to analyze the 5'-noncoding region which was used to detect virus. Virus was isolated from 87 stools and cerebrospinal fluid specimens of the patients by cultured RD and HEp-2 cell. Neutralizing antibody tests using enterovirus serum pool were performed on the specimens with cytopathic effect. 3 of ECHO 7 viruses and 5 of Coxsackie B3 viruses were isolated from stool specimens and 1 of ECHO 7 and Coxsackie B3 mixed type was confirmed from cerebrospinal fluid specimens. RNA was isolated from the culture supernatants of infected cells and general primers were selected in highly conserved part of the 5'-noncoding region of the enteroviral genome for RT-PCR. PCR product from this virus showed a 152bp band on gel electrophoresis. Sequence of obtained DNA was compared with prototype sequences by accessing to the Genebank database. 5'-noncoding region of isolated Coxsackie B3 virus, which has point mutations in nucleotide sequence positions 493, 497, 502, 523, was closely related to that of polio virus type 1, Mahoney strain. In case of isolated ECHO 7 virus, nucleotide has been changed from cytosine to thymine at position 581 and from thymine to cytosine at position 583. We concluded the causative agents of the outbreak of aseptic meningitis during June to July in 1995 were both ECHO 7 and Coxsackie B3 virus, and the primer used in this study could allow a rapid diagnosis of enteroviruses by PCR.

• The Journal of the Convergence on Culture Technology
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• v.3 no.4
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• pp.93-100
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• 2017

The purpose of this study was to examine what was the child's character education recognized by mothers of multicultural families and what was the actual conditions and needs of the child's character education at home through the in-depth interviews, and to suggest the efficient direction of the child's character education for mothers of multicultural families. The research participants were 6 mothers with children in multicultural families who lived in E city of Gangwon-do. The results of this study were as follows. First, as for the child's character education recognized by mothers of multicultural families, it was said to doing character education at home such as becoming a good person, becoming a child to listen to the parent's words and to reconcile with family, and becoming a child who was in harmony with friends. Second, as for the actual conditions of child's character education, they often used a control language such as "Do not, no", when children did not behave properly. In particular, there were some cases of using threatening words such as "taking you to the police station". Third, they hoped that various interests and support would be provided, such as not listening to "You are ill-behaved because you are in a multicultural family," receiving husband's educational support, receiving grandparents' support, and interests from the educational institution, etc.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.454-460
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• 2007

Traumatic dental injuries in childhood and adolescent occurred more frequently than in adult. The time between the accident and the treatment is one of the most critical factors to prognosis, and because of the limited time available to examine and treat patients with traumatic dental injuries, if not treat appropriately, the result would be critical for the patient. In the previous studies, the prevalence and incidence of traumatic injuries were the most frequent at the age of 8 to 10 years, the majority of dental injuries involve the anterior teeth, especially the maxillary incisors, and males were more prevalent than females in an approximated proportion of 2:1. As the mean age of complete root formation is 10 years old, the maxillary permanent incisor involved in the most affected age group is usually immature, and the possibility of pulpal healing through excellent revascularization exists, more positive prognosis for pulp vitality would be expected. These are treatment cases of the immature maxillary permanent central incisor involved in the traumatic injury, and reports for progress and results of preserving the pulp vitality through the conservative treatment instead of the conventional endodontic root therapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.126-132
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• 2009

Injuries of permanent teeth by trauma occur frequently in childhood and adolescence. Crown fractures are as frequent as 25-76% and especially maxillary incisors are prone to fractures. There have been numerous efforts to achieve both aesthetically and functionally satisfying restoration. When a mature tooth is fractured, porcelain crown or laminate veneer could be a choice of prosthodontic treatment. However, in a case of immature permanent incisor fracture, prosthodontic treatment is more complicated due to the immaturity of the tooth. Moreover, if endodontic treatment is accompanied with the prosthodontic treatment, the treatment period is prolonged. In the past, restoration using an orthodontic band, a ready-made crown, or glass ionomer cement did not exhibit esthetically satisfying result. As restorational materials have been improved, now more esthetic restoration is possible by reattaching fractured fragments or light-curing composite resin restoration. We reports cases of patients with fractured maxillary incisors and their successful treatment results through reattachment of fractured fragments and composite resin restoration.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.114-118
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• 2009

Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.57-62
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• 2000

Purpose: Unilateral ureteropelvic junction obstruction with high grade of hydronephrosis an obstructed diuretic renogram but good differential renal function were studied to evaluate the natural history of untreated obstruction. Materials and Methods: During the last three years, we encountered 18 kidneys with hydronephrosis detected on prenatal ultrasound. In all these patients other urologic abnormalities were excluded by voiding cystourethrography and other radiological studies. Diuretic renography was initially performed at an age ranging from 2 weeks to 4 weeks. Five had high degree of hydronephrosis and obstructed diuretic renogram despite good relative renal function. Periodic urine examination, ultrasonography and diuretic renogram were done at regular intervals. Results: We have followed 5 neonates with unilateral hydronephrosis and suspected ureteropelvic junction obstruction with noroperative treatment for 15 months. During followup, percentage and relative renal function were maintained in all patients and hydronephrosis improved. Obstructive patterns on diuretic renogram were variable. Conclusions: These findings help to define the natural history of untreated good functioning hydronephrotic kidneys. Many newborn kidneys with severe hydronephrosis are not obstructed despite even high grade of hydronephrosis and obstructed diuretic renogram.

• Childhood Kidney Diseases
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• v.6 no.1
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• pp.123-130
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• 2002

Posttransplant lymphoproliferative disease (PTLD) represents a diverse lymphoproliferative disorder ranging front nonspecific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus (EBV) infection and high dose immunosuppression. PTLD after renal transplantation was reported at first in adult in Korea in 1997. In children there have been several cases of PTLD after liver transplantation but PTLD after renal transplantation has not been reported. This is a case report of PTLD developed 4 months after renal transplantation in a 9-year-old boy. The major clinical manifestations were fever, multiple lymph nodes enlargement and blood-tinged stool. EBV was detected by in-situ hybridization in the enlarged cervical lymph node and the colonic tissue. Histological examination revealed B-cell lineage. Use of ganciclovir and reduction of the immunosuppression level resulted in complete remission of PTLD. This is the first pediatric case report of PTLD following renal transplantation in Korea. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 123-30)

• Childhood Kidney Diseases
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• v.10 no.2
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• pp.201-212
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• 2006

Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.