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Enteral Nutrition in Pediatric Patients

  • Yi, Dae Yong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.12-19
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    • 2018
  • Pediatric patients require specialized attention and have diverse demands for proper growth and development, and thus need a different approach and interest in nutritional assessment and supply. Enteral nutrition is the most basic and important method of nutritional intervention, and its indications should be identified. Also, the sites, modes, types, and timing of nutritional intervention according to the patient's condition should be determined. In addition, various complications associated with enteral nutrition supply should be identified, and prevention and treatment are required. This approach to enteral nutrition and proper administration can help in the proper growth and recovery of pediatric patients with nutritional imbalances or nutritional needs.

Treatment of steroid-resistant pediatric nephrotic syndrome

  • Kang, Hee-Gyung
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.317-321
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    • 2011
  • Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be problematic; peritoneal dialysis may be accompanied by significant protein loss through the peritoneal membrane, and kidney allograft transplantation may be complicated by recurrence of SRNS. Plasmapheresis and rituximab were initially used for treatment of recurrent SRNS after transplantation; these are now under consideration as rescue therapies for refractory SRNS. Although the prognosis of SRNS is complicated and unfavorable, intensive treatment in the early stages of the disease may achieve remission in more than half of the patients. Therefore, timely referral of pediatric SRNS patients to pediatric nephrology specialists for histological and genetic diagnosis and treatment is highly recommended.

Enteral Nutrition and Its Clinical Application (장관 영양제의 임상적 적용)

  • Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.27-36
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    • 2009
  • Some pediatric patients who can not eat orally depend on enteral tube feedings, and some patients require more nutrients and calories to achieve the catch-up growth. If a patient is counting on the parenteral nutrition, early initiation of enteral feeding, orally or enterally, is a very good for the intestinal mucosal maturity and motility. There are numerous kinds of formulas and supplements for the enteral feeding for neonates, infants, and children. Depending on the intestinal symptoms, allergic symptoms, requirement of special nutrients, we can choose regular infant formula (milk-based, soy-based), protein hydrolysate formula, amino acid hydrolysate formula, elemental formula. Proper use of these formulas would help for the pediatric patients to recover from their diseases, to facilitate the intestinal mucosal maturity and to achieve their goal of growth.

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

  • Pak, Seong Min;Lee, Yeoun Joo;Hwang, Jae Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.87-91
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    • 2022
  • Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

Pediatric Nondysraphic Intramedullary Lipoma : Report of Two Cases and Review of the Literature

  • Jong Seok Lee;Young Mi Kim;Soo Ahn Chae;Seung-Ki Kim;Ji Hoon Phi
    • Journal of Korean Neurosurgical Society
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    • v.66 no.2
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    • pp.211-218
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    • 2023
  • Pediatric nondysraphic intramedullary lipoma is very rare, and only limited cases have been reported. In the present case, we present two infant patients with these pathologies who were surgically treated. Previous literature on 20 patients with these diseases who had undergone surgical treatments was analyzed. Surgical treatment should be considered in most symptomatic patients, and laminoplastic laminotomy and internal debulking of the lipoma under intraoperative neurophysiological monitoring are mostly recommended.

Analysis of Complication in Pediatric Patients with Hickman Catheters (히크만 카테터를 삽입한 소아 환자에서 발생한 합병증 분석)

  • Kim, Tae-Hoon;Kim, Dae-Yeon;Cho, Min-Jeong;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.25-31
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    • 2010
  • Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

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Renal replacement therapy in children with acute renal failure (소아 급성 신부전증의 신장 대체 요법)

  • Paik, Kyung Hoon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.938-947
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    • 2007
  • Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

Pediatric Finger Warts Treated Using Taeeumjowi-tang: a case report

  • Yeon-kyoung Pak;Sang-won Shin
    • Journal of Pharmacopuncture
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    • v.27 no.2
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    • pp.172-176
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    • 2024
  • Warts caused by the human papillomavirus (HPV) are generally treated with cryotherapy, CO2 laser ablation, interferon injections, and bleomycin injections. However, it is sometimes difficult to treat children because the treatment can be painful. In addition, recurrence may occur after treatment. In this study, warts completely disappeared following the administration of herbal medicine in two children, with warts in multiple parts of the hands and around the nails. Two pediatric patients visited the hospital for treatment of warts around their fingers and nails. Both patients received Taeeumjowi-tang (TJT) as a decoction for 60 days. TJT was performed twice per day for the 11-year-old patient and once per day for the 7-year-old patient. Patient progress was observed monthly, and the visual condition of the warts was photographed during the visits. After approximately two months of treatment, the warts disappeared from the fingers and nails of both patients. This case study suggests that the oral administration of TJT may be effective for pediatric patients with warts. Further studies are required to determine the efficacy and safety of these therapies.

Nuclear Medicine in Pediatric Urology

  • Jang, Su Jin
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.14-22
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    • 2015
  • Renal scintigraphic methods, which are physiologic and minimally invasive, have played important role in the management of various renal diseases in children, providing sensitive tool for early detection of disease even before structural changes become prominent and giving valuable functional and anatomical information to aid medical decision makings in the treatment and follow-up of patients. This review article focuses on the concept and advantages of renal scintigraphy in pediatric patients with various urologic diseases.

A Case Report Regarding a Treatment Includes Lots of Different Version of Samchulkunbi-tang (蔘朮健脾湯) to Two Pediatric Patients Diagnosed as Sik-gan (食癎) (삼출건비탕가미방(蔘出健脾湯加味方)을 이용한 식간(食癎) 환아 치험 2례에 대한 증례보고)

  • Kim, Eun Jin;Min, Sang Yoen;Kim, Jang Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.27 no.4
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    • pp.1-9
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    • 2013
  • Objectives The purpose of this study is to report the cases of two pediatric patients diagnosed as Sik-gan (食癎), a kind of epileptic seizure thought to be caused by uncontrolled consumption of food, treated by formula variation of Samchulkunbi-tang (蔘朮健脾湯). Methods Two pediatric patients diagnosed as Sik-gan (食癎) according to traditional Korean medical terms were administered by variety of Samchulkunbi-tangs (蔘朮健脾湯) while correcting unhealthy eating habit. To measure the degree of the patients' process, the number and exact symptoms of seizure events, and gastrointestinal symptoms were recorded. Results The treatment of various Samchulkunbi-tang (蔘朮健脾湯) was not only extended remission period of seizure, but also improved gastrointestinal symptoms on both of the patients. Conclusions Pediatric patients who have past medical conditions for epileptic seizure as well as unhealthy eating habits or gastrointestinal malfunctions are prone to have a specific form of seizure called the Sik-gan (食癎). In this report, we have proven that variety of Samchulkunbi-tang (蔘朮健脾湯) can considerably be effective in improving the patients' gastrointestinal symptoms and preventing recurring seizure events.