• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.50-54
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• 2016

Regular dental visit of disabled patients is an important strategy for maintenance of oral health because of the lack of awareness of oral care. But there is limited information about follow up period in disabled patients after dental treatment. The aim of this study was to investigate the pattern of dental visit and dental management of special care needs patients according to the types of disabilities. A total of 140 patients who received dental treatment at Seoul National University Dental Hospital from 2010 to 2012 were reviewed. Patients were divided 3 groups according to the types of disabilities (disorder of external physical function, disorder of internal organ, psychic disability). Patient's characteristic, dental treatment performed, follow up period and frequency were investigated. The mean follow up period was 28.2 months and average frequency of visit was 3.69 times per year. There was no difference in period and annual visit between 3 groups, but significantly difference in cooperation with medical hospital in affiliation. Regular check-up was the most common dental treatment in all groups. In psychic disorder group, the proportion of sedative treatment was significantly higher than other groups. The results of this study provide information necessary for treatment planning and dental management of disabled patients.

• Advances in pediatric surgery
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• v.2 no.1
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• pp.8-16
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• 1996

Laparoscopic appendectomy is relatively well-established as an alternative to conventional open appendectomy by many laparoscopic surgeons. However, experience in the pediatric population remains limited. Over a period of 2 years, a total of 155 pediatric patients with acute appendicitis or complicated appendicitis were studied to compare laparoscopic and open appendectomies in childhood. Laparoscopic appendectomy was attempted in 49 patients and completed in 48 patients(98.0%). Open appendectomy was performed in 107 patients. The severity of disease, age, and male to female ratio were similar in both groups. The operation time was shorter in the laparoscopic group than open group but the difference was not significant statistically($43.7{\pm}11.3$ minutes versus $49.0{\pm}21.4$ minutes, p=0.066). In the laparoscopic group, the mean duration of surgery for the former half patients was significantly longer than for the latter half($49.6{\pm}9.2$ minutes versus $38.1{\pm}10.3$ minutes, p=0.001). The mean number of doses of analgesia required postoperatively was significantly less in patients undergoing laparoscopic appendectomy($2.4{\pm}1.8$ versus $3.3{\pm}2.5$, p=0.021). There were only 2(4.2%) wound infections after laparoscopic appendectomy compared with 10(9.3%) complications including 7 wound infections, 1 intestinal obstruction, and 2 pulmonary complications after open appendectomy, but the difference was not significant(p=0.614). Patients undergoing laparoscopic appendectomy had a shorter period of hospitalization($3.2{\pm}2.2$ days versus $6.4{\pm}1.6$ days. p=0.001). The present study suggests that laparoscopic appendectomy shortens operating time and hospital stay with diminished postoperative pain. Laparoscopic appendectomy in children offers advantages over open appendectomy as noted in adults. The authors consider laparoscopic appendectomy to be the reasonable alternative to open appendectomy in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.2
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• pp.164-172
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• 2021

Purpose: The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood. Methods: Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Results: Of the 41 patients included in the study 25 were girls (61.0%), mean age was 12.2±4.2 years. EUS was performed for biliary colic in 21 (51.2%), for recurrent pancreatitis in 12 (29.2%), for cholecystitis/cholangitis in 5 (12.2%), and for acute pancreatitis in 3 (7.4%) patients. EUS had a significant clinical effect in the decision of treatment and follow-up of 6/21 biliary colic cases, in diagnosis and follow-up of 6/12 recurrent pancreatitis cases, in decision-making and monitoring of invasive procedures (ERCP/surgery) of 3/5 acute cholecystitis/cholangitis and 2/3 of acute pancreatitis cases as well as in follow-up of the other cases. The effectiveness of EUS in determining direct treatment and invasive intervention was 43.9%. None of the patients had complications related to the EUS procedure. Conclusion: Although current guidelines show that EUS can be used in pediatric patients, this is limited to a few published studies. In this study, it is shown that EUS is a safe method for the diagnosis, follow-up and treatment of common pancreatobiliary pathologies in childhood.

• Advances in pediatric surgery
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• v.5 no.1
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• pp.58-63
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• 1999

Neuroblastoma is a solid tumor derived from neural crest cells of the sympathetic nervous system. It is the most common extracranial solid tumor in children. Although it has the highest rate of spontaneous regression, it has a bad prognosis. Recent reports indicate a much improved outcomes utilizing the multitreatment approaches and early diagnosis as a result of patient screening. We have studied 42 patients managed in the last decade at the Severance and Yongdong Severance Hospitals. The patients were followed until January 1998 and analyzed in terms of age, sex, admission period, stage, diagnostic studies, clinical symptoms, physical findings, operative time, treatment modalities, and survival rate. Twenty eight patients underwent operative procedures, 16 patients had postoperative chemotherapy, and 19 patients had preoperative chemotherapy. Sexual difference was 1.33:1 in favor of males, and 43 % of patients were under one year of age. The patients were initially diagnosed as a result of symptoms and signs. An abdominal mass was the most common clinical finding. Eighty six percent of the patients were in advanced stages (>Stage III of INSS). The 2 year survival rate was 59.2 % and the 5 year survival rate was 29.6 %.

• Child Health Nursing Research
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• v.16 no.1
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• pp.66-72
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• 2010

Purpose: This study was done to identify factors associated with fatigue in pediatric patients with cancer in order to develop nursing interventions for this population. Methods: The participants were 95 pediatric cancer patients admitted to a university medical center in Seoul, Korea, and 95 parents. The $PedsQL^{TM}$, Multidimensional Fatigue Scale developed by Varni (2002) was used to measure fatigue. Data were analyzed with the SAS program and t-test, analysis of variance (ANOVA), Pearson correlation coefficients, and multiple regression were used to identify the association of factors with fatigue. Results: The mean score for fatigue was 30.42 in the pediatric cancer patients and 34.77 in the parents. Fatigue was higher in patients living with a single parent, in patients whose father had a lower education and those patients with a fever. Pain, frequency and intensity of nausea and vomiting, depression, anxiety, and disruption of usual activity were positively associated with fatigue. The predictive factors for fatigue were disruption of usual activity, depression and living with or without parents. Conclusion: Pediatric patients with cancer experienced fatigue during their diagnosis and treatment. Of the multiple factors associated with fatigue, the association between disruption of usual activity and fatigue was the highest indicating a need to be concerned with this factor when providing interventions to alleviate fatigue.

• Clinical and Experimental Pediatrics
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• v.58 no.5
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• pp.194-198
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• 2015

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.459-473
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• 2004

Recently, many children have been treated under sedation in the department of pediatric dentistry of the dental hospital of Kangnung National University, and sedation cases are increasing gradually. So, in this study. the author analyzed and studied about the characteristics of sedated pediatric dental patients and their parents with patient chart and questionnaire at first visit, from 1999 to 2002 for the purpose of making pediatric dental treatment plan more effective and the improvement of behavior management for better pediatric dentistry. The results were follows : 1. The number of total pediatric and sedative patients increased from 1999 to 2002. 2. The sedated pediatric dental patients were younger than total pediatric dental patients(p<0.001). 3. In visit frequency per month, the sedated patients showed higher percentage on March, July, November contrast to non-sedated patients(p<0.001). 4. In parental occupation, there was a significant difference between sedated patients and non-sedated patients(p<0.001). 5. Caries treatment rather than preventive care or orthodontic treatment, was primarily composed of chief complaint of sedated patients(p<0.001). 6. The sedated patients showed worse response to previous treatment than non-sedated patients, and their parents also expected worse response contrast to non-sedated patients (p>0.001). 7. The patients who were introduced, occupied 31.2% of sedated pediatric dental patients and referral by the dentist were composed of the highest percentage(58.3%). 8. In case of uncooperative child at conventional behavior management, the parents of sedated pediatric dental patients prefered to sedation(50.9%). while the parents of non-sedated patients prefered to physical restraint(54.6%) (p<0.001).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.163-169
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• 2018

Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged between 2 and 18 years who underwent colonoscopy and esophagogastroduodenoscopy (EGD) for the first time due to the prediagnosis of IBD. In EGD, samples were taken from duodenum, antrum, corpus, and esophagus; and gastritis, duodenitis, and esophagitis were identified through histopathologic examination. The data gathered the ends of the research were compared between IBD with non-IBD groups and between CD-UC with non-IBD groups, and the presence of significant differences between groups were determined. Results: In our study, 16 patients were diagnosed with CD, 13 with UC, 3 with undeterminate colitis, and 13 with non-IBD. In the histopathological examination of the groups, GIS involvement was found in 94.1% of patients diagnosed with IBD and in 38.5% of non-IBD patients. Moreover, the difference was found to be statistically significant (p=0.032). No significant difference was found between the CD and UC groups. Gastritis was mostly observed in 93.8% of CD-diagnosed patients, 76.8% of UC-diagnosed patients, 81.2% of IBD-diagnosed patients, and 38.5% of non-IBD-diagnosed patients. On the other hand, significant differences were found between CD and non-IBD groups (p=0.03), UC and non-IBD groups (p=0.047), and IBD and non-IBD groups (p=0.03). Conclusion: The results of the study show that gastritis was highly observed in UC- and CD-diagnosed patients than in non-IBD-diagnosed patients.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.181-187
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• 2018

Background: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML. Methods: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days. Results: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was $26.8{\pm}16days$. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49). Conclusion: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.116-122
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• 2016

Purpose: We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn's disease patients who had failed treatment with infliximab. Methods: In this retrospective study, patients included were those who had been diagnosed with Crohn's disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adalimumab were explored. Results: Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment. Conclusion: Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn's disease patients who had failed treatment with infliximab.