• Clinical and Experimental Pediatrics
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• 제65권5호
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• pp.254-261
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• 2022

Background: The use of systemic steroids for 6+ weeks in children is associated with decreased bone mineral content (BMC) and density (BMD). However, the effects of a shorter duration of use on BMD are unknown. Purpose: To determine the effect of the use of systemic steroids for 2-6 weeks on BMD and BMC in pediatric patients. Methods: Twenty-five pediatric patients (21 with tuberculosis, 2 with systemic juvenile idiopathic arthritis, 1 with inflammatory bowel disease, 1 with autoimmune hemolytic anemia) who received systemic steroids for 2-6 weeks and 25 age- and sex-matched controls were enrolled. BMC, BMD, and z scores of the whole body (WB), lumbar spine (LS), nondominant distal radius (DR), and total body less the head (TBLH) were determined by dual-energy x-ray absorptiometry at baseline, the end of steroid therapy or 6 weeks (whichever was earlier; first follow-up), and at the end of 3 months from baseline (second follow-up) in patients and at baseline in controls. The values were adjusted for confounding variables. Continuous and categorical variables were compared using Student t test and the chi-square test or Fisher exact test, respectively. Pairwise comparisons employed Bonferroni correction. Results: Statistically significant decreases in BMC, BMD, and all z scores were observed. BMC declined by 5.37%, 2.08%, 1.82%, and 2.27%, and 11.42%, 3.75%, 3.34%, and 4.17% for WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. Similarly, BMD declined by 2.01%, 2.31%, 2.18%, and 1.70% and 4.59%, 3.76%, 3.14%, and 3.50% for the WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. A significant negative correlation was found among bone densitometric parameters, duration, and cumulative dose. Conclusion: The use of systemic steroids for 2-6 weeks in pediatric patients decreased the BMD and BMC of trabecular and cortical bones, an effect that persisted after discontinuation.

• Clinical and Experimental Pediatrics
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• 제54권4호
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• pp.141-145
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• 2011

Pertussis is an acute respiratory infection characterized by paroxysmal cough and inspiratory whoop for over 2 weeks. The incidence of pertussis has decreased markedly after the introduction of DTwP/DTaP vaccine, but the incidence of pertussis has increased steadily among young infant and among adolescents and adults in many countries. Td vaccine was used in this age group but the increase in pertussis has lead to the development of a Tdap vaccine. The Tdap vaccine is a Td vaccine with a pertussis vaccine added and is thought to decrease the incidence and transmission of pertussis in the respective age group. In Korea, two products are approved by the KOREA FOOD & DRUG ADMINISTRATION, which are ADACEL$^{TM}$ (Sanofi-Pasteur, Totonto, Ontario, Canada) and BOOSTRIX$^{(R)}$ (GlaxoSmithKline Biologicals, Rixensart, Belgium) for those aged between 11-64. This report summarizes the recommendations approved by the Committee on Infectious Diseases, the Korean Pediatric Society.

• 대한예방한의학회지
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• 제8권2호
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• pp.31-44
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• 2004

Bibliographic study on pediatric Chuna in the Myung Chung dynasties resulted as the following. 1. Pediatric Chuna experts in Myung dynasty utilized methods of Chuna to a great extense as means of preventing and treating various kinds of pediatric disorders. 2. Pediatric Chuna experts in Myung dynasty put emphasis on diagnosis through the doctor's inspection. 3. Pediatric Chuna experts in Myung dynasty developed and applied special acupoints for pediatric Chuna. 4. Pediatric Chuna experts in Myung dynasty put emphasis on replenishing and discharging according to hand manipulation. 5. Pediatric Chuna experts in Myung dynasty developed and applied methods of massaging with herbal medicine. 6. Pediatric Chuna experts in Myung dynasty put methods of Chuna into songs for handier use. 7. Pediatric Chuna experts in Chung dynasty corrected the errors of the predecessors and further developed the handed down advantages. 8. Pediatric Chuna experts in Chung dynasty specifically combined the theories of Chuna with characteristics of pediatric physiology. 9. Pediatric Chuna experts in Chung dynasty described treatments by symptoms systematically. 10. Pediatric Chuna experts in Chung dynasty, criticizing the trend at the time of despising pediatric Chuna, endeavored to spread pediatric Chuna. 11. Pediatric Chuna experts in Chung dynasty arranged the relationship between hand manipulation of Chuna and herbal medicine. 12. Pediatric Chuna experts in Chung dynasty arranged various kinds of methods for diagnosis, including diagnosis by palpation of the chest and the abdomen. 13. Pediatric Chuna experts in Chung dynasty combined the method of multiple hand manipulation and method of basic hand manipulation. 14. The theories of pediatric Chuna before Myung Chung dynasties only put emphasis on Ki and Blood, not combining with the basic principles of Korean medicine like Eum/Yang and Five Phases. The scholars of Myung Chung dynasties came to successfully combine the principles of Korean medicine like stability theory, Jang and Bu (internal organs) theory, and Eum-Yang theory with the theories of pediatric Chuna. This combination best characterizes the theories of pediatric Chuna in the Myung Chung dynasties.

• Clinical and Experimental Pediatrics
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• 제48권3호
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• pp.235-250
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• 2005

Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include : (1) normal variant stool versus diarrhea (2) infectious versus non-infectious condition and (3) bacterial versus non-bacterial etiology. The use of antibiotics should be considered to manage diarrhea caused by bacteria accompanying fever and bloody diarrhea in the following cases : (1) patients with serious clinical course, (2) under three months, (3) immunocompromised patients, (4) patients with nutritional deficiency and (5) patients presenting with moderate-to-severe dehydration. In patients presenting with the symptoms suspected to be bacterial origin, whose clinical course is not serious, antibiotic therapy is not necessary. These patients are easily manageable at OPD level. Moreover, except for some cases in which the use of antibiotics is inevitable, pediatric diarrhea can be managed by providing the suitable foods alone with no necessity of other specific drugs. Accordingly, it is crucial not so much to depend on the drugs as to provide appropriate foods including oral rehydration solution(ORS) with no further episodes of diarrhea. Special attention should be paid to the fact that younger pediatric patients will undergo nutritional deficiency unless acute diarrhea is properly managed.

• 한국임상약학회지
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• 제26권2호
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• pp.115-120
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• 2016

Background: Azithromycin has broad spectrum and is effective to treat several bacterial respiratory tract infection. It is also relatively safe and tolerable to pediatric patient. Careful use of azithromycin is also required for the prescribers because it could cause cardiovascular toxicity (QTc prolongation) and ototoxicity. There has been no study on duration of azithromycin use in pediatric patients in Korea. Methods: The outpatient sample data on the azithromycin prescription was obtained from Korean health insurance review and assessment service. The characteristics of azithromycin prescription were analyzed with two different years (2011 and 2014). Results: Total 4,215 cases were analyzed. The azithromycin was prescribed the most frequently in the children (73.2% in 2011 and 62.5% in 2014) and for the condition of bronchopneumonia (28.7% in 2011 and 21.7% in 2014) in both years. The duration of prescribed for azithromycin has significantly different between 2011 and 2014. In 2014, 94.3% of prescription were indicated less than 5 days, but 86.6% were in 2011. Acute bronchiolitis and bronchopneumonia prescriptions more longer duration of treatment compared with acute bronchitis and others. Conclusion: The pattern of prescribing azithromycin has been changed for the treatment of several infectious diseases in pediatric patients. The rate of appropriate duration of azithromycin treatment has increased.

• The Journal of Korean Physical Therapy
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• 제25권1호
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• pp.1-9
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• 2013

Purpose: This study sought to identify the utilization and confidence in assistive technology (AT) for pediatric physical therapists (PPTs) and pediatric occupational therapists (POTs) for the purpose of improving the utilization of AT in clinics. Methods: The subjects of this study were 167 therapists (98 PPTs and 69 POTs) who work at general hospitals, welfare centers, facilities for the disabled, and special education schools in Seoul and Gyeonggi province. The frequency analysis and chi-squared test were used. Results: This study found that both PPTs and POTs recognize that AT benefits infants with disabilities; however, they show low confidence in using AT. Applications of AT are concentrated on wheelchairs for mobility and assistance with seating position, with orthotics/prosthetics for both purposes. POTs were found to use a wider variety of AT devices. While both PPTs and POTs frequently select/recommend devices, both groups are less involved with delivery methods, manufacture of devices, and education on AT use. Conclusion: These findings show the actual conditions of utilization and confidence in AT of PPTs and POTs deeply involved with AT, and emphasize that AT training is essential for pediatric treatment by comparing domestic and foreign studies.

• 대한소아치과학회지
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• 제25권3호
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• pp.513-524
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• 1998

The purpose of this study was to compare the staining ratio on the enamel surface following the use of chlorhexidine mouthwash and the chlorhexidine varnish application. Labial and lingual surfaces of maxillary and mandibular incisors of adults were selected to evaluate the staining ratio. The control group was consisted of 8 individuals, the experimental group 1 and 2 were consisted of 50 each. Prophylaxis with pumice was performed to remove the stain already established on the enamel surface of all groups. The group 1 was asked to use chlorhexidine mouthwash(Hexadent, chlorhexidine gluconate 1ml/100ml) for a minute twice a day. The chlorhexidine $varnish^{(R)}$($Chlorzoin^{(R)}$, consisted of solution 1(10% chlorhexidine acetate) and solution 2(polyurethane sealant)) was applied on the enamel surfaces of the group 2. After 4 weeks of experiment, intraoral photogragh of tooth surfaces were taken in order to record the stained area on the enamel of the control and the experimental groups. Outline of teeth and the stained area in the photographs was traced on the OHP film. Scanner and computer processor were used to calculate stained surface ratio.

• Translational and Clinical Pharmacology
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• 제26권4호
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• pp.155-159
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• 2018

For regulatory approval of a new drug, the most preferred and reliable source of evidence would be randomized controlled trials (RCT). However, a great number of drugs, being developed as well as already marketed and being used, usually lack proper indications for children. It is imperative to develop properly evaluated drugs for children. And expanding the use of already approved drugs for other indications will benefit patients and the society. Nevertheless, to get an approval for expansion of indications, most often with off-label experiences, for drugs that have been approved or for the development of pediatric indications, either during or after completing the main drug development, conducting RCTs may not be the only, if not right, way to take. Extrapolation strategies and modelling & simulation for pediatric drug development are paving the road to the better approval scheme. Making the use of data sources other than RCT such as EHR and claims data in ways that improve the efficiency and validity of the results (e.g., randomized pragmatic trial and randomized registry trial) has been the topic of great interest all around the world. Regulatory authorities should adopt new methodologies for regulatory approval processes to adapt to the changes brought by increasing availability of big and real world data utilizing new tools of technological advancement.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.337-346
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• 2023

Background: This study aimed to investigate the effect of local anesthesia (LA) on postoperative pain and hemostasis after dental rehabilitation under general anesthesia (DRGA) in pediatric patients. Methods: A total of 43 patients, aged 3-7 years and rated ASA I or II, who had a definitely negative rating on Frankel's behavior rating scale, were included in this two-arm, parallel-design, single-blinded, randomized, controlled study. The patients were allocated equally into two main groups receiving both restorative treatments and tooth extractions. Two pain scales and one bleeding scale were used. In Group A, the treatment was done with LA, and in Group B, the treatment was done without LA. Results: The statistical analysis revealed no significant differences in the pain scores between the groups. It also revealed significant differences in the bleeding scores between the groups but no significant differences in the duration of bleeding. Conclusion: Within the limitations of this study, the use of LA in pediatric dental patients undergoing DRGA had no effects on postoperative pain reduction or bleeding duration after teeth extraction. We also observed that the use of LA had an impact on the reduction in the bleeding scores in pediatric dental patients undergoing DRGA.

• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.237-244
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• 2017

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.