Pub Date : 2009-03-01DOI: 10.5223/KJPGN.2009.12.1.79
H. Park, Byeong Sam Choi, H. Yang, J. Chang, J. Ko, C. Shin, S. Yang, J. Seo
Familial chylomicronemia syndrome is a rare disorder characterized by severe hypertriglyceridemia and fasting chylomicronemia. Causes of the syndrome include lipoprotein lipase (LPL) deficiency, apolipoprotein C-II deficiency, or the presence of inhibitors to LPL. We managed a 3-month-old girl who had recurrent acute pancreatitis caused by chylomicronemia. We report the first case of familial chylomicronemia in Korea caused by LPL deficiency in an infant with recurrent acute pancreatitis. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 79∼83)
{"title":"A Case of Lipoprotein Lipase Deficiency in an Infant with Recurrent Pancreatitis","authors":"H. Park, Byeong Sam Choi, H. Yang, J. Chang, J. Ko, C. Shin, S. Yang, J. Seo","doi":"10.5223/KJPGN.2009.12.1.79","DOIUrl":"https://doi.org/10.5223/KJPGN.2009.12.1.79","url":null,"abstract":"Familial chylomicronemia syndrome is a rare disorder characterized by severe hypertriglyceridemia and fasting chylomicronemia. Causes of the syndrome include lipoprotein lipase (LPL) deficiency, apolipoprotein C-II deficiency, or the presence of inhibitors to LPL. We managed a 3-month-old girl who had recurrent acute pancreatitis caused by chylomicronemia. We report the first case of familial chylomicronemia in Korea caused by LPL deficiency in an infant with recurrent acute pancreatitis. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 79∼83)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114536552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.160
J. Rim, J. Moon, Chul-Gab Lee, K. Moon
Purpose: This study was designed to characterize the nutritional status and assess obesity to determine the relationship between obesity and serum lipid profiles in 6 ∼ 7 year old children. Methods: In 2007, we surveyed 483 children (233 boys and 250 girls) aged 6 ∼ 7 years. The total cholesterol, triglyceride levels and HDL-cholesterol were measured in the fasting state. Dietary information was obtained by a questionnaire. Results: The prevalence of obesity was 9.9%. There was no significant difference between genders. The mean caloric intake was 1,781 kcal in boys and 1,640 kcal in girls. The prevalence of excessive calories was 33% in boys and 30% in girls. The prevalence of a total cholesterol ≥ 200 mg/dL was 8.4%, TG ≥ 130 mg/dL was 5.0%, LDL-cholesterol ≥ 130 mg/dL was 3.1%, and HDL-cholesterol <35 mg/dL was 4.4%. The prevalence of hypertension was 2.1%. There was no significant difference between genders. The systolic blood pressure, triglyceride levels and LDL-cholesterol were significantly related to an increased obesity index ( p ＜ 0.05). The mean caloric intake and nutritive component were not related to the obesity index. The obesity group was compared to the control group: for triglycerides ≥ 130 mg/dL the odds ratio was 4.08; for LDL-cholesterol ≥ 130 mg the odds ratio was 2.85; for a TC/HDL-cholesterol ≥ 4.0 the odds ratio was 1.16. The BMI and triglyceride levels in the group with hypertension were higher than control group ( p ＜ 0.05). There were significant positive correlations between the BMI and blood pressure as well as the LDL-cholesterol and triglycerides ( p ＜ 0.05). The BMI was not correlated with the mean caloric intake or nutrition.
{"title":"Serum Lipid Profile and Nutritional Status in 6~7 Year Old Obese Children","authors":"J. Rim, J. Moon, Chul-Gab Lee, K. Moon","doi":"10.5223/KJPGN.2008.11.2.160","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.160","url":null,"abstract":"Purpose: This study was designed to characterize the nutritional status and assess obesity to determine the relationship between obesity and serum lipid profiles in 6 ∼ 7 year old children. Methods: In 2007, we surveyed 483 children (233 boys and 250 girls) aged 6 ∼ 7 years. The total cholesterol, triglyceride levels and HDL-cholesterol were measured in the fasting state. Dietary information was obtained by a questionnaire. Results: The prevalence of obesity was 9.9%. There was no significant difference between genders. The mean caloric intake was 1,781 kcal in boys and 1,640 kcal in girls. The prevalence of excessive calories was 33% in boys and 30% in girls. The prevalence of a total cholesterol ≥ 200 mg/dL was 8.4%, TG ≥ 130 mg/dL was 5.0%, LDL-cholesterol ≥ 130 mg/dL was 3.1%, and HDL-cholesterol <35 mg/dL was 4.4%. The prevalence of hypertension was 2.1%. There was no significant difference between genders. The systolic blood pressure, triglyceride levels and LDL-cholesterol were significantly related to an increased obesity index ( p ＜ 0.05). The mean caloric intake and nutritive component were not related to the obesity index. The obesity group was compared to the control group: for triglycerides ≥ 130 mg/dL the odds ratio was 4.08; for LDL-cholesterol ≥ 130 mg the odds ratio was 2.85; for a TC/HDL-cholesterol ≥ 4.0 the odds ratio was 1.16. The BMI and triglyceride levels in the group with hypertension were higher than control group ( p ＜ 0.05). There were significant positive correlations between the BMI and blood pressure as well as the LDL-cholesterol and triglycerides ( p ＜ 0.05). The BMI was not correlated with the mean caloric intake or nutrition.","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114318505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.223
Curie Kim, Dong Soon Kim, H. Lee, Y. Ahn, J. Uhm
Rhododendron species is one of the largest and most diverse genera in the plant kingdom, comprising over 800 species and existing all over the globe. Grayanotoxin intoxication is caused by ingestion of honey and flowers. Grayanotoxin exists in honey, flowers, pollen, and nectar of the Rhododendron species. Grayanotoxin-intoxicated patients may present with nausea, vomiting, dizziness, weakness, hypotension, bradycardia, and syncope for several hours. We report a case of grayanotoxin intoxication associated with mental changes. A 9-year-old male presented with impaired consciousness and delirium 26 hours after eating about 10 rhododendron sclippenbachii flowers. A brain MRI and EEG were normal. Parenteral fluids were administered and these symptoms resolved completely in 17 hours. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 223∼225)
{"title":"A Case of Grayanotoxin Intoxication Presenting with Mental Changes and Vomiting","authors":"Curie Kim, Dong Soon Kim, H. Lee, Y. Ahn, J. Uhm","doi":"10.5223/KJPGN.2008.11.2.223","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.223","url":null,"abstract":"Rhododendron species is one of the largest and most diverse genera in the plant kingdom, comprising over 800 species and existing all over the globe. Grayanotoxin intoxication is caused by ingestion of honey and flowers. Grayanotoxin exists in honey, flowers, pollen, and nectar of the Rhododendron species. Grayanotoxin-intoxicated patients may present with nausea, vomiting, dizziness, weakness, hypotension, bradycardia, and syncope for several hours. We report a case of grayanotoxin intoxication associated with mental changes. A 9-year-old male presented with impaired consciousness and delirium 26 hours after eating about 10 rhododendron sclippenbachii flowers. A brain MRI and EEG were normal. Parenteral fluids were administered and these symptoms resolved completely in 17 hours. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 223∼225)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125914321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.219
Sang Yee Kim, S. Lee, H. Koh, Seung-Tae Lee, C. Ki, Jong-Won Kim, K. Chung
Crigler-Najjar syndrome is a rare inherited disease associated with unconjugated hyperbilirubinemia. It is inherited via an autosomal recessive pattern and is caused by mutation in one of the five exons of the bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (UGT1A1) gene. The synthesis of inactive isoforms of bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (B-UGT) results in unconjugated hyperbilirubinemia. A 13-year-old boy with jaundice for 4 months was admitted to our hospital. He had unconjugated hyperbilirubinemia with no evidence of infection, hemolysis, or structural abnormalities on abdominal ultrasonography or 99mTc-DISIDA scan. The authors identified a missense mutation of Tyr486Asp in the fifth exon of the UGT1A1 gene and diagnosed the patient with Crigler-Najjar syndrome type II. This is the first reported case of Crigler-Najjar syndrome in a Korean child, and it is also the first reported case of a genetic mutation leading to Crigler-Najjar syndrome in Korea. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 219∼222)
{"title":"A Case of Crigler-Najjar Syndrome Type 2 Diagnosed Using Genetic Mutation Analysis","authors":"Sang Yee Kim, S. Lee, H. Koh, Seung-Tae Lee, C. Ki, Jong-Won Kim, K. Chung","doi":"10.5223/KJPGN.2008.11.2.219","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.219","url":null,"abstract":"Crigler-Najjar syndrome is a rare inherited disease associated with unconjugated hyperbilirubinemia. It is inherited via an autosomal recessive pattern and is caused by mutation in one of the five exons of the bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (UGT1A1) gene. The synthesis of inactive isoforms of bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (B-UGT) results in unconjugated hyperbilirubinemia. A 13-year-old boy with jaundice for 4 months was admitted to our hospital. He had unconjugated hyperbilirubinemia with no evidence of infection, hemolysis, or structural abnormalities on abdominal ultrasonography or 99mTc-DISIDA scan. The authors identified a missense mutation of Tyr486Asp in the fifth exon of the UGT1A1 gene and diagnosed the patient with Crigler-Najjar syndrome type II. This is the first reported case of Crigler-Najjar syndrome in a Korean child, and it is also the first reported case of a genetic mutation leading to Crigler-Najjar syndrome in Korea. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 219∼222)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123089183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.137
G. Yeon, H. Kim, J. Park
Purpose: Interferon is a widely used treatment for chronic hepatitis B in children. However, additional treatment options are needed because more than 50% of hepatitis B patients are unresponsive to interferon. Although lamivudine is widely used to treat hepatitis B, there are few studies on the effect of lamivudine in hepatitis B patients unresponsive to interferon. Methods: Eight interferon unresponsive patients (6 males and 2 females) were treated with lamivudine (3 mg/kg/day, maximum 100 mg/day) from 6∼12 months after interferon treatment was discontinued among 33 children with chronic hepatitis B. They were treated with interferon (interferon α-2b, 10 MU/m or pegylated interferon 1.5μg/kg) for 6 months from January 2000 to December 2007 at the Pusan National University Hospital. The medical records were analyzed retrospectively. Results: The age at treatment with interferon and lamivudine was 4.9±3.1 and 6.1±3.2 years, respectively. The serum ALT level before treatment with interferon was 148.1±105.8 IU/L and the log HBV-DNA PCR mean value was 6.95±0.70 copies/mL. The serum ALT level after treatment with interferon was 143.1±90.4 IU/L and the log HBV-DNA mean PCR value was 6.46±2.08. HBeAg negativization occurred in 2 patients. For all patients, normalization of the serum ALT levels and HBeAg seroconversion (except 2 patients with HBeAg negativization) occurred at 7.4±2.1 and 7.9±2.1 months respectively after lamivudine treatment. The HBV-DNA PCR became negative in 7 patients (87.5%) at 2.4±2.8 months. Complete response was achieved in 7 patients and no recurrence was observed in 2 patients for 3 years after the completion of treatment. Five patients are still under treatment for a mean treatment duration of 24.4±9.1 months. In one patient, viral breakthrough occurred and the treatment was stopped. Conclusion: The number of patients was small, however, lamivudine treatment in patients with chronic hepatitis B who were unresponsive to interferon was highly effective. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 137∼142)
{"title":"Effect of Lamivudine Treatment on Chronic Hepatitis B Infection in Children Unresponsive to Interferon","authors":"G. Yeon, H. Kim, J. Park","doi":"10.5223/KJPGN.2008.11.2.137","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.137","url":null,"abstract":"Purpose: Interferon is a widely used treatment for chronic hepatitis B in children. However, additional treatment options are needed because more than 50% of hepatitis B patients are unresponsive to interferon. Although lamivudine is widely used to treat hepatitis B, there are few studies on the effect of lamivudine in hepatitis B patients unresponsive to interferon. Methods: Eight interferon unresponsive patients (6 males and 2 females) were treated with lamivudine (3 mg/kg/day, maximum 100 mg/day) from 6∼12 months after interferon treatment was discontinued among 33 children with chronic hepatitis B. They were treated with interferon (interferon α-2b, 10 MU/m or pegylated interferon 1.5μg/kg) for 6 months from January 2000 to December 2007 at the Pusan National University Hospital. The medical records were analyzed retrospectively. Results: The age at treatment with interferon and lamivudine was 4.9±3.1 and 6.1±3.2 years, respectively. The serum ALT level before treatment with interferon was 148.1±105.8 IU/L and the log HBV-DNA PCR mean value was 6.95±0.70 copies/mL. The serum ALT level after treatment with interferon was 143.1±90.4 IU/L and the log HBV-DNA mean PCR value was 6.46±2.08. HBeAg negativization occurred in 2 patients. For all patients, normalization of the serum ALT levels and HBeAg seroconversion (except 2 patients with HBeAg negativization) occurred at 7.4±2.1 and 7.9±2.1 months respectively after lamivudine treatment. The HBV-DNA PCR became negative in 7 patients (87.5%) at 2.4±2.8 months. Complete response was achieved in 7 patients and no recurrence was observed in 2 patients for 3 years after the completion of treatment. Five patients are still under treatment for a mean treatment duration of 24.4±9.1 months. In one patient, viral breakthrough occurred and the treatment was stopped. Conclusion: The number of patients was small, however, lamivudine treatment in patients with chronic hepatitis B who were unresponsive to interferon was highly effective. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 137∼142)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122951715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.103
Hyun jung Kwon, D. Yi, E. Ryoo, K. Cho, D. Son, Hann Tcha
목 적: 소아에서 식도염은 성인과 달리 나이별로 다양하고, 비특이적인 증상이나 징후를 보인다. 또한 식도염을 진단하기 위한 상부 위장관 내시경과 조직 생검을 시행하는 것도 쉽지 않다. 이에 본 연구에서는 소아에서 식도염의 유병률과 조직 검사의 필요성 및 위험 인자에 대해 알아보고자 하였다. 방 법: 2006년 1월부터 2007년 12월까지 가천의대 길병원 소아과에 내원하여 급만성 상복부 복통을 보인 환자들 266명을 대상으로 문진 및 신체 검사, 상부 위장관 내시경과 함께 식도 및 위 조직 생검을 시행하였다. 식도염의 진단은 조직 검사로 확진 하였으며, H. pylori 감염 여부는 CLO 검사, H&E 염색과 Giemsa 염색 혹은 요소호기검사로 확인하였다. 식도염과 관련된 위험인자 및 내시경 소견과 조직학적 소견의 관련성을 비교분석하였다. 결 과: 상부 내시경과 조직 생검을 시행 환자 266명 중 조직학적 식도염 환자는 전체 266명 중 53명(19.9%)이었으며, 남자 18명(34.0%), 여자 35명(66.0%)으로 평균 나이는 11.6 ${pm}$ 0.87세였다. 내시경 소견의 민감도는 41.5%, 특이도는 77.0%, 양성 예측도 31.0%였다. 조직학적 식도염 환자 중 역류성 식도염은 50명, 호산구성 식도염은 2명, 캔디다 감염증에 의한 식도염은 1명이었다. 모든 연령에서 복통이 가장 흔한 증상으로 나타났으며, 8세 이하 환아들에서 구토가 의미 있게 많았다(p 【Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p】
颈迹:小儿食道炎与成人不同，根据年龄表现出多种多样的非特异性的症状或征兆。另外，为诊断食道炎，进行上胃肠内视镜和组织活检也不容易。为此，本研究试图了解小儿食道炎的发病率和组织检查的必要性及危险因素。方法:2006年1月至2007年12月，到嘉泉医科大学吉医院小儿科就诊，对266名急慢性上腹部腹痛患者进行问诊及身体检查，上胃肠内窥镜及食道及胃组织活检。食道炎的诊断通过组织检查确诊，是否感染H. pylori通过CLO检查、h&e染色、Giemsa染色或尿素检查确认。比较分析食道炎相关的危险因素及内窥镜诊断与组织学诊断的关联性。结科:266名上内窥镜和组织活检患者中，组织学食道炎患者在全部266名患者中有53名(19.9%)，男性18名(34.0%)，女性35名(66.0%)，平均年龄为11.6美元(pm) 0.87美元。内窥镜诊断的敏感度为41.5%，特异度为77.0%，阳性预测为31.0%。组织学食道炎患者中，反流性食道炎有50人，湖酸组成食道炎有2人，坎迪达感染症引起的食道炎有1人。在所有年龄层中，腹痛是最常见的症状，在8岁以下的患者中，呕吐是有意义的。Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age;and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform。The aim of this study was to examine The prevalence of esophagitis in children with upper abdominal pain, to determine The necessity of esophageal biopsy, and to evaluate The associated risk factors。methods:We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007。Esophagitis was confirmed on biopsy。我们analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy。The prevalence of esophagitis was 19.9% (53/266 patients)。The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%。reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient。Vomiting was a significant factor in patients under 8 yr of age (p)
{"title":"Prevalence and Risk Factors Associated with Esophagitis in Children with Abdominal Pain","authors":"Hyun jung Kwon, D. Yi, E. Ryoo, K. Cho, D. Son, Hann Tcha","doi":"10.5223/KJPGN.2008.11.2.103","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.103","url":null,"abstract":"목 적: 소아에서 식도염은 성인과 달리 나이별로 다양하고, 비특이적인 증상이나 징후를 보인다. 또한 식도염을 진단하기 위한 상부 위장관 내시경과 조직 생검을 시행하는 것도 쉽지 않다. 이에 본 연구에서는 소아에서 식도염의 유병률과 조직 검사의 필요성 및 위험 인자에 대해 알아보고자 하였다. 방 법: 2006년 1월부터 2007년 12월까지 가천의대 길병원 소아과에 내원하여 급만성 상복부 복통을 보인 환자들 266명을 대상으로 문진 및 신체 검사, 상부 위장관 내시경과 함께 식도 및 위 조직 생검을 시행하였다. 식도염의 진단은 조직 검사로 확진 하였으며, H. pylori 감염 여부는 CLO 검사, H&E 염색과 Giemsa 염색 혹은 요소호기검사로 확인하였다. 식도염과 관련된 위험인자 및 내시경 소견과 조직학적 소견의 관련성을 비교분석하였다. 결 과: 상부 내시경과 조직 생검을 시행 환자 266명 중 조직학적 식도염 환자는 전체 266명 중 53명(19.9%)이었으며, 남자 18명(34.0%), 여자 35명(66.0%)으로 평균 나이는 11.6 ${pm}$ 0.87세였다. 내시경 소견의 민감도는 41.5%, 특이도는 77.0%, 양성 예측도 31.0%였다. 조직학적 식도염 환자 중 역류성 식도염은 50명, 호산구성 식도염은 2명, 캔디다 감염증에 의한 식도염은 1명이었다. 모든 연령에서 복통이 가장 흔한 증상으로 나타났으며, 8세 이하 환아들에서 구토가 의미 있게 많았다(p 【Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p】","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125342299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.116
Y. Han, J. Park
Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the 10 percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 116∼121)
{"title":"Clinical Features of Cricopharyngeal Incoordination in Newborns and Infants","authors":"Y. Han, J. Park","doi":"10.5223/KJPGN.2008.11.2.116","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.116","url":null,"abstract":"Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the 10 percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 116∼121)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132318865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.187
Kun-Song Lee, H. Yang, J. Ko, J. Seo, H. Lee
Most cases of mucosa-associated lymphoid tissue (MALT) lymphoma occur in adults. MALT lymphoma is very rare in children. Helicobacter pylori ( H. pylori ) infection is known to be an important etiologic factor predisposing to the development of gastric MALT lymphoma. A 12-year-old girl was admitted because of intermittent abdominal pain occurring over the preceding 2 years. Nodular gastritis of the stomach was demonstrated on endoscopy. H. pylori infection was confirmed using the rapid urease test and histopathology. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. Therefore, the patient was diagnosed with gastric MALT lymphoma. Clinical manifestations and histopathologic findings compatible with MALT lymphoma improved with the eradication of H. pylori infection. We report a case of primary gastric MALT lymphoma in a child, associated with H. pylori infection and presenting as nodular gastritis. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 187 ∼ 192)
{"title":"A Case of Gastric MALT Lymphoma Presenting as Nodular Gastritis in a Child","authors":"Kun-Song Lee, H. Yang, J. Ko, J. Seo, H. Lee","doi":"10.5223/KJPGN.2008.11.2.187","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.187","url":null,"abstract":"Most cases of mucosa-associated lymphoid tissue (MALT) lymphoma occur in adults. MALT lymphoma is very rare in children. Helicobacter pylori ( H. pylori ) infection is known to be an important etiologic factor predisposing to the development of gastric MALT lymphoma. A 12-year-old girl was admitted because of intermittent abdominal pain occurring over the preceding 2 years. Nodular gastritis of the stomach was demonstrated on endoscopy. H. pylori infection was confirmed using the rapid urease test and histopathology. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. Therefore, the patient was diagnosed with gastric MALT lymphoma. Clinical manifestations and histopathologic findings compatible with MALT lymphoma improved with the eradication of H. pylori infection. We report a case of primary gastric MALT lymphoma in a child, associated with H. pylori infection and presenting as nodular gastritis. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 187 ∼ 192)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121095781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.110
K. Ko, Y. W. Song, Bo-Kyung Je, J. Han, C. Woo, B. Choi, Jung Hwa Lee
Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3±17.2 months vs. 18.0±15.8 months, p=0.03), longer symptom duration before reduction (33.6±29.0 hr vs. 21.5±20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2∼ 5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2∼4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9∼12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1∼10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1∼0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 110∼115)
{"title":"Risk Factors for the Failure of Non-operative Reduction of Intussusceptions","authors":"K. Ko, Y. W. Song, Bo-Kyung Je, J. Han, C. Woo, B. Choi, Jung Hwa Lee","doi":"10.5223/KJPGN.2008.11.2.110","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.110","url":null,"abstract":"Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3±17.2 months vs. 18.0±15.8 months, p=0.03), longer symptom duration before reduction (33.6±29.0 hr vs. 21.5±20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2∼ 5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2∼4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9∼12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1∼10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1∼0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 110∼115)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130899258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-01DOI: 10.5223/KJPGN.2008.11.2.214
Sang Lee, Ji Eun Kim, Ji Hyuk Lee, H. Lee, Jong Seung Lee, Jee Hyun Lee, Y. Choe
Primary primitive neuroectodermal tumor (PNET) of the liver is a rare disease with aggressive behavior and poor prognosis. We report a case of a PNET of the liver in a 13-year-old boy. The patient was admitted to the hospital with fever and abdominal pain. Abdominal CT and MRI revealed a 5.5 cm sized, septated, non-enhancing mass in the hepatic hilum. The patient was initially diagnosed with an inflammatory pseudotumor. Despite 9 days of antibiotic therapy, the patient’s clinical symptoms did not improve. A liver biopsy was performed in the interest of formulating a differential diagnosis. This procedure revealed tumor cells positive for CD99 on immunohistochemistry. The patient was diagnosed with a PNET. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 214∼218)
{"title":"Primitive Neuroectodermal Tumor of the Liver in a 13-year-old Boy: A Case Report","authors":"Sang Lee, Ji Eun Kim, Ji Hyuk Lee, H. Lee, Jong Seung Lee, Jee Hyun Lee, Y. Choe","doi":"10.5223/KJPGN.2008.11.2.214","DOIUrl":"https://doi.org/10.5223/KJPGN.2008.11.2.214","url":null,"abstract":"Primary primitive neuroectodermal tumor (PNET) of the liver is a rare disease with aggressive behavior and poor prognosis. We report a case of a PNET of the liver in a 13-year-old boy. The patient was admitted to the hospital with fever and abdominal pain. Abdominal CT and MRI revealed a 5.5 cm sized, septated, non-enhancing mass in the hepatic hilum. The patient was initially diagnosed with an inflammatory pseudotumor. Despite 9 days of antibiotic therapy, the patient’s clinical symptoms did not improve. A liver biopsy was performed in the interest of formulating a differential diagnosis. This procedure revealed tumor cells positive for CD99 on immunohistochemistry. The patient was diagnosed with a PNET. (Korean J Pediatr Gastroenterol Nutr 2008; 11: 214∼218)","PeriodicalId":212346,"journal":{"name":"Korean Journal of Pediatric Gastroenterology and Nutrition","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130833634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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