PURPOSE:Insuline-like growth factor I(IGF-I) is polypeptide mitogen and mediate growth effect of growth hormone(GH). It's serum level is regulated by GH. The aim of this study is to evaluate whether -2 standard deviation of IGF-I level in normal short stature after insuline and L-dopa stimulation test has any diagnostic significance in GH deficiency. METHOD:We included 64 children with GH deficiency(complete GH deiciency 18 cases, partial GH deficiency 46 cases). Their height was below 10 percentile of korean children's standard growth chart. Control group was 175 children whose test results were normal after insuline and L-dopa stimulation test. Serum growth hormone level was measured by IRMA(immunoradiometric assay) with "Daiichi" kit(Japan) and serum IGF-I level was measured with 125I RIA kit (U.S.A). RESULTS: 1)Serum IGF-I level in normal stimulation test result group was increased with the age and the level was higher in female than that of male. 2)Using the cut-off value of -2SD of IGF-I level in control group, sensitivity was 17.2%, specificity was 98.86%, positive predictive value was 84.62%, negative predictive value was 76.55%, and test accuracy was 76.99%. Sensitivity and test accuracy was 44.44% and 93.26% in th complete GH deficiency, respectively. 3)Serum IGF-I level was significantly correlated with peak GH level with insuline stimulation test in control and GH deficiency group(Y=0.018889X+11.32 r= 0.23930 P=0.0014, Y=0.008592X+4.189 r=0.28141 P=0.0267). But serum IGF-I level was was not correlated with peak GH level with L-dopa stimulation test(Y= 0.005609X+13.88 r=0.06625 P=0.3823, Y=0.008293X+2.98 r=0.20895 P=0.1031). CONCLUSION: Serum IGF-I level in GH deficiency group was lower than that of control group and had wide variation of normal range. Based upon above results IGF-I level has limited clinical value in the diagnosis of GH deficiency.
Child ; Diagnosis ; Female ; Growth Charts ; Growth Hormone* ; Humans ; Insulin ; Insulin-Like Growth Factor I* ; Levodopa ; Male ; Reference Values ; Sensitivity and Specificity

PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

PURPOSE: A febrile convulsion is a common event during childhood, its pathogenesis is not clear. But there are some hypotheses including electrolyte imbalance, neurotransmitter and metabolic change. Hyponatremia has been thought to decrease the threshold for febrile convulsion and low cerebrospinal zinc level induced by fever or infections causes low cerebrospinal gamma-aminobutyric acid(GABA) which is a major inhibitory neurotransmitter. We therefore carried out a prospective study to investigate whether there is an association with serum sodium levels, CSF zinc concentration and febrile convulsions. METHODS: Blood and CSF samples for sodium and zinc were taken from 37 children at Pusan Saint Benedict Hospital due to febrile illness from March 1998 to December 1998. They were divided into three groups: 11 with fever but without convulsions(Group I), 15 with aseptic(viral) meningitis(Group II), and 11 with febrile convulsions(Group III). The results were analyzed by Wilcoxon 2 Sample Test. RESULTS: The means of serum sodium, Zn level and CSF Na, Zn level in the febrile convulsion group were not significantly lower than in other groups(for serum Na : group I 143.09+/-2.84mmol/L, group II 141.60+/-2.49mmol/L, group III 142.54+/-1.80mmol/L; for CSF Na : group I 138.72+/-5.53mmol/L, group II 139.64+/-4.64mmol/L, group III 138.82+/-2.25mmol/L; for serum Zn : group I 90.38+/-9.09micro gram/L, group II 90.28+/-13.64micro gram/L, group III 97.16+/-14.54micro gram/L; for CSF Zn : group I 41.61+/-13.30micro gram/L, group II 45.80+/-12.66micro gram/L, group III 41.04+/-11.17micro gram/L). There was no statistically significant difference in serum sodium and CSF zinc between the three groups of children. CONCLUSION: There is no evidence in this study, that hyponatremia may increase the susceptability to febrile convulsion or that zinc deprivation may play a role in the pathogenesis of febrile convulsion in previous study. So, more study of pathophysiology of febrile convulsion is needed.
Busan ; Child ; Fever ; Humans ; Hyponatremia ; Neurotransmitter Agents ; Prospective Studies ; Saints ; Seizures, Febrile* ; Sodium* ; Zinc*

PURPOSE: Hepatitis B virus(HBV) with various mutations has been reported. The aims of this study were to investigate the frequency and manifestation of HBV pre-S/S mutations in children with chronic hepatitis B infection. METHODS: Sera from 17 children with chronic hepatitis B infection were analyzed by direct sequencing of polymerase chain reaction amplification of HBV DNA. Results: Seventeen cases of adr type were analyzed. The deletions in HBV pre-S region were observed in 3(17.6%) of 17 cases. Of 3 deleted cases, 2 had an in-phase deletion in the pre-S1 region spanning 18 bp. Another case had a 18 bp and 3 bp deletions in the pre-S1 region. Many point mutations in HBV pre-S region were detected in all cases and these mutations were observed more frequently in the pre-S2 region than the pre-S1 region. Six point mutations in the pre-S1 region were observed. Eight point mutations in pre-S2 region were observed. Point mutations in the S region were detected in 14(82.4%) of 17 cases. Among these, mutations of the "a" determinant were detected in 4(23.5%) of 17 cases. Mutations at codon 130 and at codon 146 were noted in 2 cases. Combined mutations at codon 124, 126, 146 and at 130, 131, 136, 146 were noted in the other 2 cases. Mutations except "a" determinant region included at codon 3, 29, 73, 120, 184, 214, 226, 227. CONCLUSION: These observations suggest that deletion and point mutations in HBV pre-S1, pre- S2 regions and point mutations in HBV S region are frequent in the children with chronic hepatitis B infection.
Child* ; Codon ; DNA ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Point Mutation ; Polymerase Chain Reaction

PURPOSE: The aim of the present study was to investigate the effect of single dose imipramine on nocturnal urine output in patients with nocturnal enuresis. METHODS:A total of 6 monosymptomatic enuretic patients of more than 5 years of age were enrolled in this study. We measured nocturnal urine output, urine osrnolality, creatinine clearance, osmolal clearance, excretion rate of solutes, fractional excretion of sodium and potassium, and plasma vasopressin with and without a single oral dose of imipramine(lmg/kg of body weight) at 8 p.m. RESULTS: The administration of imipramine was followed by a significant decrease in noctumal urine output(P=0.02). Urine osmolality was not significantly increased(P>0.05), but osmolal clearance was significantly decreased during imipramine medication(P=0.03). Urinary excretion rate of sodium and potassium showed a statistically insignificant trend toward lower values during imipramine administration in nocturnal enuretics. Fractional urinary excretion of sodium and potassium was significantly decreased during imipramine medication(P<0.05). There was no significant difference in plasma vasopressin level and creatinine clearance in nocturnal enuretics after imipramine. CONCLUSION: Imipramine has a vasopressin independent antidiuretic effect in patients with nocturnal enuresis. The antidiuretic effect of imipramine can be attributed prirnarily to increased a-adrenergic stimulation in the proximal tubules with secondary increased urea and water reabsorption more distally in the nephron. (J Korean Pediatr Soc 2000;43:792 - 797)
Antidiuretic Agents ; Creatinine ; Enuresis ; Humans ; Imipramine* ; Nephrons ; Nocturnal Enuresis* ; Osmolar Concentration ; Plasma ; Potassium ; Sodium ; Urea ; Vasopressins

PURPOSE: Osteoporosis and growth failure have been known one of the serious side effects of corticosteroid therapy especially in children. This study was designed to evaluate the effect of long-term administration of steroids on bone mineral density(BMD) in children with nephrotic syndrome and its relationship to cumulative steroid dose, the duration of therapy and sex. Meathods : The BMD of the spine and arm were measured by dual energy x-ray absorptiometry in 24 children with biopsy-proven minimal change nephrotic syndrome who have been revealed steroid dependent and/or frequent relapse in its clinical course and in age- and sex-matched healthy controls. The mean duration of steroid therapy was 37+/-29.8 months and the mean cumulative steroid doses was 12.8+/-7.7g/m2. RESULTS: 1) The BMD at arm was 0.57+/-0.06g/cm2 in patient group and 0.59+/- 0.06g/cm2 in control group. The BMD at spine was 0.68+/-0.1g/cm2 in patient group and 0.76+/-0.1g/ cm2 in control group. Compared with control group significant decrease in BMD was detected in patient group at arm(p=0.011) and spine(p<0.01). The bone loss at spine and arm was -10.6+/-7.44% and -3.7+/-5.5%, respectively. The bone loss was more prominant at spine(p<0.01). 2) Bone loss at arm was significantly correlated to the total cumulative dose of steroid(Y=-0.0029-0.294X, r=-0.4148, p=0.0434), but was not correlated to the duration of steroid(Y=-2.15-0.04X, r=0.1396, p=0.4619). At spine, there were no significant correlation between bone loss and the cumulative steroid doses(Y=-8.47-0.178X, r=-0.19397, p=0.363) and the duration of steroid therapy (Y=-9.75-0.025X, r=0.09081, p=0.6332). CONCLUSIONS: The long-term use of steroid can induce significant bone loss at the both site of arm and spine. To minimize the extent of corticosteroid-induced bone loss, BMD measurement using dual energy x-ray absorptiometry in children with nephrotic syndrome would be helpful.
Absorptiometry, Photon ; Arm ; Bone Density* ; Child* ; Humans ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Osteoporosis ; Recurrence ; Spine ; Steroids

The authors retrospectively reviewed the high resolution computed tomographic scans of 19 patients who had hematogenous or lymphangitic metastatic lung lesions. In all patients, the histologic diagnosis for primary cancers and the radiographic manifestations of pulmonary metastasis were established. Certain characteristic findings of metastatic lung tumors on HRCT scans were evident: uneven thickening of bronchovascular bundles, multiple small nodules, thickening of interlobular septum, and the presence of polygonal lines. The nodules are more predominent in hematogenous metastasis. The prevalent site of nodules is cortical portion of lung.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies

PURPOSE: The respiratory tract infections including pneumonia have been the major contributing factor for bronchial asthma, and are frequently involved in hospitalization due to asthma attack. We studied clinical characteristics of hospitalized cases due to asthma attack with and without pneumonic infiltrates. METHODS: Over 5 years between January 1993 and December 1997, 628 patients were hospitalized due to asthma attack. 315 of them had pneumonic infiltrates on chest X-ray (defined as pneumonia group) and 197 patients had no pneumonic infiltrates (uncomplicated group). The clinical characteristics of both groups were reviewed retrospectively. RESULTS: The age on admission and first attack in pneumonia group were significantly younger than those of uncomplicated group (P<0.05). The incidence of male was higher than that of female in both groups. The interval from attack to admission and duration of hospitalization were much longer in pneumonia group (P<0.05). The bronchial asthma attack was most frequently occurred between September and November. The atopy-perennial type was predominant in the both groups, and the incidence of non-atopy type was higher in the pneumonia group. The mild asthma attack was predominant in the pneumonia group and moderate one was predominant in the uncomplicated group. The incidence of fever and inflammatory reaction (peripheral blood WBC count, serum CRP level) were higher in the pneumonia group (P<0.05). There was no significant difference in the serum IgE level between two groups. CONCLUSION: Frequency and duration of hospitalization due to asthma attack might be lessened by prevention against respiratory tract infection.
Asthma* ; Female ; Fever ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Male ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Thorax

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.
Adolescent ; Animals ; Child ; Fever ; Humans ; Infant ; Influenza, Human ; Orthomyxoviridae ; Oseltamivir ; Pediatrics ; Rats ; Virus Shedding

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.