No abstract available.
Infant, Newborn ; Humans

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).
Catheters ; Child ; Eating ; Emergencies ; Endoscopes ; Endoscopy ; Esophagus ; Fluoroscopy ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Methods ; Upper Gastrointestinal Tract ; Urinary Catheterization

No abstract available.
Female ; Hepatitis B/*transmission ; Humans ; *Infectious Disease Transmission, Vertical ; *National Health Programs ; Pregnancy ; *Tertiary Care Centers

We present a case of an 8-year-old boy with visceral autonomic neuropathy complicated by Guillain-Barre syndrome. In this pediatric patient, gastroparesis was the major symptom among the autonomic symptoms. Due to the gastroparesis, there was no progress with the oral diet, and nutrition was therefore supplied through a nasojejunal tube and gastrojejunal tube via Percutaneous endoscopic gastrostomy (PEG). After tube feeding for 9 months, the patient's gastrointestinal symptoms improved and his oral ingestion increased. The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome. Then he started treatment with low-dose amitriptyline, which resulted in improvement. Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.
Amitriptyline ; Child* ; Diet ; Eating ; Enteral Nutrition ; Gastroparesis ; Gastrostomy ; Guillain-Barre Syndrome* ; Humans ; Male ; Primary Dysautonomias ; Recurrence ; Vomiting*

No abstract available.
Genetic Therapy* ; Hepatocytes* ; Liver Diseases* ; Liver*

Since the introduction of flexible fiberoptic endoscope in clinical medicine from the early 1970s, the size of the caliber has become gradually so smaller and more functional as to be available in children and even in newborn infants. And the indications of gastrointestinal endoscopy have been extended not only to the diagnosis and evaluation of gastrointestinal diseases, but also to the effective management. Foreign body removal is one of the most important indications of therapeutic endoscopy in children. We have successfully removed foreign bodies in 3 newborn infants, using flexible endascope (0; 7.9 mm) without general anesthesia. They were one Nelaton catheter and two DeLee suction catheters which had been incidentaly broken during neonatal routine care in a delivery room. In the case of DeLee suction catheter ingestion, the end of the broken plastic bulb was snared and withdrawn carefully not to injure the esophageal mucosa by its sharp edge. All of the newborn infants got well thereafter and were discharged without any complications. We could avoid the general anesthesia and laparotomy by using flexible endoscope, and these 3 therapeutic endoscopic cases of newborn infants are the youngest patients reported so far. We hereby emphasize that foreign body can be removed easily and safely with routine gastrointestinal endoscope even in newborn infants.
Anesthesia, General ; Catheters ; Child ; Clinical Medicine ; Delivery Rooms ; Diagnosis ; Eating ; Endoscopes ; Endoscopes, Gastrointestinal ; Endoscopy ; Endoscopy, Gastrointestinal ; Foreign Bodies* ; Gastrointestinal Diseases ; Humans ; Infant, Newborn* ; Laparotomy ; Mucous Membrane ; Parturition* ; Plastics ; SNARE Proteins ; Suction

Comprehensive understanding of the natural course of chronic hepatitis B virus (HBV) infection is mandatory for the management and treatment of chronic hepatitis B, of which the natural course consists of immune tolerance, immune clearance, inactive carrier state, and reactivation phase. Evidence based medical approach is essential for the management of HBV carriers and treatment of active hepatitis to decrease risks of liver cirrhosis and hepatocellular carcinoma as well as to increase survival. In addition, education of patients or their parents are required to achieve a better therapeutic outcome and to prevent unconfirmed alternative medicine and anecdotal approaches.
Carcinoma, Hepatocellular ; Carrier State ; Complementary Therapies ; Hepatitis ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Immune Tolerance ; Internet ; Korea ; Liver Cirrhosis ; Parents ; Patient Education as Topic ; Viruses

Interferon (IFN) alpha has been the first line therapy of chronic hepatitis B in children, but HBeAg seroconversion occurred in 26% of treated children compared to 11% of controls in multinational randomized controlled study. Recently, lamivudine was shown to be a potent inhibitor of Hepatitis B virus (HBV) reproduction both in HBeAg positive and in HBeAg negative (the pre-core mutant form) chronic hepatitis in randomized studies worldwide. Lamivudine therapy led to considerable improvement in the seroconversion rate of HBeAg in children with chronic hepatitis B, though long-term therapy resulted in the expansion of lamivudine-resistant mutant viruses. Combination therapy with lamivudine plus alpha-IFN does not seem to improve HBe Ag seroconversion. Above all, the most effective way to prevent hepatitis B is universal HBV vaccination.
Child* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferons ; Lamivudine ; Reproduction ; Vaccination

Iron overdose is one of the most common, potentially fatal intoxication in children. We rescued a 3-year-old girl who ingested about 20 iron tablets(110 mg/kg of elemental iron) with early endoscopic intervention. The stomach showed diffusc hemorrhagic gastritis with large amount of retained corrosive iron material. Removal of iron tablets was performed successfully by gastroscope with condom attached on its tip and she recovered completely without any sequelae. The severity of the endoscopic findings even in the early stage and the uneventful clinical recovery in our patient strongly support that this approach could be tried before traditional methods. We think that gastroscopy can be both diagnostic and therapeutic tool in acute drug intoxication in children, because of its safety and easy, rapid availability.
Child* ; Child, Preschool ; Condoms ; Female ; Gastritis ; Gastroscopes* ; Gastroscopy ; Humans ; Iron* ; Stomach ; Tablets*

Korea is now classified as an area of intermediate endemicity for hepatitis B virus (HBV), due to the implementation of universal HBV vaccination and national preventive programs for HBV infection. A national program of HBV vaccination was launched in Korea in 1988 for school-going children and was listed on a vaccination guideline in 1991. In 1995, universal vaccination for newborn infants was started for the prevention of perinatal HBV transmission. The prevalence of HBsAg among Korean middle school students has shown marked decreased from 3.2% in the late 1990s to 0.44% in 2007. HBsAg positivity in preschool children was 0.9% in 1995, decreased to 0.2% in 2007 by national prevention program of hepatitis B vertical transmission, launched in 2002. Vaccine failure rate of HBV immunoprophylaxis is 4.2% by this program. The infected children should be monitored per 6-12 months interval. Lamivudine and interferon are approved therapies for children with chronic hepatitis B in immune-clearance phase in Korea.
Child ; Child, Preschool ; Collodion ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Infant, Newborn ; Interferons ; Korea ; Lamivudine ; Prevalence ; Vaccination