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

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*

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

The persistence of jaundice beyond the first 2 weeks of life require further investigation and this can be determined if the conjugated bilirubin levels are greater than 1.5 mg/dL or greater than 20% of the total bilirubin level. There is a diverse differential diagnosis for the cause of neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads to liver cirrhosis if uncorrected before 60~80 days of life. Long-established initial studies include abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy, but better diagnostic methods are needed. Promising new options are described including MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde cholangiography), and PCC (percutaneous cholecysto-cholangiography). Though no single test can differentiate biliary atresia from other neonatal cholestasis with confidence, a combination of diagnostic methods is usually consistently beneficial. By excluding biliary atresia as early as possible, the risk of unnecessary explolaparotomy with intraoperative cholangiography is decreased. Further evaluation would be required for the diagnosis of neonatal cholestasis after excluding biliary atresia.
Biliary Atresia ; Bilirubin ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Diagnosis, Differential ; Hepatitis ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Liver ; Liver Cirrhosis

Obesity is a disease that decreases life span. Childhood obesity leads to the higher prevalence of obesity in adulthood, which increases the risk of metabolic syndrome. Recently, the prevalence of obesity and metabolic syndrome is rapidly increasing among children and adolescents in Korea. The percentage of affected individuals was 17.9% among 10 to 14 year-old boys at its highest or 9.7% (boys 11.3%, girls 8.0%) on average, according to KNHANES III (The Third Korea National Health and Nutrition Examination Survey, 2005) and 2005 Korean children and adolescents' growth standard program, respectively. The incidence of metabolic syndrome was 30 to 40% in obese children and adolescents in Korea. Intervention program to prevent and reduce childhood obesity on a national scale is required.
Adolescent ; Child ; Humans ; Incidence ; Korea ; Nutrition Surveys ; Obesity ; Prevalence

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*

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

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