PURPOSE: The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 4000 without electrolytes and lactulose, evaluating the efficacy and safety for the treatment of constipation in children. METHODS: Fifty-six children with chronic functional constipation were randomly assigned to receive polyethylene glycol 4000 (24 patients) or lactulose (32 patients). Patients or their parents reported defecation frequency, stool consistency, abdominal pain, stool incontinence and side effects after 1, 3, 6 and 12 months of treatment. Percentage of recovered patients were compared with each group. RESULTS: Defecation frequency, abdominal pain and stool incontinence were improved in each group. At 12 months of follow up, 60% of patients treated with polyethylene glycol and 57.7% of patients treated with lactulose were considered as recovered. CONCLUSION: In this study, both polyethylene glycol and lactulose were equally effective and safe in the long-term treatment of constipation in children. There were no significant differences in recovery rates between 2 groups.
Abdominal Pain ; Child* ; Constipation* ; Defecation ; Electrolytes ; Follow-Up Studies ; Humans ; Lactulose* ; Laxatives ; Parents ; Polyethylene Glycols* ; Polyethylene*

PURPOSE: In order to clarify the role of Helicobacter pylori(H. pylori) in recurrent abdominal pain, we investigated prospectively the effect of eradication of H. pylori based on symptom improvement in children with recurrent abdominal pain. METHODS: Children with recurrent abdominal pain were evaluated with diagnostic upper gastrointestinal endoscopy to rule out peptic ulcer disease, etc. During endoscopy, biopsies were taken and sent for CLO test and histologic evaluation with H-E stain and Alcian-Yellow stain. Twenty four out of 28 H. pylori infected children didn't have peptic ulcer disease. They underwent triple therapy with bismuth subcitrate, amoxicillin and clarithromycin. Four weeks after the end of the therapy, patients were evaluated with regard to their symptoms. RESULTS: In patients with H. pylori eradication, the mean total symptom score decreased significantly at four weeks' follow-up after the treatment(9.1+/-3.6 vs. 1.4+/-1.5; P<0.001). The frequency of abdominal pain per week also decreased significantly from 26.0+/-21.1 times/week to 1.4+/-1.5 times/ week after eradication of H. pylori(P<0.001). Age, duration of symptom and endoscopic findings did not prove to be positive predictive factors of significant improvement of symptoms after H. pylori eradication. CONCLUSION: We strongly recommend looking for H. pylori infection in children complaining of recurrent abdominal pain. Eradication of this organism will effectively and significantly reduce the extent of symptoms associated with recurrent abdominal pain.
Abdominal Pain* ; Amoxicillin ; Biopsy ; Bismuth ; Child* ; Clarithromycin ; Endoscopy ; Endoscopy, Gastrointestinal ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Prospective Studies ; Upper Gastrointestinal Tract

PURPOSE: The aim of this study was to document the causes of chronic abdominal pain in children referred to a hospital setting and evaluate the frequency and characteristics of functional gastrointestinal disorder (FGID) classified by Rome III criteria. METHODS: One hundred thirty two patients with chronic abdominal pain were evaluated. Examinations were performed in order to find organic causes in patients when organic disease was suspected. RESULTS: Among the 132 patients, 20 patients (15.2%) had organic diseases and 112 patients (84.8%) were diagnosed as having FGIDs. Functional dyspepsia was the most common cause of FGIDs, followed by irritable bowel syndrome. Overlap of some FGIDs was observed in seven patients (5.3%). CONCLUSION: FGIDs are the main causes of chronic abdominal pain in children and functional dyspepsia was the most prevalent disorder.
Abdominal Pain* ; Child* ; Dyspepsia ; Gastrointestinal Diseases* ; Humans ; Irritable Bowel Syndrome

Childhood functional gastrointestinal disorders are defined as a variable combination of often age-dependent, chronic, or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. A better understanding of genetic background of these disorders would help to better identify their complex biology and make it possible to identify subgroups of patients who respond to customized therapies. Family and twin studies have shown a genetic component in irritable bowel syndrome. Candidate gene studies have identified a few genetic polymorphisms that may be associated with functional dyspepsia and irritable bowel syndrome. Studies of associations of spontaneous genetic variations and altered functions may provide novel insights of the mechanisms contributing to the disease.
Biology ; Dyspepsia ; Gastrointestinal Diseases ; Genetic Variation ; Humans ; Irritable Bowel Syndrome ; Polymorphism, Genetic

PURPOSE: This study was done to identify the retention effects of a basic life support training program for nursing students on their attitude, knowledge, and skillfulness. METHODS: A one-group repeated posttest design was employed for this study. The subjects included 44 junior nursing students from Gachon University in Incheon. Data were collected by a structured questionnaire test immediately after, 3 months after, 6 months after, and 9 months after the training respectively from May 2014 through March 2015. RESULTS: The respective attitude, knowledge and skillfulness score on BLS of the nursing students had reduced significantly at 3 months after (p<.001), 6 months after (p<.001), and 9 months after (p<.001, p=.011 for Attitudes) the training compared to immediately after the training. CONCLUSION: Re-training on basic life support for nursing students should be implemented within 3 months for retention of educational effects. Thus, it is recommended that basic life support training programs, including a curriculum for nursing students, is developed to support re-training. And it is expected that the improved skills of nursing students on basic life support would contribute to the successive first aid nursing for patients at risk of cardiac arrest.
Cardiopulmonary Resuscitation ; Curriculum ; Education* ; First Aid ; Heart Arrest ; Humans ; Incheon ; Nursing* ; Students, Nursing*

PURPOSE: Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. METHODS: From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. RESULTS: A total of 70 patients, consisting of 31 males and 39 females, with a mean age of 2.6+/-3.3 years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. CONCLUSION: MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.
Biliary Atresia ; Biopsy ; Child* ; Cholangitis, Sclerosing ; Choledochal Cyst ; Cholestasis ; Diagnosis ; Female ; Hepatitis ; Humans ; Jaundice, Obstructive ; Liver Cirrhosis, Biliary ; Male ; Pancreatitis ; Sensitivity and Specificity ; Ultrasonography

Anisakiasis is a accidental parasitic infection caused by nematode larvae belonging to the subfamily Anisakinae when a raw or inadequately cooked fish is ingested. The common clinical symptoms are severe colicky abdominal pain or epigastric full sensation, nausea, vomiting and fever, but hematemesis or melena is very rare. We report a case of a 11-year-old female child who developed severe epigastric pain recurrently for 2 months, and recalled that she had eaten the raw flesh of an Astroconger myriaster. Endoscopic examination showed the whitish worm invading the stomach wall. Clinical symptoms disappeared after endoscopic removal. This study may be the first pediatric case of gastric anisakiasis in korea.
Abdominal Pain* ; Anisakiasis* ; Child* ; Female ; Fever ; Hematemesis ; Humans ; Korea ; Larva ; Melena ; Nausea ; Sensation ; Stomach ; Vomiting

BACKGROUND/AIMS: Many candidate gene studies have revealed that polymorphisms of the 5'-flanking controlled SERT gene linked polymorphic region (5HTT-LPR) gene and G-protein beta3 C825T gene might be associated with functional dyspepsia (FD) and irritable bowel syndrome (IBS). This study was performed to investigate polymorphisms of the 5HTT-LPR gene and G-protein beta3 C825T gene in FD and IBS in Korean children. METHODS: In total, 102 patients with FD, 72 patients with IBS based on the Rome III criteria and 148 healthy controls without gastrointestinal symptoms were included in the study to analyze 5HTT-LPR and G-protein beta3 C825T polymorphisms. RESULTS: 5HTT-LPR genotype analysis revealed no signifi cant differences in FD and IBS patients compared with controls. The GNbeta3 C825T genotype distribution for CC, CT, and TT was 23.6%, 53.4%, and 23.0% in controls, 36.3%, 38.2%, and 25.5% in FD and 37.5%, 38.9%, and 23.6% in IBS, respectively. The CC genotype was more common in FD and IBS patients than controls (p<0.05). When the IBS patients were grouped according to IBS subtypes, CC genotype GNbeta3 C825T was common in diarrhea-dominant IBS, and the TT genotype was common in constipation-dominant IBS (p<0.05). CONCLUSIONS: The CC genotype of G-protein beta3 C825T may be associated with FD and diarrhea-predominant IBS. The TT genotype may be associated with constipation-predominant IBS.
Child ; Dyspepsia ; Genotype ; GTP-Binding Proteins ; Heterotrimeric GTP-Binding Proteins ; Humans ; Irritable Bowel Syndrome ; Rome ; Serotonin ; Serotonin Plasma Membrane Transport Proteins

PURPOSE: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. METHODS: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. RESULTS: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (kappa=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. CONCLUSION: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.
Abdominal Pain ; Adolescent ; Child ; Dyspepsia ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Parents ; Rome

PURPOSE: Recently, vitamin D insufficiency has increased and has been correlated to growth and puberty in children. This study was conducted to find the prevalence of subclinical vitamin D insufficiency and its influence on school-aged children in Korea. METHODS: The subjects of this study were 397 children aged 7 to 15 years who had been tested for 25-OH vitamin D3 among the outpatients of the Department of Pediatrics in Eulji General Hospital from March 2007 to February 2011. Data for age, sex, comorbidities, serum 25-OH vitamin D3, height, weight, body mass index (BMI), and sunlight exposure time were collected before and after 3 months of vitamin D administration, retrospectively. RESULTS: Vitamin D insufficiency was present in 343 (86%) of the subjects. In the vitamin D insufficient group, chronological age was 8.96+/-1.72 years, mean height (z-score [z]) was 0.51+/-1.26, mean BMI (z) was 0.81+/-2.20, and bone age was 10.26+/-1.75 years. In the vitamin D sufficient group, chronological age was 9.61+/-1.77 years, mean height (z) was-0.66+/-0.98, mean BMI (z) was-0.01+/-1.16, and bone age was 9.44+/-2.12 years. A paired t-test showed that three months after vitamin D administration, the mean 25-OH vitamin D3 level in the insufficient group increased to 24.38 +/-10.03 ng/mL and mean BMI (z) decreased to 0.67+/-1.06. CONCLUSION: In Korean school-aged children, vitamin D insufficiency were relatively higher and may be closely related with higher BMI. Insufficient rise of the level of vitamin D after supplementation suggest the new supplementation guidelines, especially for Korean children.
Adolescent ; Body Mass Index ; Body Weight ; Child* ; Cholecalciferol ; Comorbidity ; Hospitals, General ; Humans ; Korea ; Outpatients ; Pediatrics ; Prevalence ; Puberty ; Retrospective Studies ; Sunlight ; Vitamin D* ; Vitamins*