Pediatric vasculitis and adult vasculitis differ in several aspects. While both involve inflammation of blood vessels, pediatric vasculitis tends to present with distinct clinical features and may involve different types of blood vessels compared to adult vasculitis.Despite its relatively rare occurrence compared to adult vasculitis, pediatric vasculitis warrants careful attention due to its potential for profound and diverse clinical manifestations, ranging from mild cutaneous symptoms to life-threatening systemic complications. Childhood vasculitis should be suspected in children who present symptoms attributable to systemic inflammation and complications arising from multi-organ dysfunction. However, achieving a diagnosis necessitates thorough exclusion of alternative conditions manifesting similar symptoms and findings. Hence, children suspected of vasculitis should undergo meticulous history-taking, comprehensive physical examination, and requisite laboratory investigations, imaging studies, and sometimes tissue biopsies to elucidate the diagnosis. Early detection and treatment of childhood vasculitis are crucial, as the condition can affect various organs and potentially lead to life-threatening complications or long-term sequelae in adulthood if left untreated. This review aimed to provide an exhaustive overview of childhood vasculitis, outlining its epidemiology, classification, clinical presentation, diagnostic modalities, therapeutic strategies and outcome.

PURPOSE: As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. METHODS: Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status. RESULTS: Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%). CONCLUSION: Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children.
Child ; Child Care ; Communicable Diseases ; Surveys and Questionnaires ; Day Care, Medical ; Gastroenteritis ; Hepatitis A Vaccines ; Humans ; Immunization ; Immunization Programs ; Influenza, Human ; Otitis Media ; Pneumonia ; Rotavirus ; Vaccination ; Vaccines

PURPOSE: Human bocavirus (hBoV), a recently discovered virus, has been detected in children with respiratory tract infections worldwide. The aim of this study was to analyze the frequency and molecular phylogeny of hBoV in the respiratory samples of children with acute respiratory tract infections in 2010. METHODS: Nasopharyngeal samples were collected from 953 children with lower respiratory tract infections at Severance children's hospital in Korea from January 2010 to December 2010. We applied the multiplex PCR technique for the identification of 12 respiratory viruses from the samples. Among the total specimens, hBoV positive samples were subjected to phylogenetic analysis by sequencing a fragment of the VP1/VP2 gene junction. RESULTS: hBoV was detected in 141 (14.8%) among 953 patients. The 61.7% of hBoV-positive samples were found to co-exist with other respiratory viruses. The results of phylogenetic analysis showed that all 141 hBoV-positive isolates were identified as hBoV 1, revealing a high similarity among the isolates (>98%). CONCLUSION: hBoV 1 with minimal sequence variations circulated in children with acute respiratory infections during 2010. More research is needed to determine the clinical severity and outcomes of the minimal sequence variations.
Child ; Child, Hospitalized ; Human bocavirus ; Humans ; Korea ; Multiplex Polymerase Chain Reaction ; Phylogeny ; Respiratory System ; Respiratory Tract Infections ; Viruses

Interlocking medullary nails have been widely used in the treatment of long bone fractures especially in tibia and femur. But with increasing use of nails, many preoperative, intra-operative and post-operative complications have been reported. We have experienced 3 cases of very rare complication, fracture of tibia shaft which occurred during removal of interlocking medullary nail after complete healing of original tibial fracture. We report these rare complications with literature review.
Femur ; Fractures, Bone ; Tibia* ; Tibial Fractures

In orthopedic practice, patients sometimes ask certain kinds of medical documents certifying their disability grading. But many orthopedic surgeons are not accustomed to issue such medical certificates. So we want to review the way of evaluation and grading of disabilities for such different kinds of medical certificates(for examples: disability grading certificate for use in traffic accident, industrial accident, liability of national compensation, private insurance, the handicapped, military service and others) and compare the differences between them.
Accidents, Occupational ; Accidents, Traffic ; Compensation and Redress ; Disability Evaluation ; Disabled Persons ; Humans ; Insurance ; Military Personnel ; Orthopedics*

The aim of this review was to identify the utility of biomarkers used in the diagnosis and the monitoring and treatment of Juvenile idiopathic arthritis (JIA). JIA is a heterogeneous group of diseases characterized by arthritis of unknown etiology that lasts for at least 6 weeks, with onset before the age of 16 years. Unlike adult rheumatoid arthritis, JIA is a heterogeneous arthritis with different subtypes. The diagnosis of JIA is based on clinical evaluation and often involves ruling out other causes of arthritis.Many biomarkers have been studied or are under development to define the classifications of JIA, assess disease activity, predict disease course, treatment response, or the risk of relapse. The diagnostic and prognostic use of biomarkers in JIA could be applied differently depending on diverse subtypes or individuals. To obtain the best clinical outcomes in JIA, it is important to understand the pathophysiology of each JIA subtype and to select and use appropriate biomarkers.

The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is comprised of vaginal atresia with other variable Mullerian duct abnormalities. Its features include an absent or very short vagina and a uterus that can be absent or immaturely formed. Female with MRKH syndrome have functioning ovaries, normal external genitalia and the typical 46, XX, karyotype. MRKH syndrome is the second most common cause of primary amenorrhea, usually remains undetected until the patient presents with primary amenorrhea despite normal sexual female development. We report a case of MRKH syndrome, associated with ovarian follicular cyst, in a 14-years-old girl who visited for primary amenorrhea and sexual precosity.
Amenorrhea* ; Female ; Follicular Cyst ; Genitalia ; Humans ; Karyotype ; Ovary ; Uterus ; Vagina

PURPOSE: Childhood obesity is associated with complications such as hyperinsulinemia/insulin resistance, dyslipidemia and fatty liver. The aims of this study were to evaluate the difference of measurements between obese and normal weight children and to investigate the factors related to complications of obesity. METHODS: The body mass index (BMI), trunk and total fat percent, lipid profiles, ALT, AST, leptin, LH, FSH, fasting insulin, glucose, IGF-1, IGFBP-3 were measured in 97 children (49 obese children and 48 non-obese controls). We calculated G/I ratio, loginsuin, HOMA-IR, logHOMA-IR, and QUICKI and evaluated the relationship between each anthropometric data and metabolic data. RESULTS: Hyperinsulinemia, dyslipidemia and abnormal ALT showed high prevalence in obese children. In obese, BMI was correlated with G/I ratio (r=-0.309, P<0.05), loginsuin (r=0.381, P<0.05), logHOMA-IR (r= 0.342, P<0.05), QUICKI (r=-0.343, P<0.05), ALT (r=0.451, P<0.01)) and AST (r=0.289, P<0.05). Serum insulin level had positive correlation with BMI (r=0.345, P<0.01), serum triglyceride (r=0.332, P<0.05) and all insulin resistance indices (P<0.01). Serum leptin levels were significantly correlated with BMI (r=0.555, P<0.01), trunk (r=0.463, P<0.01)) and total (r=0.506, P<0.01) fat percent, LDL (r=0.350, P<0.05), total cholesterol (r=0.297, P<0.05). CONCLUSION: BMI is valuable for predicting insulin resistance and prevalence of abnormal ALT or AST. Monitoring of insulin level is helpful to assess the morbidities of obesity. Also, serum leptin level might be an important predictor of obesity.
Body Mass Index ; Child ; Cholesterol ; Dyslipidemias ; Fasting ; Fatty Liver ; Glucose ; Humans ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Leptin ; Obesity ; Pediatric Obesity* ; Prevalence ; Triglycerides

Tibia fractures are frequently occurred with increased traffic accident and industrial accident recently. And there are controversies in treatment of tibia fractures. From Jan. 1986 to Oct. 1988, tibial fractures of 107 cases in 105 patient, treated at the Department of Orthopedic Surgery of Dae Han Hospital, were analyzed. Results were obtained as follows. l. Of 105 patients, 85 patients were male & 20 patients were female. 2. The most common causes of fracture was traffic accident. 3. The most common level of fracture was middle one-third of tibial shaft. 4. Of 107 cases, conservative treatment was 35 cases and operative treatment in 72 cases. 5. Average union time was 16 weeks in conservative treatment & 18.5 weeks in operative treatment.
Accidents, Occupational ; Accidents, Traffic ; Female ; Humans ; Male ; Orthopedics ; Tibia ; Tibial Fractures

Neonatal lupus (NL) is a passively acquired autoimmune disease that occurs in infants born from asymptomatic mothers having anti-SSA or anti-SSB antibody. Infants with NL may show symptoms of systemic lupus erythematosus, including skin rash, congenital heart block, hepatic dysfunction, and hematological abnormalities. Mothers of the infants are asymptomatic or diagnosed with autoimmune diseases. When infants born to asymptomatic mothers who have never been diagnosed with the diseases show symptoms of NL, they may be mistaken for having infections. We report an NL case of a 47-day-old girl who presented to the emergency department with fever and skin rash.