No abstract available.
Child ; Adolescent ; Male ; Female ; Humans

PURPOSE: The role of plain, abdominal radiography in childhood constipation has not been fully evaluated. The aim of this study was to determine the accuracy and reliability of scoring systems assessing a fecal load on plain, abdominal radiographs in children with functional constipation. METHODS: Plain, abdominal radiographs from 38 constipated children and 39 control children were examined by four independent inspectors, pediatric residents. Four inspectors independently scored the radiographs according to three different scoring systems Barr, Blethyn, and Leech. No clinical information about the patients was available to the inspectors. Each abdominal radiograph was evaluated on two separate occasions, one week apart. Kappa coefficients were calculated as indicators of inter-and intra-inspector variability, coefficients < 0.20, 0.21~0.40, 0.40~0.60, 0.60, 0.61~0.80 and 0.81~1.00 were considered to indicate poor, fair, moderate, good, and very good agreement, respectively. RESULTS: The Leech score showed the highest reproducibility: the inter-inspector agreement was uniformly very good on two separate occasions (kappa values of 0.88, 0.91, 0.92, 0.86 in the first time and 0.81, 0.88, 0.89, 0.84 in the second time). Agreement using the Barr score was good (kappa values of 0.66, 0.67, 0.69, 0.66 in the first time and 0.68, 0.65, 0.71, 0.68 in the second time). However, agreement for the Blethyn score was the lowest of the three scoring systems. The Leech scoring system had the highest sensitivity and specificity compared to the Barr scoring system for the diagnosis of functional constipation by plain, abdominal radiographs. CONCLUSION: The Leech score appeared to be a more accurate and reliable method because of its high sensitivity and specificity for evaluating the fecal load on plain, abdominal radiographs in children with functional constipation. Therefore, the Leech scoring system was found to be the most useful for assessment for the degree of constipation on plain, abdominal radiographs in children.
Child ; Constipation* ; Diagnosis ; Humans ; Radiography ; Radiography, Abdominal ; Sensitivity and Specificity

Although transfusion of blood and plasma products are accepted as the principle means of transmission of HCV, other parenteral methods, such as acupuncture, tattooing needles, piercing, and surgery are possible methods of transmission of HCV. We managed a case of chronic hepatitis C acquired through ear piercing and acupuncture. A 10-year old girl presented with nausea, abdominal pain, and anorexia for 1 month. Her laboratory finding showed the following: AST/ALT, 865/1,290 IU/L; positive anti-HCV Ab; and HCV RNA. One year previously, she was treated with acupuncture for an ankle sprain and 2 years previously, she had her ears pierced. Laboratory findings of family members showed AST/ALT in the normal ranges, and negative anti-HCV Ab and HCV RNA. The pathologic findings of a liver biopsy revealed chronic hepatitis with mild lobular activity, moderate porto-periportal activity, and portal fibrosis. She was treated with pegylated interferon alpha-2a and oral ribavirin for 6 months, after which the clinical symptoms and laboratory findings improved.
Abdominal Pain ; Acupuncture ; Animals ; Ankle ; Anorexia ; Biopsy ; Body Piercing ; Ear ; Fibrosis ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Liver ; Nausea ; Needles ; Plasma ; Reference Values ; Ribavirin ; RNA ; Sprains and Strains ; Tattooing

No abstract available.
Parenteral Nutrition*

PURPOSE: The purpose of this study was to find an objective criteria to determine the position of normal anus in Korean children and to evaluate the clinical significance of anterior displacement of anus in children with constipation. METHODS: Three hundred and thirty-nine normal children and 24 children with idiopathic constipation represented the basis of this study. The position of the normal anus was defined by the anogenital index, which is the distance from the anus to the vagina or scrotum divided by the distance between the vagina or scrotum and coccyx. RESULTS: The mean anogenital index were 0.54 +/- 0.08 in normal male children, and 0.52 +/- 0.04 in male with constipation (P>0.05). The mean anogenital index were 0.43 +/- 0.08 in normal female children, and 0.42 +/- 0.07 in female with constipation (P>0.05). The anogenital index was very constant by age except for late male childhood. The anogenital index in female was significantly lower than in the male (P<0.001). There was no significant difference of the anogenital index between the normal and constipated groups. In both male and female groups with constipation, the anogenital index did not deviate from the mean, but one female patient had an anogenital index of 0.29. The ratio of the anterior displacement of the anus was 21 out of 339 (6.2%) in the normal group (SD<0.05), and 2 out of 24 (9%) in the constipated group (SD<0.05), and there was no difference (P>0.05). CONCLUSION: The anogenital index is an objective criteria to define the position of normal anus or anterior displacement of anus. There is no correlation between anterior displacement of the anus and idiopathic constipation.
Anal Canal ; Child* ; Coccyx ; Constipation* ; Female ; Humans ; Male ; Scrotum ; Vagina

No abstract available.
Chondrodysplasia Punctata*

Prevalence of obesity in Korean children and adolescents has dramatically increased since the last 10-20 years. It is important to initiate prevention efforts early in childhood because prevalence of obesity in adolescence is the strongest predictor of its prevalence in adulthood. Intrauterine life, infancy, and preschool years may comprise the critical periods that are essential for the long-term regulation of energy balance therefore, obesity-prevention strategies should be initiated in utero and continued throughout childhood and adolescence. Families with high-risk children should be provided early education about maintaining normal weight. Encouraging physical activity and, especially, avoiding inactivity, are key challenges in the prevention of future obesity. Schools should be primarily involved in educating parents to discourage their children from excessively watching TV or playing computer games and eating unhealthy snacks and food. The involvement of medical practitioners is also important, especially, in the case of obese parents, obesity prevention strategies should be promoted from the first visit of pregnant women to the physicians. Health professionals can also be involved in obesity prevention because they are ideally equipped to identify young children at risk of obesity. Community and nation-wide efforts to increase awareness and promote environments that encourage physical activity and healthy nutrition are required.
Adolescent ; Child ; Critical Period (Psychology) ; Eating ; Female ; Health Occupations ; Humans ; Motor Activity ; Obesity ; Parents ; Pregnant Women ; Prevalence ; Snacks

PURPOSE: The aim of this study was to determine how much acid exposure would occur in the proximal esophagus, both in normal and in patients with abnormal distal esophageal acid exposure. METHODS: Fourty-six patients with suspected GER were classified into two groups, 24 patients with pathological distal reflux (group II); 22 patients with normal distal reflux(group II). The ambulatory dual-probe esophageal pH monitoring was performed for 18-24hr. The abnormal reflux was defined when the percent of time that pH was below 4.0 exceeded the 95th percentile of normal value. RESULTS: The siginficant differences between distal and proximal esophageal pH recordings in group I persisted for all parameters except for the longest episode, but didn't persist in group II. At the distal esophageal site, the median percent time with pH<4.0 in group I was 19.3 and significantly higher than at proximal site. Half of patients with pathological distal reflux also had proximal acid reflux. Correlation coefficients between the distal and proximal esophageal sites in group I of the number of reflux episodes and time of the longest episode were 0.451 and 0.646 respectively. CONCLUSION: The 50 percent of patients with pathological distal acid reflux also had abnormal acid exposure in the proximal esophageal site. Therefore, we recommand simultaneous pH recordings from dual probe esophageal sites in children with gastroesophageal reflux.
Child* ; Esophageal pH Monitoring ; Esophagus ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration* ; Reference Values

PURPOSE: Recurrent abdominal pain (RAP) is common, affecting between 7% and 25% of school- aged children and young adult. This study was designed to assess the relationship between RAP and depressive trends in school-aged children. METHODS: In 1999, We surveyed 1,181 elementary school children (566 boys and 615 girls) whose ages ranged from 9 to 12 years. The degree of depression was compared between the group with RAP and normal control group without RAP according to Korean Children's Depression Inventory (CDI) of Kovacs and Beck. RESULTS: The number of the group with RAP was significantly higher in female (25.7%) than in male (18.9%). The most common site of abdominal pain was periumbilical. The mean depression score in the group with RAP was higher than that of the control group. The depression score was significantly higher in the group with RAP who has frequently pain and additional symptoms. The depression score was significantly higher in the group with RAP who prefered to play alone, did not enjoy going to school and had few friends than in the group with RAP who had a lot of friends, had active and meticulous characters. The depression scores were not significantly different according to the duration of abdominal pain, the onset time of pain, and the day of pain in the group with RAP. CONCLUSION: The depression score of the group with RAP was higher than that of normal group. So, there is relatively a specific association between childhood RAP and depression in school aged children. It is good for physicians to consider psychological support in the treatment of childhood RAP.
Abdominal Pain* ; Child* ; Depression ; Female ; Friends ; Humans ; Male ; Young Adult

An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is >l centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment.
Carbamates ; Child ; Humans ; Ibuprofen ; Organometallic Compounds ; Stomach Ulcer ; Ulcer ; Vomiting