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Correction: Clinical Features of Symptomatic Meckel's Diverticulum in Children: Comparison of Scintigraphic and Non-scintigraphic Diagnosis.

Jung Hee RHO ; Jae Sook KIM ; Sang Yong KIM ; Soon Ki KIM ; Yoon Mi CHOI ; Seong Min KIM ; Hann TCHAH ; In Sang JEON ; Dong Woo SON ; Eell RYOO ; Kang Ho CHO ; Deok Young CHOI ; Yun Mi KIM

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):135-135. doi:10.5223/pghn.2013.16.2.135

The name "Sung Min Kim" should be "Seong Min Kim" and "Yoon Mi Kim" should be "Yun Mi Kim".

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A Case of Cecal Volvulus Presenting with Chronic Constipation in Lissencephaly.

Eun Kyung LEE ; Ji Eun KIM ; Yun Young LEE ; Saeyoon KIM ; Kwang Hea CHOI

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):131-134. doi:10.5223/pghn.2013.16.2.131

Cecal volvulus is uncommon in pediatric patients and there are few reports of cecal volvulus with cerebral palsy. Here, we report the case of a 19-year-old male patient who presented with abdominal distension, a history of cerebral palsy, refractory epilepsy due to lissencephaly, and chronic constipation. An abdominal x-ray and computed tomography without contrast enhancement showed fixed dilated bowel intensity in the right lower abdomen. Despite decompression with gastric and rectal tube insertion, symptoms did not improve. The patient underwent an exploratory laparotomy that revealed cecal volvulus. Cecal volvulus usually occurs following intestinal malrotation or previous surgery. In this patient, however, intestinal distension accompanying mental disability and chronic constipation resulted in the development of cecal volvulus. We suggest that cecal and proximal large bowel volvulus should be considered in patients presenting with progressive abdominal distension combined with a history of neuro-developmental delay and constipation.
Abdomen ; Cecum ; Cerebral Palsy ; Constipation ; Decompression ; Epilepsy ; Humans ; Intestinal Volvulus ; Laparotomy ; Lissencephaly ; Male

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A Case of Rapunzel Syndrome.

Joon Sung KIM ; Chang Woo NAM

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):127-130. doi:10.5223/pghn.2013.16.2.127

Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. We describe a case of Rapunzel syndrome in an 8-year-old girl who presented with abdominal mass, epigastric pain and vomiting. Abdominal computed tomography scan showed a markedly dilated stomach filled with coarse heterogeneous materials. Upper gastrointestinal endoscopy revealed a huge hairy ball with a tail extending through the pylorus. We performed a surgical laparotomy and successfully removed a huge trichobezoar with a long tail extending into the middle portion of jejunum. Psychiatric consultation with review showed her past history of trichotillomania and trichophagia 4 years ago. But her parents denied further psychiatric therapy and she was lost to the follow-up. Rapunzel syndrome should be included in the differential diagnosis in children with chronic abdominal pain and trichophagia.
Abdominal Pain ; Bezoars ; Child ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Follow-Up Studies ; Hair ; Humans ; Jejunum ; Laparotomy ; Parents ; Pylorus ; Stomach ; Trichotillomania ; Vomiting

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Co-Infection with Cytomegalovirus and Helicobacter pylori in a Child with Menetrier's Disease.

Yangho YOO ; Yoon LEE ; Yoo Min LEE ; Yon Ho CHOE

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):123-126. doi:10.5223/pghn.2013.16.2.123

Menetrier's disease is a rare protein-losing gastropathy characterized by hypertrophic gastric fold, foveolar hyperplasia, and hypoproteinemia with resulting peripheral edema. It is clinically evident as nonspecific gastrointestinal symptoms, including abdominal discomfort, nausea and vomiting, abdominal pain, weight loss, diarrhea, and edema. Pediatric Menetrier's disease usually has an insidious onset and progressive, chronic clinical course and it spontaneously resolves in weeks or months. The pathogenesis of Menetrier's disease is not clearly understood. Menetrier's disease is thought to be associated with some gastric infections. But the cause of Menetrier's disease is unknown, an association with cytomegalovirus (CMV) and Helicobacter pylori has been suggested. In Korea, We present the first a case of pediatric Menetrier's disease with positive evidence of CMV and H. pylori.
Abdominal Pain ; Child ; Coinfection ; Cytomegalovirus ; Diarrhea ; Edema ; Gastritis, Hypertrophic ; Helicobacter ; Helicobacter pylori ; Humans ; Hyperplasia ; Hypoproteinemia ; Korea ; Nausea ; Vomiting ; Weight Loss

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Clinical Factors Affecting Lipid Metabolism and Optimal Dose of Heparin in Preterm Infants on Parenteral Nutrition.

Mi Sun LIM ; Chang Won CHOI ; Beyong Il KIM ; Hye Ran YANG

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):116-122. doi:10.5223/pghn.2013.16.2.116

PURPOSE: Preterm infants on parenteral nutrition are at a relatively high risk for hypertriglyceridemia because they have immature lipoprotein lipase activity. The purpose of this study was to analyze the clinical factors affecting lipid metabolism in preterm infants receiving parenteral nutrition and to evaluate the influence of intravenous heparin on serum triglycerides to determine the adequate heparin dose to prevent hypertriglyceridemia in preterm infants. METHODS: A single-center retrospective review was conducted among preterm infants receiving parenteral nutrition between January 2006 and February 2011. In 75 patients, 110 determinations were performed within 28 days postnatal age. Demographic and clinical data, including laboratory parameters, the dose and the duration of lipid administration, and the amount of intravenous heparin, were analyzed. RESULTS: Serum triglycerides were higher in the small for gestational age (SGA) infants than in the appropriate for gestational age infants (185.5+/-134.9 mg/dL vs. 126.9+/-101.9 mg/dL, p=0.019). Birth weight, gestational age, and body weight were negatively correlated with serum triglyceride level (r=-0.289, p=0.002; r=-0.208, p=0.029; r=-0.287, p=0.002, respectively). The serum triglyceride level was statistically lower in preterm infants receiving 1 U/mL of heparin than in those receiving 0.5 U/mL heparin or no heparin. CONCLUSION: Preterm infants receiving parenteral nutrition, particularly SGA and extremely low birth weight infants, tend to have hypertriglyceridemia. Thus, administration of 1 U/mL of heparin rather than 0.5 U/mL or none may be helpful to prevent hypertriglyceridemia in preterm infants.
Birth Weight ; Body Weight ; Gestational Age ; Heparin ; Humans ; Hypertriglyceridemia ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Lipid Metabolism ; Lipoprotein Lipase ; Parenteral Nutrition ; Retrospective Studies ; Triglycerides

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Dietary Supplements Use and Related Factors of Preschoolers in 3 Korean Cities.

Hye Sil KIM ; Hye Young LEE ; Mi Kyung KIM

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):104-115. doi:10.5223/pghn.2013.16.2.104

PURPOSE: To estimate the prevalence of dietary supplement (DS) use, investigate the related factors associated with DS use among preschoolers and support the adequate nutrition. METHODS: We conducted a questionnaire survey of mothers of children aged between 1 and 6 years who visited pediatric clinics in 3 Korean cities (Jeonju, Suncheon, Jeongeup) between October and November 2012 at Presbyterian Medical Center. The responses from 929 questionnaires were analyzed. RESULTS: Approximately 45.1% of the preschoolers used DS in the past month. The following factors were associated with greater use of DS: older age (p<0.001), whether or not the preschoolers attended kindergarten (p<0.001), higher mother's concern about the nutritional facts (p<0.001), whether or not the mother use DS (p<0.001), whether or not the mother counsel with a doctor or pharmacist about DS use (p<0.001). Vitamin.mineral supplements (77.5%) were the most commonly used DS among the preschoolers, followed by ginseng (49.3%) and probiotics (25.6%). Additionally, of the DS users, 95.9% gave DS to their healthy children. Of the users and non-users, 97.6% and 62.2%, respectively, indicated that they would like to have their children take DS. The information on DS was obtained from family or friends in 48.2% of the DS users and from doctors in only 6.1%. CONCLUSION: Approximately half of the preschoolers in our study used DS, which might not have been medically indicated for most of them. Therefore, the role of professionals in counseling on desirable diet behaviors and DS use for preschoolers is warranted.
Aged ; Child ; Counseling ; Diet ; Dietary Supplements ; Energy Intake ; Friends ; Humans ; Mothers ; Panax ; Pharmacists ; Prevalence ; Probiotics ; Protestantism ; Surveys and Questionnaires

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Is It Possible to Predict the Iron Status from an Infant's Diet History?.

Hyung Jin KIM ; Dong Hyun KIM ; Ji Eun LEE ; Young Se KWON ; Yong Hoon JUN ; Young Jin HONG ; Soon Ki KIM

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):95-103. doi:10.5223/pghn.2013.16.2.95

PURPOSE: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. METHODS: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. RESULTS: The mean score of the IDA group was 7.8+/-2.6 points, which was significantly higher than that of the control group (5.6+/-2.1) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. CONCLUSION: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.
Anemia, Iron-Deficiency ; Breast Feeding ; Child ; Diet ; Hemoglobins ; Humans ; Infant ; Iron ; Mass Screening ; Sensitivity and Specificity ; Weaning

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Increase in Aminotransferase Levels during Urinary Tract Infections in Children.

Ju Yi PARK ; Kyung Ok KO ; Jae Woo LIM ; Eun Jeong CHEON ; Jung Min YOON

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):89-94. doi:10.5223/pghn.2013.16.2.89

PURPOSE: The aim of this study was to evaluate the prevalence of increased aminotransferase levels and to identify associated factors in children admitted to hospital with urinary tract infections (UTIs). METHODS: The study included children with a diagnosis of UTI who were admitted to the Konyang University Hospital from January 2007 to May 2011. The total number of patients was 249 and the mean age was 15.88+/-28.21 months. UTI was defined as a positive urine culture (>105/colony forming unit [CFU]) with pyrexia. Patients were treated by intravenous antibiotics, such as ampicillin/sulbactam, aminoglycoside, cephalosporins or vancomycin. Patients with neonatal jaundice or other liver disease were excluded. We investigated the relationship of aminotransferase levels with the type of antibiotic, degree of vesicoureteral reflux (VUR), and causative organisms. RESULTS: Children with increased aminotransferase levels were younger than those with normal levels (p=0.001), but white blood cell count, platelet count, causative organisms, type of antibiotics and presence of VUR were not associated with aminotransferase levels. Aminotransferase levels became normal within 1 month after discharge without special measures, except in 1 case. CONCLUSION: We found that many children with UTI have abnormal aminotransferase levels. In most cases, this change is mild and self-limiting. We conclude that increased aminotransferase level increase during UTI do not require unnecessary tests and excessive treatment.
Anti-Bacterial Agents ; Cephalosporins ; Child ; Fever ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; Leukocyte Count ; Liver Diseases ; Liver Function Tests ; Platelet Count ; Prevalence ; Sepsis ; Urinary Tract ; Urinary Tract Infections ; Vancomycin ; Vesico-Ureteral Reflux

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Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B.

Suk Jin HONG ; Yeo Hyang KIM ; Byung Ho CHOE ; Hyo Jung PARK ; Won Young TAK ; Young Oh KWEON

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):80-88. doi:10.5223/pghn.2013.16.2.80

PURPOSE: To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B. METHODS: Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children (age< or =6). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels. RESULTS: HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age (age< or =6, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients (age< or =6), and with higher pretreatment ALT levels, but no significant difference. CONCLUSION: Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.
Adolescent ; Aged ; Alanine Transaminase ; Child ; Child, Preschool ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Lamivudine ; Multivariate Analysis

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Current Status and Future Promise of the Human Microbiome.

Bong Soo KIM ; Yoon Seong JEON ; Jongsik CHUN

Pediatric Gastroenterology, Hepatology & Nutrition.2013;16(2):71-79. doi:10.5223/pghn.2013.16.2.71

The human-associated microbiota is diverse, varies between individuals and body sites, and is important in human health. Microbes in human body play an essential role in immunity, health, and disease. The human microbiome has been studies using the advances of next-generation sequencing and its metagenomic applications. This has allowed investigation of the microbial composition in the human body, and identification of the functional genes expressed by this microbial community. The gut microbes have been found to be the most diverse and constitute the densest cell number in the human microbiota; thus, it has been studied more than other sites. Early results have indicated that the imbalances in gut microbiota are related to numerous disorders, such as inflammatory bowel disease, colorectal cancer, diabetes, and atopy. Clinical therapy involving modulating of the microbiota, such as fecal transplantation, has been applied, and its effects investigated in some diseases. Human microbiome studies form part of human genome projects, and understanding gleaned from studies increase the possibility of various applications including personalized medicine.
Cell Count ; Colorectal Neoplasms ; Human Body ; Human Genome Project ; Humans ; Precision Medicine ; Inflammatory Bowel Diseases ; Metagenome ; Metagenomics ; Transplants

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