Korea-nationwide incidence of pediatric deceased donors and single-institutional status of liver transplantation using pediatric donor liver grafts

Jung-Man Namgung,Shin Hwang,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Dea-Yeon Kim,Kyung Mo Kim,Seak Hee Oh,Sung Gyu Lee 대한이식학회 2020 Korean Journal of Transplantation Vol.34 No.3

Background: The present study intended to investigate the allocation status of pediatric deceased donor liver allografts. We analyzed the incidence of pediatric deceased donors in the Korean Network for Organ Sharing (KONOS) database and single-institutional status of liver transplantation (LT) using pediatric donors. Methods: We assessed the nationwide incidence of pediatric donors aged ≤15 years and conducted single-center analysis of LT using pediatric donors. Results: Between 2010 and 2019, pediatric donors aged ≤15 years accounted for 171 out of 4,395 donors (3.9%) in the KONOS database and 31 out of 640 liver donors (4.8%) in Asan Medical Center (AMC) database. In AMC, 11 (35.5%) and 20 (64.5%) grafts were allocated to pediatric recipients aged ≤15 years and adult recipients aged ≥19 years, respectively. All nine livers from donors aged ≤5 years were implanted in pediatric recipients aged ≤5 years. From 21 donors aged ≥9 years, 16 whole liver grafts and four split extended right liver grafts were implanted in 20 adult recipients and two split left lateral section grafts were implanted in two pediatric recipients. Four split liver grafts were implanted in other institutions. The overall patient survival rates at 1, 3, and 5 years were 90.9%, 80.8%, and 80.8%, respectively in pediatric-to-pediatric LT group and 69.6%, 58.4%, and 58.4%, respectively in pediatric-to-adult LT group (P=0.21). Conclusions: More than half of the pediatric donor livers were allocated to adult patients. Recipient criteria for allocation of liver allografts from pediatric donors need revision for children on pediatric LT waitlist.

Whole liver deceased donor liver transplantation for pediatric recipients: single-center experience for 20 years

남궁정만,황신,김대연,하태용,Gi-Won Song,정동환,Gil-Chun Park,김경모,오석희 대한이식학회 2020 Korean Journal of Transplantation Vol.34 No.4

Background: We investigated the incidence and outcomes of pediatric deceased donor liver transplantation (DDLT) using whole liver grafts in a high-volume liver transplantation (LT) center. Methods: The study was a retrospective single-center analysis of whole LT in pediatric recipients. The study period was set as 20 years between January 2000 and December 2019. We defined pediatric recipients and donors to be aged ≤18 years. Results: During the study period, there were 98 cases of pediatric DDLT, and 34 patients (34.7%) received whole liver grafts. The age range of the deceased donors was 3 months to 56 years and that of pediatric recipients was 7 months to 17 years. Common primary diseases for LT were biliary atresia in 13, acute liver failure in four, Wilson disease in four, congenital portal vein agenesis in three, and genetic metabolic diseases in three. Pediatric-to-pediatric and adult-to-pediatric whole LTs were 22 (64.7%) and 12 (35.3%), respectively. A good correlation was noted between the donor and the recipient’s body weight, and the recipient’s body weight and allograft’s weight. Graft and overall patient survival rates were 91.2% and 91.2% at 1 year, 88.0% and 88.0% at 3 years, and 88.0% and 88.0% at 5 years, respectively. Conclusions: The results of this study revealed that Korean Network for Organ Sharing (KONOS) regulations with donor-recipient body weight matching exhibited good performance. Considering the reciprocal trades of liver organs among pediatric and adult donors and recipients, it is necessary to establish a policy for pediatric donor liver grafts to pediatric recipients on a priority basis.

한국 소아 청소년기 림프종의 아형별 분포 및 특성

김인선,이승숙,김진만,고영혜,허주영,강창석,김철우,강윤경,고재향,김민경,김완섭,김윤정,김현정,김희경,남종희,문형배,박찬금,박태인,오영하,이동화,이종실,이주희,이혜경,임성철,장규윤,장희경,전윤경,정혜라,조민선,차희정,최석진,한재호,홍숙희 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.2

Background: The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features. Methods: All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification. Results: Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites. Conclusions: The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.

Intraoperative pediatric electroencephalography monitoring: an updated review

Yuan Ian,Bong Choon L.,Chao Jerry Y. 대한마취통증의학회 2024 Korean Journal of Anesthesiology Vol.77 No.3

Intraoperative electroencephalography (EEG) monitoring under pediatric anesthesia has begun to attract increasing interest, driven by the availability of pediatric-specific EEG monitors and the realization that traditional dosing methods based on patient movement or changes in hemodynamic response often lead to imprecise dosing, especially in younger infants who may experience adverse events (e.g., hypotension) due to excess anesthesia. EEG directly measures the effects of anesthetics on the brain, which is the target end-organ responsible for inducing loss of consciousness. Over the past ten years, research on anesthesia and computational neuroscience has improved our understanding of intraoperative pediatric EEG monitoring and expanded the utility of EEG in clinical practice. We now have better insights into neurodevelopmental changes in the developing pediatric brain, functional connectivity, the use of non-proprietary EEG parameters to guide anesthetic dosing, epileptiform EEG changes during induction, EEG changes from spinal/regional anesthesia, EEG discontinuity, and the use of EEG to improve clinical outcomes. This review article summarizes the recent literature on EEG monitoring in perioperative pediatric anesthesia, highlighting several of the topics mentioned above.

Implication of ICRP pediatric reference voxel phantoms on dose assessment of patients in radioiodine therapy

이수민,최찬수,최지원,민철희,고슬기,신방호,김찬형,염연수 한국원자력학회 2024 Nuclear Engineering and Technology Vol.56 No.6

To investigate the impact of the recently released pediatric reference voxel phantoms (0-, 1-, 5-, 10-, 15-year-old males and females) of the International Commission on Radiological Protection (ICRP) on organ dose estimates for radioactive iodine (RAI) treatment in pediatric patients, we calculated and analyzed pediatric-specific iodine- 131 S values (rT ← thyroid) for the 30 radiosensitive organs by conducting Monte Carlo simulations using the Geant4. The gender dependency in the S values was frequently seen for the 15-year-old phantoms with higher S values of female than male. In addition, the age dependency in the S values was observed for most target organs; that is, the S values tend to decrease for older ages (e.g., ~120 times for the gonads between the adult and newborn) due mainly to the inter-organ distances generally longer for older ages. Moreover, we observed that the iodine-131 S values tend to be significantly greater by up to ~145.5 times than those of the stylized phantoms that have been widely used for organ dose estimates of pediatric RAI patients. We believe that the pediatricspecific iodine-131 S values (rT ← thyroid) of the ICRP pediatric reference voxel phantoms should be beneficial to improve the dosimetry of pediatric RAI patients.

Adalimumab Treatment in Pediatric-Onset Crohn's Disease Patients after Infliximab Failure: A Single Center Study

Song, Won Jae,Kang, Ben,Choi, So Yoon,Choe, Yon Ho The Korean Society of Pediatric Gastroenterology 2016 Pediatric gastroenterology, hepatology & nutrition Vol.19 No.2

Purpose: We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn's disease patients who had failed treatment with infliximab. Methods: In this retrospective study, patients included were those who had been diagnosed with Crohn's disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adalimumab were explored. Results: Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment. Conclusion: Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn's disease patients who had failed treatment with infliximab.

소아기에 발병하는 염증성장질환(IBD)은 성인 IBD와 다른 질환인가? - 조기발병 소아 IBD의 역학적, 임상적, 유전학적 특성 및 치료 시 고려 사항-

서정기,Seo, Jeong-Kee 대한소아소화기영양학회 2011 Pediatric gastroenterology, hepatology & nutrition Vol.14 No.1

Inflammatory bowel disease (IBD) develops during childhood or adolescence in approximately 25% of patients with IBD. Recent studies on pediatric IBD have revealed that early-onset IBD has distinct phenotype differences compared to adult onset IBD. Pediatric early-onset IBD differs in many aspects including disease type, location of the lesions, disease behavior, gender preponderance and genetically attributable risks. This review examines the currently published data on the clinical, epidemiological and genetic differences between early-onset and adult-onset IBD. And finally, therapeutic considerations in the management of pediatric-onset IBD are also discussed.

Analysis of dermatologic consultation of pediatric inpatients

( Young Bin Shin ),( Chang Il Kwon ),( Jeong Won Jo ),( Yun Sun Moon ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Recently, the role of dermatologists in the treatment of skin diseases in children and adolescents is increasing. Therefore, dermatologic consultation can be important to diagnosis and treatment. Objectives: The purpose of this study is to analyze the dermatologic consultation referred by the department of pediatrics in our hospital. Methods: For this study, we reviewed the records of 40 cases with implement of clinical photograph among the patients referred for dermatologic consultation in patients admitted to pediatrics from 2017 to 2019. Results: In 40 cases, 24 (60%) patients were female and 16 (40%) patients were. There were 13 (32.5%) patients under 1 year old, followed by 11 (27.5%) in 1-5 years old, 8 (20%) in 6-10 years old, 7 (17.5%) in 11-15 years old and 1 (2.5%) in over 15 years old. Twelve (35%) patients were classified as infection related disease. Six (15%) patients were presented as neutrophilic, eosinophilic and mast cell disorders, followed by 4 (10%) as reactive erythema, 4 (10%) as dermatitis, 4 (10%) as neoplasia. The reasons for dermatologic consultations, 28 (70%) patients were represented as dermatologic disease or conditions. Conclusion: This study revealed the distribution of dermatologic disorders in patients referred by department of pediatrics. As the number of referrals for pediatrics increases in hospitals, we believe these results will improve understanding of pediatric patients and lead to proper management outcomes.

동의보감(東醫寶鑑) 소아문(小兒門) 처방(處方)에 대한 고찰(考察)

민들레,Min, Deul Le 대한한방소아과학회 2016 대한한방소아과학회지 Vol.30 No.2

Objectives The purpose of this study is to find a way to apply current oriental pediatrics treatment guidelines based on a pediatric chapter in DongEuiBoGam. Methods I learned pediatrics prescription formula, indications of drugs, dosage regimen from DongEuiBoGam, and I classified herbs that can be used for pediatrics prescriptions based on their types, effects, tempers, flavors, toxicities, and attributive channels. Results & Conclusions I learned similarities among pediatrics prescription regimens and the herbs commonly used in pediatrics. Also, I found out physiological and pathological characteristics in pediatrics. I expect that this study would be helpful for current oriental pediatric treatments.

소아청소년 심리학(Pediatric Psychology)에 기반한 소아와 청소년을 위한 건강심리학적 이슈

박진희 한국건강심리학회 2017 한국심리학회지 건강 Vol.22 No.1

'Health' has become the concern of every age and class in modern society, 'Health psychology' is no longer a discipline only for a specific group. To date, children and adolescents have not the center of attention in the clinical setting and research of health psychology. But, the stages of child and adolescents development have been an emerging subject of interest because of the importance of prevention and treatment during periods making a fundamental and long-lasting impact on the whole life. The aim of this study is to introduce the creation of Pediatric Psychology, created by the academic and clinical interest in the need for children and adolescents in health psychology. The "new marriage between Psychology and Pediatrics" (Kagan, 1965) also started the academic gestation of interdisciplinary groups such as Clinical Psychology, Child and Adolescents Clinical Developmental Psychology, Clinical Nursing, Social Work, Family Therapy, Preventive Medicine and Public Health Medicine. The Society of Pediatric Psychology, the 54th division in the American Psychological Association, was established in 2001. At last, health psychologists for children and adolescents are suggesting looking at domestic issues both now and in the future. 100세 시대를 맞아 건강심리학은 정신건강과 신체건강의 조화를 통해 인간의 건강한 삶을 지향하는 균형 잡힌 학문으로 새롭게 발전하고 있다. ‘건강’이 전 국민의 관심사가 된 현대사회에서 ‘건강심리학’은 더 이상 특정 대상만을 위한 학문이 아니다. 소아청소년은 지금까지 건강심리학의 학문적, 임상적 분야에서 중심대상이 되지 못했지만 전 생애의 건강에 미치는 소아청소년기 건강관리의 중요성이 입증되면서 새로운 관심의 대상이 되고 있다. 이러한 시점에서 본 연구는 소아청소년에 대한 건강심리학의 학문적 관심과 임상적 필요성에 의해 탄생된 소아청소년 심리학(Pediatric Psychology)을 소개하고자 한다. ‘심리학과 소아의학(소아청소년의학)의 새로운 결혼(Kagan, 1965)’으로 시작된 학문적 태동은 임상심리학과 소아청소년임상의학 뿐 아니라 발달심리학, 임상간호학, 사회복지학, 가족치료학, 예방의학과 공중보건학 등 다학제적으로 융합되어 2001년 미국심리학회의 54번째 분과학회로 자리매김하였다. 소아청소년 심리학자들은 대학병원 및 1차 진료 장면, 학교, 연구소, 지역사회 등지에서 임상활동과 연구활동, 교육(임상수련)활동을 하고 있으며 증거기반 치료 및 개입을 통해 과학적 연구와 임상 영역을 넓혀나가고 있다. 현재까지 의료장면에서 소아청소년이 경험하는 치료 불순응과 치료적 협조, 만성 질환의 관리와 치료 과정에서 겪는 스트레스의 관리, 건강 증진과 질병 예방 등과 같이 건강에 관련된 다양한 이슈들이 연구되었다. 더불어 e-Health의 연구 및 대중적 활용, 가족과 간병 보호자의 건강관리 및 지역사회기반 서비스 등의 연구가 이어지고 있다. 앞으로 소아청소년 심리학의 발전을 위해서는 소아청소년 건강을 담당하는 타 분야 보건 전문가들과의 의사소통과 협조 및 행정적 지원이 필수적이다. 마지막으로 국내 소아청소년을 위한 건강심리학자의 역할과 학문적 기틀 마련을 위한 몇 가지 대안을 제시하였다.