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Case report
Remimazolam in pediatric surgery under general anesthesia: a case series
Hong-Sik Shon, Seyeon Park, Jung-Pil Yoon, Yeong Min Yoo, Jimin Lee, Da Eun Lee, Hee Young Kim
Received January 8, 2024  Accepted April 1, 2024  Published online May 9, 2024  
DOI: https://doi.org/10.7180/kmj.24.105    [Epub ahead of print]
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Abstract PDFPubReader   ePub   
Remimazolam is a promising drug for general anesthesia due to its rapid onset, short duration, and short context-sensitive half-life. However, its use in pediatric patients remains off-label, and limited prospective data have been published. Herein, we report successful anesthesia using remimazolam in pediatric patients who had a history of epilepsy or required shared airway surgery. In all cases, remimazolam provided general anesthesia, and flumazenil was used for reversal with rapid recovery. Remimazolam offers advantages for pediatric anesthesia in scenarios with a risk of seizure or shared airway surgery. However, the potential for higher bispectral index values and the risk of anaphylaxis in dextran-allergic patients necessitate caution and further research.
Review article
Safety issues regarding melatonin use in child and adolescent patients with sleep problems
Eunsoo Moon, Jung Hyun Lee
Kosin Med J. 2022;37(4):264-270.   Published online December 23, 2022
DOI: https://doi.org/10.7180/kmj.22.142
  • 2,466 View
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Abstract PDFPubReader   ePub   
Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.
Original articles
Empirical antibiotics for recurrent urinary tract infections in children
Hyun Gil Choi, Ji Young Lee, Chi Eun Oh
Kosin Med J. 2018;33(2):159-170.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.159
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Abstract PDFPubReader   ePub   
Objectives

The purpose of this study was to compare antibiotic resistance patterns between first urinary tract infection (UTI) and recurrent UTI groups and to obtain information regarding empirical antibiotic selection for treating recurrent UTI.

Methods

We retrospectively reviewed 148 children treated for UTIs from January 2009 to June 2016. The patients were divided into two groups: first UTI (N = 148) and recurrent UTI (17 patients and 20 episodes).

Results

In both groups, Escherichia coli was the most frequent causative organism, accounting for 89.9% and 75.0% in the first and recurrent UTI groups, respectively. When E. coli or Klebsiella pneumoniae was the causative organism, extended-spectrum β-lactamase (ESBL)-producing organisms were more frequent in the recurrent UTI group (17.6%) than in the first UTI group (14.0%); however, this difference was not statistically significant (P = 0.684). Cefotaxime was the most frequently used first-line empirical antibiotic in both groups. In the first UTI and recurrent UTI groups, 7.4% and 15.0% of patients were treated with intravenous antibiotics as definitive therapy, respectively (P = 0.250). Fifteen out of 17 patients having a second UTI had different causative organisms or antibiotic susceptibility patterns compared to their previous episode.

Conclusions

Escherichia coli was the most frequent causative organism in the recurrent UTI group. There were no differences in the proportion of ESBL-producing organisms between the first UTI and recurrent UTI groups. Therefore, when a UTI recurs in children, the antibiotics effective on the most common causative organism might be administered as empirical antibiotics.

Experience of Campylobacter gastroenteritis in Korean children: Single-center study
Seung Hyeon Seo, Yeoun Joo Lee, Sang Wook Mun, Jae Hong Park
Kosin Med J. 2018;33(2):150-158.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.150
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Abstract PDFPubReader   ePub   
Objectives

Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE.

Methods

Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR.

Results

Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was 10.2 ± 5.0 years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications.

Conclusions

Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.

Antibiotic resistance of Staphylococcus aureus colonized in children with staphylococcal scalded skin syndrome
Seom Gim Kong
Kosin Med J. 2018;33(1):12-19.   Published online January 21, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.1.12
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  • 1 Citations
Abstract PDFPubReader   
Objectives

Systemic antibiotic therapy with semisynthetic penicillinase-resistant penicillin or vancomycin and clindamycin are recommended for the treatment of staphylococcal scalded skin syndrome (SSSS). This study assessed the rate of antibiotic resistance of Staphylococcus aureus isolated from the anterior nares or skin of children diagnosed with SSSS.

Methods

A retrospective review of the medical records of 25 patients with SSSS between July 2010 and October 2014 was conducted. The clinical characteristics of patients were collected and the antibiotic susceptibility of S. aureus were analyzed using automated systems.

Results

The median age of the patients was 22 months (range: 2-95). Ninety-two percent of patients were less than 5 years of age. Nasal swab samples of all patients and skin swab samples of 17 patients were cultured to isolate S. aureus. Twenty-one (84%) of 25 patients were colonized with methicillin-resistant S. aureus (MRSA). The results of swab samples of the other four patients were no growth or isolation of bacteria other than S. aureus. Among 20 strains isolated from the anterior nares, 1 strain (5%) was methicillin-susceptible S. aureus. All 15 strains isolated from the skin were MRSA. All 21 strains isolated from anterior nares or skin were found to be resistant to clindamycin upon evaluation using automated systems.

Conclusions

The rates of methicillin and clindamycin resistance in S. aureus colonized in children with SSSS were very high. Further studies evaluating proper antibiotic regimens and the effectiveness of systemic antibiotic therapy are needed.

Citations

Citations to this article as recorded by  
  • Comparison of Clindamycin with Other Anti-staphylococcal Antibiotics for the Treatment of Pediatric Staphylococcal Skin-Scaled Syndrome
    Houman Hashemian, Majid Asgharzadeh, Seyed Lida Baghaei, Seyyedeh Azade Hoseini Nouri
    Archives of Pediatric Infectious Diseases.2023;[Epub]     CrossRef
High Proportion of Nervous System Disease among Major Cause of Under-Five Death in Korea; Compared with OECD 14 Nations (2005-2010)
Hyun Seok Seo, Seok Won Choi, Ji Sung Kim, Jae Yong Choi, Cheol Am Kim, Byeong Hee Son, Kyun Woo Lee, Kwang Wook Koh
Kosin Med J. 2014;29(1):37-45.   Published online December 17, 2014
DOI: https://doi.org/10.7180/kmj.2014.29.1.37
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Abstract PDFPubReader   
Abstract Objectives

To compare the mortality rate of children under ages five from different countries by their causes and to explore the cause of death that is relatively higher in South Korea and came up with measures for resolution.

Methods

The statistics were based from section ICD(International Classification of Diseases)-10 of WHO(World Health Organization) Mortality Database. Among the OECD(Organization for Economic Cooperation and Development) countries, 15 countries with higher GDP(Gross Domestic Product) than South Korea were studied by the mortality rate from 2005 to 2010 sorted into two groups: 0 year group and 1-4 years group. Then the cause of death investigated in detail.

Results

Among the 15 countries, average mortality of 0 year group in Korea ranked 8th and the average mortality of 1-4 years group ranked 4th out of 15. There were no significance in the mortality of 0 year group caused by any specific disease, but unnatural death was ranked 2nd after the United States. The natural death of 1-4 years group was ranked 6th, and the unnatural death was ranked 2nd after the Unites States. Among the natural deaths of 1-4 years group, the cause of death significantly higher was found to be disease G(nervous system disease). Among the subgroups of disease G, the orders went epilepsy, cerebral palsy, paralysis, and inflammatory disease.

Conclusions

We have identified major causes of death of children under age 5. The highest proportion of cause of death in 1-4 years group was nervous system disease and we have proposed resolution. Henceforth, this data will be used as a foundational data for formulating policies relation to the Mother-Child Health.

Case report
Traumatic Atlantoaxial Rotatory Fixation Developed in an Elderly Patient - A Case report -
Ju Ho Jeong, Dae Yong Kim
Kosin Med J. 2009;24(1):169-172.   Published online June 30, 2009
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Original article
Growth Assessment of Children and Adolescents Complaining of Short Stature
Jung Hyun Lee
Kosin Med J. 2008;23(3):42-48.   Published online September 30, 2008
  • 251 View
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Case report
A Case of Granular Cell Tumor of the Epiglottis in a Child
Jae Gyu Oh, Sun Ju Park, Tai Hyun Yu
Kosin Med J. 2008;23(3):105-107.   Published online September 30, 2008
  • 222 View
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Original article
Emotional and Behavioral Problems Based on Parent Reported Problem Checklist in Primary School Children
Soon Yoe, Yoo Rha Hong, Jae Sun Park, Yong Hwan Lee, Min Hyang Kim
Kosin Med J. 2007;22(2):71-82.   Published online December 31, 2007
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Case report
A Case of Granulocytic Sarcoma
Sook Ja Park, Jin Sook Lee, Jae Sun Park
The Journal of Kosin Medical College. 1990;6(2):177-184.
  • 196 View
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Review article
Theoretical Review for Violence in Family
Eun-Sil Kang
The Journal of Kosin Medical College. 1991;7(1):109-124.
  • 240 View
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Case report
A Case of Attention Deficit Hyperactivity Disorder in Association with Postinflammatory Hydrocephalus
JIN SOOK CHEON
The Journal of Kosin Medical College. 1992;8(2):215-224.
  • 301 View
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Review article
Recent Advance and Future Prospects in the Treatment of Childhood Acute Lymphoblastic Leukemia
Jae Sun Park
The Journal of Kosin Medical College. 1993;9(1):129-140.
  • 248 View
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Case report
Two cases of Wilson's disease developed in sisters
Jeon Kyoung Hi, Chang Youn Lee, Huh Jae Won
The Journal of Kosin Medical College. 1996;11(1-2):127-134.
  • 284 View
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KMJ : Kosin Medical Journal