Values of Lung CT in Children with a Vague History of Aspiration / 소아과

PURPOSE: The purpose of this study was to investigate the diagnostic value of spiral computed tomography (CT) using contiguous slices with partially thin sections around the hilar level in the bronchial foreign bodies of children with a vague history of aspiration. METHODS: Fourteen children were identified to be examined with spiral CT due to obscure histories of aspiration episodes. A retrospective analysis of the medical records provided information concerning the clinical and radiological findings. RESULTS: Of the 14 patients examined with spiral CT, there were no significant differences among the clinical and initial radiological findings with the exception of gender distribution. However, the spiral CT scans allowed accurate discrimination among patients with a vague history of aspiration episodes, in which seven were identified with bronchial foreign body aspiration and seven with bronchiolitis, asthma, tracheobronchitis and/or pneumonia. CONCLUSION: We found that spiral CT using contiguous slices with partially thin sections around the hilar level are a useful non-invasive method in the early diagnosis of bronchial foreign bodies in children with a vague history of aspiration.

Clinical Analysis of Intussusception Delayed in the Final Diagnosis / 대한소아소화기영양학회지

PURPOSE: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. METHODS: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. RESULTS: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. CONCLUSION: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.

Cause and Prognosis of Pediatric Acute Respiratory Failure by Intrapulmonary Lesion / 소아과

PURPOSE: Respiratory failure arises from derangements in pulmonary gas exchange. The causes may be classified as due to either lung disease or respiratory pump dysfunction. Problems with lung mechanics is an important cause of acute respiratory failure in children clinically. The aims of this study were to survey the cause and prognosis of children diagnosed with acute respiratory failure by intrapulmonary lesion. METHODS: We performed a retrospective study of 52 children(M:F=31:21) diagnosed with acute respiratory failure by intrapulmonary lesion in Gyeongsang National University Hospital from January, 1989 to July, 2003. The age distribution was from 0.1 to 12 years old(2.6+/-3.3 yr). RESULTS: The causes of acute respiratory failure were bronchiolitis and infectious pneumonia(24 cases, 46.1%), acute respiratory distress syndrome(14 cases, 26.9%), near drowning(seven cases, 13.5%), aspiration pneumonia(three cases, 5.8%), sepsis with intrapulmonary lesion(three cases, 5.8%) and croup(one case, 1.9%). The underlying diseases of acute respiratory distress syndrome were aspiration pneumonia(four cases, 28.6%), near drowning(three cases, 21.4%), pneumonia(three cases, 21.4%), sepsis with pneumonia(two cases, 14.3%), and shock(two cases, 14.3%). The survival rate of all subjects was 67.3%. The survival rate of underlying diseases were:83.3% in cases of bronchiolitis and infectious pneumonia, 57.1% in near drowning, 42.8% in acute respiratory distress syndrome, 33.3% in sepsis, and 100% in aspiration pneumonia and croup. CONCLUSION: The major cause of acute respiratory failure by intrapulmonary lesion in children was respiratory infection. And acute respiratory distress syndrome and sepsis with intrapulmonary lesion had relatively poor prognoses, thus active and prompt intervention is important in these conditions.

A Case of Actinomycotic Thyroiditis in a Child with Fourth Branchial Cleft Fistula / 소아과

Fistulas of the fourth branchial pouch have an external opening in the neck and the inner opening at the apex of the pyriform fossa. The tract passes from the left lobe of the thyroid, resulting in acute suppurative thyroiditis in most cases. Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic gram-positive bacteria, primarily of the genus Actinomyces. These bacteria are filamentous with branching and may colonize in the oral cavity. Actinomycosis is a chronic disease characterized by abscess formation, tissue fibrosis, and draining sinuses. We experienced a case of 6-year-old boy who had presented with a left neck mass. Neck sono showed an approximately 3 cm-sized low echoic mass in the left thyroid gland. Thyroid scan was compatible with thyroid hypofunction. Gomori-methenamine silver stain after fine needle aspiration showed colonies of bacteria, are composed of long, thin, filamentous bacteria. Barium esophagogram showed a linear barium-filled track at the left pyriform sinus. Neck excisional biopsy was consistent with the remnant of a fourth branchial cleft fistula. We report a case of actinomycotic thyroiditis in a child with fourth branchial cleft fistula, with a brief review of related literature.

Anaphylactic Shock in a Breast Milk-Fed Infant due to Skin Contact with Egg White / 대한소아소화기영양학회지

Food allergy is not uncommon among small children. Cow milk and eggs are most frequently incriminated as the major cause of food allergy. A 4-month-old female infant who did not have a previous history of contact with the egg developed anaphylactic shock when an emulsion of raw egg white was rubbed on the buttock by her mother to relieve erosive diaper dermatitis. She had been fed on breast milk. She had no past medical history of any other allergy and no family history of atopy, asthma or allergic rhinitis. Her IgE PRIST was 29.46 IU/ml and multiple antigen simultaneous testing chemiluminescent assay for food specific IgE antibody showed a level 4 positive value only to egg white.

Monosomy 21 Mosaicism in a Child with Dyserythropoiesis

All complete monosomy 21 appear to be lethal early in their development in humans and only survive in mosaic forms. Complete monosomy 21 is a very rare and usually debilitating genetic disorder. Partial monosomy 21 is also rare and is thought to constitute a clinical syndrome consisting of peculiar faces, hypertonia, psychomotor retardation, and slow growth. We experienced a case of monosomy 21 mosaicism. Chromosome analysis demonstrated mosaicism for cell lines in the lymphocytes examined; 45, XX, -21/46, XX. The main clinical features were craniofacial dysmorphism including high arched palate, submucosal cleft, micrognathia and arthrogryposis-like symptoms including flexion deformity of fingers. And hematological findings were revealed dyserythropoiesis, thrombocytopenia and eosinophilia. Currently, the patient has nearly compatible growth, but a mild degree of mental retardation. We report here an 8 years old female child with apparent monosomy 21 mosaicism associated with dyserythropoiesis, thrombocytopenia and eosinophilia, with a review of the associated literatures.

Necrotizing Lymphadenitis Mimicking Acute Appendicitis Affecting Mesenteric Lymph Node / 대한소아소화기영양학회지

Kikuchi disease (histiocytic necrotizing lymphadenitis) is a rare disorder affecting young women where the presentation is usually with the fever and the self-limiting localized lymphadenopathy. The lymphadenopathy is usually observed in the cervical region, and the involvement of intra-abdominal lymph nodes is quite rare. A 8-year-old boy had been operated under the impression of acute appendicitis at a local clinic due to the acute right lower abdominal pain and tenderness. He was found with a large cecal mass and an intact appendix, and was transferred. Abdominal CT showed the conglomerates of lymph nodes located in the mesenteric area. Mesenteric lymph node excisional biopsies and incidental appendectomy were performed. The biopsy specimen showed many necrotic areas with infiltration of the foamy histiocytes. Laboratory tests revealed increased serum CRP concentration with leukopenia. Serologic tests for viral causes were negative. The postoperative course was accompanied with fever which resolved gradually without a specific treatment. In cases of unclear acute abdomen with a mesentereic lymphadenopathy, an attempt at achieving histological view of a lymph node is desirable in order to realize a rare differential diagnosis such as Kikuchi disease.

Helicobacter pylori Infection and Gastroduodenal Pathology in Children with Upper Gastrointestinal Symptoms / 대한소아소화기영양학회지

PURPOSE: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. METHODS: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. RESULTS: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. CONCLUSION: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

A Case of Henoch-Schonlein Purpura Nephritis Complicating Encephalopathy Accompanied by Hypertension and Cerebral Vasculitis

Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.

A Case of ARCI Syndrome with Hypoplasia of Corpus Callosum and Heart Anomaly

ARCI syndrome consists of arthrogryposis, renal tubular acidosis, cholestatic jaundice and icthyosis. We experienced an ARCI syndrome case with corpus callosum hypoplasia and atrial septal defect. This case had oral feeding difficulty, multiple joint contracture, renal tubular acidosis and neurogenic muscular atrophy at neonatal period. At two months of age, icthyosis and cholestatic jaundice were diagnosed. The case was hospitalized due to pneumonia at four months of age. Corpus callosum hypoplasia and atrial septal defect were detected. The case was treated with a mechanical ventilator because pneumonia was aggravated and respiratory failure occurred. The patient expired at five months of age.

A Review of Endoscopic Removal Methods in 127 Cases of the Esophageal Foreign Bodies

PURPOSE: The aim of this study was to evaluate the latest tendency of esophageal foreign body's extraction and to obtain a consensus from recent trends of indications and techniques of flexible endoscopy of esophageal FB in children. METHODS: We retrospectively reviewed medical records of 127 cases with foreign bodies in esophagus at Dept. of Pediatrics and Otorhinolaryngology, Gyeongsang National University Hospital (GNUH) from Jun, 1987 to July, 2001. They were divided into two groups by the kinds of endoscopy: flexible endoscope(66 cases) or rigid endoscope(61 cases). Rigid endoscopy was performed under general anesthesia at Dept. of Otorhinolaryngology but flexible endoscopy was performed without general anesthesia or sedative drugs(midazolam or diazepam). RESULTS: An annual number of cases of two groups were similar from 1991 to 1998. But from 1999, flexible endoscopy was performed actively. Asymptomatic cases were frequently observed in flexible endoscopy(28 cases/66 cases) but swallowing difficulties were frequently observed in the rigid endoscopy group(25 cases/61 cases). Other symptoms were vomiting, irritability, chest discomfort and abdominal pain. The total number of cases with underlying disease(esophageal stenosis, cerebral palsy) was 8. The total number of cases with complications (erosion, ulcer, bleeding, perforation) was 11. The above cases were not correlated between the two groups. In 55 cases(83.3%) of the flexible endoscopic group and 53 cases(86.8%) of the rigid endoscopic group, foreign bodies in the esophagus were removed within 24 hours. CONCLUSION: We could not find any benefit in rigid endoscopic technique. Flexible endoscopic FB removal can be performed safely and effectively in children by an experienced endoscopist.

Gastrointestinal Foreign Bodies: Review of 96 Cases / 대한소아소화기영양학회지

PURPOSE: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. METHODS: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. RESULTS: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. CONCLUSION: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.

Serum C-Reative Protein As a Predictor for Cardiac Sequelae in Kawasaki Disease

PURPOSE: The aim of this study was to identify the predictive factors in the early laboratory findings for cardiac sequelae in Kawasaki disease(KD). METHODES: A retrospective review of the records was conducted of all children with KD who were admitted to the Ulsan Dongkang General Hospital, Masan Samsung Hospital, and Gyeongsang National University Hospital between January 1995 and December 1999. We analyzed and compared the early laboratory findings between the patients with and without coronary artery dilatation. RESULTS: A total of 981 patients were divided into two groups : 826 patients(84.3%) with normal coronary artery and 155 patients(15.7%) with coronary artery dilatation. Age and sex were not significantly different between the two groups. The mean serum C-reactive protein(CRP) in the coronary artery dilatation group and in the normal coronary artery group were 5.0 mg/dl(+/-5.3) and 4.1 mg/dl(+/-5.0), respectively, with a significant difference(P<0.05), whereas the other early laboratory findings had no difference between the groups. CONCLUSION: This study shows that the early serum CRP was higher in patients with KD who had coronary artery dilatation than in those with normal coronary artery. There may be a strong possibility of cardiac sequelae at a high level of serum CRP. However, the cut-off value of serum CRP could not be determined for the prediction of cardiac sequelae in patients with KD.

Epidemiological Study of Kawasaki Disease in Kyung Nam Area

PURPOSE: The aim of this study was to determine the epidemiology of Kawasaki disease in the Kyung Nam area and to evaluate whether the results of this epidemiological study could support infectious etiology. METHODS: We sent a questionnaire to three training hospitals in the Kyung Nam area and retrospectively reviewed their medical records of Kawasaki disease from Jun. 1995 to Dec. 1999. RESULTS: The total number of patients was 717 cases, with little differences of annual prevalence during the five years. In all cases, the monthly prevalence of Kawasaki disease was high in Apr. and Jul. At the eastern of Kyung Nam, the monthly prevalence was high in Apr. and Jul. in 1995 and 1996, Jul. in 1997, Apr. in 1998 and Apr. and Jul. in 1999. In the central area of Kyung Nam, the monthly prevalence was high in Apr. in 1995 and 1996, Apr. and Jul. in 1997 and Jul. in 1998 and 1999. In the western Kyung Nam, the monthly prevalence was high in Nov. in 1995, Aug. in 1996, Oct. in 1997, Dec. in 1998 and Nov. in 1999. CONCLUSION: In the eastern and central areas of Kyung Nam, the monthly prevalence of Kawasaki disease was similarly high in Apr. and Jul. However, in the western district, the prevalence was high in late fall and winter. We could not prove the hypothesis that Kawasaki disease occurred with the spread of single infectious agent, but the a nnually similar prevalence in eastern and central Kyung Nam supported the infection theory for the etiology of the disease.

Detection of Helicobacter pylori by Pre-embedding Immunoelectron Microscopy: Comparison with Immunoblotting Method

PURPOSE: We tried to evaluate whether the detection rate of Helicobacter pylori in gastric biopsy specimens could be improved by using pre-embedding immunoelectron microscopy. METHODS: A total of 119 children who complained of upper gastrointestinal symptoms were endoscoped at the Gyeongsang National University Hospital from July, 1996 to July, 1999. Five biopsy specimens(three for urease test, one for hematoxylin-eosin(H and E) staining, and one for pre- embedding immunoelectron microscopy) were obtained from each antrum and body. Immunoblotting analysis were also performed. RESULTS: Among the 119 patients, H. pylori were found in 116 patients(97.5%) by the immunoelectron microscopy. Among three patients who were found H. pylori negative in immunoelectron microscopy, two patients showed H. pylori in H and E stained slides and one patient was urease test positive(color change within six hours). Urease tests were positive in 107 patients(89.9 %). The positive rate of immunoblotting tests was 81.5%. However, only 13 patients(10.9%) showed H. pylori on the H and E stained antrum or body tissue. CONCLUSION: In this study, we found H. pylori histopathologically in most of the pediatric patients who complained of upper gastrointestinal symptoms. This study showed that pre-embedding immunoelectron microscopic examinations can be used as a gold standard in the diagnosis of childhood H. pylori infection. However, this method also has limited capacity to detect widely scattered H. pylori compared to the other histopathologic diagnostic methods.

Primary Pneumococcal Peritonitis in a Healthy Child / 대한소아소화기영양학회지

Primary peritonitis usually refers to a bacterial infection of the peritoneal cavity without a demonstrable intra-abdominal source. Most cases occur in children with ascites resulting from nephrotic syndrome or cirrhosis. Rarely, it may occur in previously healthy children less than 7 years of age, usually a girl. Distinguishing primary peritonitis from appendicitis may be impossible in patients without a history of nephrotic syndrome or cirrhosis. Accordingly, the diagnosis of primary peritonitis is made only at laparotomy. We report one case of primary pneumococcal peritonitis in a 27-month-old female who underwent explorative laparotomy to discover the cause of suspicious intestinal perforation and mechanical ileus. Later, pneumococci were cultured in blood and gram-positive diplococci were isolated from the pus of peritoneal cavity.

A Case of Trisomy 22 with Pulmonary Hypoplasia in a Liveborn Infant

We report a case of trisomy 22 in a liveborn male infant which was confirmed by fluorescence in situ hybridization(FISH), macrocultures and GTG-banding, and RHA-banding procedures of peripheral white blood cells. The infant showed lung hypoplasia, which is a unique presentation, with other clinical manifestations of previously reported cases of trisomy 22, such as intrauterine growth retardation, cleft palate, micrognathia, large atrial septal defect, limb anomalies, imperforate anus, and hypospadias. Our report gives weight to the previously reported observation that pulmonary hypoplasia may be associated in trisomy 22.

Nonrhizomelic Type of Chondrodysplasia Punctata Suspected in the Brothers

Chondrodysplasia punctata is a heterogenous skeletal dysplasia characterized by small focal calcifications in articular and other cartilages in infancy, with subsequent epiphysial dysplasia and associated anomalies of the face, eyes, and skin. Chondrodysplasia punctata is classified with autosomal recessive rhizomelic type, autosomal dominant nonrhizomelic type(Conradi-Hunermann type), and X-linked dominant type. These types have different clinical manifestations respectively. We report cases of autosomal dominant type of chondrodysplasia punctata which occurred in brothers, who were presented with typical face(short collumella leading to depressed tip of the nose), punctate calcification on the lumbar spine, dislocation of right hip, no obvious skin lesions, and atropic optic nerve without cataracts.

A Clinical Study of Shigellosis Epidemics over 10 Years in the Kyung Nam Area

PURPOSE: The occurrence of shigellosis patients has increased radically in 2 recent years. For this, the authors investigated the epidemic aspect of shigellosis by regional groups to know whether the epidemic aspect of shigellosis is a general situation which occurs identically in various areas of Kyung Nam. METHODS: We reviewed pediatric patients who were hospitalized in Ulsan(eastern), in Masan(cen tral), in Chinju(western) of Kyung Nam from January, 1988 to April, 1999. RESULTS: A total of 54 cases of shigellosis were noted from Ulsan(12), Masan(21) and Chinju(21) over ten years. The number of patients was 1 each in 1991 and 1993, 5 each in 1998 and 1999 at Ulasan, 9 in 1988, 8 between 1990 and 1995, 3 in 1998, 1 in 1999 at Masan, 1 each in 1990, 1991, 1994, 4 in 1998, 14 in 1999 at Chinju. The shigellosis patients increased from 1998, especially in Chinju. S. flexneri was reported in Masan(AMP)(R)5, AMP+TMP/SMX(R)4) before 1990, in Masan (2) between 1990 and 1995 and in Chinju(AMP(R)7, AMP+MP/SMX(R)1) in 1999. S. sonnei was reported in Ulsan(AMP(R)1, TMP/SMX(R)1), in Masan(6) and in Chinju(AMP(R)2, TMP/SMX(R) 1) between 1990 and 1995 and in Ulsan(TMP/SMX(R)9, AMP+TMP/SMX(S)1), in Masan(TMP/ SMX(R)2, AMP+TMP/SMX(R)1+(S)1) and in Chinju(TMP/SMX(R)6) between 1998 and 1999. CONCLUSION: Independent of the past, shigellosis patients occurred by regional groups in three parts of Kyung Nam. The present epidemic aspect of the eastern area is similar to that of the central area, but is partially similar to that of western Kyung Nam.

Whole Blood and Plasma Vitamin C Concentrations in Children of 1-6 Years of Age in the Chinju Area

PURPOSE: Vitamin C among antioxidants in human is a physiological antioxidant for protection against diseases. We measured the vitamin C concentrations of whole blood and plasma among children in early childhood at normal condition in order to know the presence of vitamin C deficiency. METHODS: The venous blood was collected from 471 subjects at 1-6 years of ages in Chinju. Concentrations of vitamin C in whole blood and plasma were measured by the 2,4-dinitrophenylhydrazine method. RESULTS: Concentrations of vitamin C in whole blood and plasma were 1.68mg/dL and 0.94mg/dL, respectively. While concentrations of vitamin C in the whole blood and plasma of males were 1.69 mg/dL and 0.92mg/dL, respectively. Those of females, were 1.68mg/dL and 1.00mg/dL, respectively. The concentrations did not significantly differ by gender. Concentrations of vitamin C in plasma were positively correlated with the age of the entire study group and of female(P=0.01). Percentages of subjects with vitamin C concentrations of the whole blood less than 1.0mg/dL were 1.9%, and those of the plasma of below 0.6mg/dL were 20.6%. CONCLUSION: Concentrations of vitamin C in whole blood and plasma did not show normal distribution. And there were no relationship among age, gender, and vitamin C concentrations at early childhood. A significant number of children in Chinju had suboptimal plasma vitamin C concentration. These findings suggest a need for an increased vitamin C intake in this area.