• Title/Summary/Keyword: 만성 질환 아동

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Clinical Features of Infectious Ileocecitis in Children (소아 감염성 회장맹장염의 임상적 고찰)

  • Lee, Tae-Ho;Hong, Yoo-Rha;Yeon, Gyu-Min;Lee, Jun-Woo;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.30-35
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    • 2010
  • Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

Perceived Uncertainty and Rearing Attitude of Mothers with Chronically ILL Children (만성질환아 어머니의 질병에 대한 불확실성 정도와 양육태도)

  • Park Eun Sook
    • Child Health Nursing Research
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    • v.2 no.2
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    • pp.5-18
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    • 1996
  • The purposes of this study were to measure the degree of perceived uncertainty and to identify the rearing attitudes of mothers with chronically ill children, and to examine the relationship between the perceived uncertainty and the rearing attitude of these mothers. The subjects of this study consisted of 133 mothers with chronically ill children, registered at 2 university hospitals in Seoul. Data was collected from April 1 to May 31, 1996. The Parents' Perception of Uncertainty Scale(28-item 4 point scale) and the Maternal Behavior Research Instrument (49-item 5 point scale) were used. Data was analyzed by Cluster analysis, ANOVA MANOVA and t-test. Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high (Mn 2.48). The degree of perceived uncertainty by the four components slightly differed unpredictability(2.72), lack in clarity(2.58), vagueness (2.52) and lack of information(2.04) . The degree of perceived uncertainty of mothers with ill children revealed to be influenced significantly by the age of the ill children, duration of illness after the diagnosis, and the experience of hospitalization. 2. Among the rearing attitudes : moderatlely high affective(Mn 3.98) and resrictive(Mn 3.58) attitudes of mothers toward their ill children were identified. Mothers tend to give positive evaluations of their childrens' behaviors (Mn 3.38) and less rejection(Mn 2.81). 3. Mothers' rearing attitude were correlated with the degree of perceived uncertainty in illness ; mothers in the Low Perceived Uncertainty Group (Mn 1.99) revealed the highest affective (Mn 4.08), the lowest resrictive(Mn. 2.72) attitudes and tendency to give positive evaluations of their childrens' behaviors (Mn 3.54) compared to the High Perceived Uncertainty Group(Mn 3.26) and Moderate Perceived Uncertaity Group(Mn 2.57). 4. The degree of perceived uncertainty, the duration of illness after the diagnosis and the experience of hospitalization revealed to be significantly influential to the rearing attitude of mothers with chronically ill children. From the above results, it can be concluded that predicting and controlling mothers' uncertainty are necessary for improved, efficient nursing interventions and normal growth & development of the chronically ill children.

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Multiple-Parallel Mediation Effects of Self-Esteem and Body-Image in the Relationship between Peer Attachment and Happiness in Children with Chronic Illness (만성질환 아동의 또래애착과 행복감 간의 관계에서 자아존중감과 신체적 자아상의 다중병렬매개효과)

  • Sangwoo Kim;Byoung-hee Lee;Minsol Jo
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.17-28
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    • 2023
  • Background: The purpose of this study is to examine the multiple-parallel mediation effects of self-esteem and body-image on the relationship between peer attachment and happiness in children with chronic diseases. In addition, this study aims to provide a basis for supporting psychological services alongside therapeutic services as a way to increase the overall happiness of children with chronic diseases. Design: This study utilized data from the 2020 Panel Study on Korean Children. Methods: The survey method was conducted as a survey by investigators, and the number of cases used in the study was 363. Results: First, children's peer attachment is associated with higher levels of overall happiness. Second, it can see that peer attachment not only increases self-esteem, but also leads to a positive perception of one's own body-image. Third, it can be seen that peer attachment, high self-esteem, and positive perception of body-image increase children's overall happiness. Finally, it can be seen that peer attachment can increase children's happiness through self-esteem and body-image Conclusion: It is thought that a more positive prognosis can be expected when psychological support is provided together with therapeutic treatment in providing medical services for children with chronic diseases.

Children with Cancer: Adjustment to Disease and Body Image (소아·청소년 암환자의 신체상과 질병적응에 관한 연구)

  • Cho, Hae-Rin;Park, So-Young;Han, In-Young
    • Journal of the Korean Society of Child Welfare
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    • no.26
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    • pp.7-30
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    • 2008
  • The survival rate of children with cancer has increased significantly from less than 30% in 1960s to 75% during the recent years with the development of modern medical technologies. As a result, the cancer of children today is no longer classified as incurable diseases. Rather, it is recognized as a chronic illness. However, children with cancer are still suffering from physical and psychosocial ailments caused by long-term hospitalization. In particular, teenagers are more likely to be affected by these problems because of interests on one's appearance and peer relationships This study investigated the relationship of the level of body distortion and disease adjustment of children with cancer, and how demographic factors, disease factors, and the level of body distortion affect disease adjustment. Data were collected between October 22, 2007 and November 16, 2007 and the total respondents consisted of 82 children, ages 10 to 18. SPSS 12.0 with descriptive statistics, t-test, correlation and multiple regression were used for data analysis. The results showed that the factors which influence the disease adjustment of children with cancer were age, school enrollment, and the level of body distortion. The result of this study has major implications for the government to provide support for children with cancer to stay in school. Additionally, programs that assist children to build positive body images need to be developed in accordance with their ages and psychosocial characteristics.

Characteristics of preschoolers' giftedness by parents' perception (부모의 지각에 의한 유아 영재의 발달 특성의 변화)

  • Yoon, Yeu-Hong
    • Journal of Gifted/Talented Education
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    • v.12 no.2
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    • pp.1-15
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    • 2002
  • The purpose of this study was to investigate the characteristics of preschoolers' giftedness by their parents' perception. Total 3 groups of 148 subjects from age 30 months to 6 years 10 months old young gifted children's parents participated. The major findings were as follows : (1) There were critical characteristics of preschoolers' giftedness by parents' perception, which were 'good memory', 'high curiosity', 'read and understand of math', 'enjoy of learning and high motivation', 'high concentration', reading books', 'verbal ability', 'creativity', 'questions', and 'independency', (2) These characteristics of preschoolers' giftedness showed more strong and intense as they got older, and (3) Some characteristics revealed more, but the other characteristics revealed less as they got older. These findings suggested the consideration of child's age as the reliable identification process of young gifted children.

How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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Eucalyptus globulus extracts inhibit Propionibacterium acnes-induced inflammation signaling (유칼립투스 추출물의 Propionibacterium acnes에 의해 유도되는 염증반응 억제 효과)

  • Lee, Sol Ji;Lee, Eun Hye;Shin, Jin Hak;Kim, Seon Sook;Kim, Nam Kyoung;Choi, Eunmi;Seo, Su Ryeon
    • Korean Journal of Microbiology
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    • v.52 no.4
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    • pp.421-427
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    • 2016
  • Acne is known as the most common skin disease. It commonly occurs during adolescents, but it is also present in children and adults because of air pollution, drug abuse and so on. In addition to the hormonal, genetic and environmental factors, Propionibacterium acnes (P. acnes) have also critical roles in outbreak of acne by inducing inflammatory mediators. Increase of sebum production provides an ideal environment for P. acnes that induce inflammation on the skin by activation of monocytic cells and stimulation of inflammatory cytokines. In this study, natural extracts were investigated for anti-inflammatory effects against inflammatory acne by P. acnes infection in terms of reducing cytokine production. Eucalyptus globulus extracts effectively suppressed mRNA synthesis of inflammatory mediators such as $TNF-{\alpha}$, $IL-1{\beta}$, IL-2, and NLRP3 in P. acnes-activated macrophages. Moreover, Eucalyptus globulus extracts inhibit activation of transcription factors, $NF-{\kappa}B$ and NFAT, which are known as key regulators of inflammatory cytokine production. This study suggests the potential of using Eucalyptus globulus extracts as alternative agents for the treatment of acne.

STUDY ON THE RELATIONSHIP BETWEEN SEROTONIN SYSTEM AND PSYCHOPATHOLOGY IN TOURETTE'S DISORDER (Tourette씨병의 Serotonin계와 정신병리와의 상호관계에 관한 연구)

  • Cho, Soo-Churl;Shin, Yun-O;Suh, Yoo-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.77-91
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    • 1996
  • In order to elucidate the biological etiology and the effects of comorbidity on biological variables in tic disorders, plasma serotonin (5-hydroxlfryptamine, 5-HT) and 5-hydroxy- indoleacetic acid (5-HIAA) we.e measured in 87 tic disorders and 30 control subjects. The 87 tic disorder were composed of 45 Tourette's disorder(TS), 22 chronic motor tic disorders (CMT) and 20 transient tic disorders (TTD). Among these patients,43 patients were pure tic disorder (PT), 28 subject also had attention deficit hyperactivity disorder (T+ADHD) and 16 subjects had obsessive compulsive disorders (T+ OCD) as comorbid disorders. The results are summarized as follows : 1) Plasma 5-HT levels showed significant positive correlations with plasma 5-HIAA levels (Pennon r=0.77, p<0.05). 2) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age in tic disorders. 3) Plasma 5-HIAA and 5-HT levels showed no significant correlations with age in control subjects. 4) There was significant difference in plasma 5-HT levels among TS, CMT, TTD and control groups (ANOVA F=34.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and ITD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TTD groups. 5) There was significant difference in plasma 5-HIAA levels among TS, CMT, TTD and control groups (ANOVA F=26.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and TTD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TID groups.f) There was significant difference in plasma 5-HT and 5-HIAA levels among PT, T+ADHD, T+OCD and contol groups (ANOVA 5-HT, F=37.59, df=3, 113, p<0.01, 5-HIAA, F=27.37, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed signiscant differences between control and PT, control and T+ADHD and control and T+OCB. But, post-hoc test showed no significant differences between PT and T+ADHD, PT and T+ OCD and T+ADHD and T+ OCD. These results show that decreased 5-HT and 5-HIAA levels may play a role in the genesis of tic disorders, but these findings have no significant correlations with the severity of tic disorders. And the comorbid disorders of tics may have minimal effects on the biochemical abnormalities. Future studies must be focused on the effects of serotonin agonists and antagonists on tic disorders and molecular biological methodology may enhance to elucidate the mechanisms of these abnormal findings.

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Development of dietary behavior items available in Korea National Health and Nutrition Examination Survey (국민건강영양조사에 활용 가능한 식생활 조사항목 개발 및 유용성 검증)

  • Lim, A-Hyun;Choi, Suk-Young;Shim, Jae-Eun;Hwang, Ji-Yun;Moon, Hyun-Kyung;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.407-418
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    • 2015
  • Purpose: Given that the indicators related to chronic diseases are important to evaluating goals of the national health policy, the aim of this study was to develop dietary behavior items available in the Korea National Health and Nutrition Examination Survey. Methods: The dietary behavior items were developed based on the literature reviews, need assessment of the field, expert focus-group interviews, and expert advisory meeting. Questions for each dietary behavior item were developed by reflecting on environmental, personal, and behavior factors of the ecological frame and then revised through expert focus-group interview and expert advisory meeting. The understanding and reliability of the developed questionnaire were assessed by cognitive interview and test-retest reliability. Results: The developed items were sodium and salt intake, added and simple sugar intake, enough time to consume a meal for all ages, caffeine drinks and fresh/healthy food intake for children and adolescents, and limited dietary intake, fresh/healthy food intake for seniors. In most questions except some questions on sodium and salt intake, subjects understood over 70% and consistency of responses based on the kappa values was acceptable. Conclusion: Developed dietary behavior items are expected to be useful for evidence-based nutrition policy, interventions and research targeting dietary patterns through investigating and monitoring dietary behavior patterns.