• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.1
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• pp.52-56
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• 2012

Congenital esophageal stenosis (CES) can be classified into three types based on the etiology of stenosis: tracheobronchial remnants (TBRs), fibromuscular hypertrophy (FMH), and membranous diaphragm (MD). It is important to make a differential diagnosis because the therapeutic plan for CES is determined by its etiology. Most cases of FMH and MD can be managed with balloon dilatation, whereas cases of TBRs require resection and anastomosis. Thus, the preoperative distinction of TBRs is critical. Recently miniprobe endoscopic ultrasonography (EUS) with a maximum diameter of 2.5 mm has been useful for distinguishing TBRs from FMH in pediatric patients with CES. EUS shows hyperechoic lesions indicating TBR cartilage. Miniprobe EUS is recommended for choosing the correct therapeutic method for CES. We report a case of CES due to TBRs in which a preoperative diagnosis was made in a child using miniprobe EUS without any difficulties.

• Journal of the Korean Home Economics Association
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• v.45 no.3
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• pp.1-10
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• 2007

The current study used the critical science paradigm to explore the kinds of oppression experienced by the families of patients in hospitals, and to suggest how the practices should be changed for problem solving. Ethnographic observations and individual interviews were peformed for data collection from the 25 family members of critically ill patients. The results revealed the powerlessness of patients' families caused by multiple oppressions. They were struggling with family-unfriendly hospital systems, negative interactions with medical staff, limited supports from health care systems, and their own resignation to fate. Strategies were discussed to facilitate changes in institutional, humane, policy, and religious/spiritual aspect. The study findings will contribute to promoting the rights of patients' families.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.51-70
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• 2001

Characteristics of handwriting were investigated and compared between the patients with writing disabilities and normal elementary school pupils. Generally, the heights of the letters of the patients were significantly larger than those of normal children, and letters of the patients were more sparsely distributed than those of controls. The distance between the words were significantly reduced in the patients’ writings, which indicated that patients had much more problems of space-leaving than normal pupils. Letter heights differences were significant across all grades in the patients and normal controls. The heights of the letters decreased as they grew older, and the slope of the decrements were more steeper in normal girls(r=-0.45) than girls with writing disabilities(r=-0.16). Sex differences were found in the letter spacings in low grades(grades 1, 2), that is, the distances between the letters were significantly narrower in the male patients than normal boys in these grades, and the differences were almost indiscriminating in grades 3 through 5, and finally, in sixth grade, letter spacings were signifycantly broader in normal boys than male dysgraphics. In girls, letter spacings were significantly broader in the patients across all grades. These findings supports the hypothesis that male and female writings were qualitatively different and that distinct mechanisms served in boys and girls dysgraphics. Across all grades and sexes, spaces between the words of the patients were significantly broader than normal pupils, which suggested that space-leaving between the words was important in Korean writings. There was trend that letter spacings and word spacings decreased across grades, but in girls, no correlations between the letter spacings and grades were found. Correlation analyses revealed that letter heights and letter spacings had mild correlation(r=0.11-0.15), and that letter spacings and word spacings had robust correlation(r=0.99). Phonological errors were mostly found in last phoneme(Jong-seong), especially double-phoneme(ㄳ, ㄵ, ㄶ, ㄺ, ㄻ, ㄼ, ㄾ, ㄿ, ㅀ, ㅄ), and in the case the sound values changed due to assimilations of phonemes. Semantic errors were rare in both groups. Space-leaving errors were correlated with phonological errors, and more frequent in boys than girls. In conclusion, significant differences existed in the letter heights, letter spacings, word spacings, and frequencies of phonological errors and spaceleaving errors between the patients with writing disabilities and normal pupils. The characteristics of writings changed across grades and the developmental profiles were somewhat quantitatively different between the groups. The differences became obvious from the second-third grades.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.1
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• pp.6-13
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• 2014

Objectives : The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. Methods : A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. Results : More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. Conclusion : The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.

• Korean Institute of Interior Design Journal
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• v.24 no.4
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• pp.152-160
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• 2015

This paper proposes high quality of healthcare environments for a user-oriented children's hospital by identifying the user needs according to residential characteristics of the child, especially the hospitalization period. Caregivers, mostly parents of children in a children's hospital, participated in a questionnaire survey. The user's demands, satisfaction and hospital environment assessment were measured. A total of 103 copies of the questionnaire were finally collected and analyzed. The data was processed statistically using SPSS WIN 18.0 Version software. The results and conclusions are as follows. 1)The participants were categorized into three groups according to the hospitalization period of the child (less than 7 days, 7-20 days, and more than 21 days). 2)When the patients stayed longer in the hospital, their satisfaction was lower and their demands were higher. The long-term group required a more spacious bathroom for the child inpatients and their caregivers as well as sufficient individual storage spaces that are appropriate for the length of stay. 3)The longer they were hospitalized, the more negative they evaluated the hospital environment. These results suggest that the period of hospitalization is one of the crucial factors that impact the user's satisfaction and demands. Therefore, it is necessary to identify the design factors such as territoriality, privacy, accessability, and aesthetics to improve the satisfaction of the long-term child inpatients and their caregivers.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.390-394
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• 2017

Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

• Child Health Nursing Research
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• v.8 no.3
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• pp.260-271
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• 2002

This study was performed to identify the level of stress recognized by the parents as a support system for their infant patients who were hospitalized in an emergency department, thus to provide the resulting data as the basic material of care intervention for the families of infant patients. This study subjected the parents with infant patients who were hospitalized in emergency department of C University Hospital in Daejeon, and the data was collected from questionnaires for them, dating from Mar. 20, to Jun. 24, 2001 This study used the tool(30 questions) which was originally developed by Ji, Dong-ok (1992) for measuring the stress of families of infant patients in emergency room, and then was modified and complemented by this researcher suitably for infant patients. Collected data was statistically analyzed with frequency, percentage, mean, standard deviation, t-test, ANOVA, by using SPSS WIN10.0 program, and the results were as follows: 1. The stress of parents with infant patients hospitalized in emergency department averaged 3.31 on the basis of 5-point measure, which means that they felt stress beyond means. 2. The factor with high average out of stress factors the parents of infant patients recognized included the followings: 'about the pain of infant patients due to examination(3.91±1.00)'; 'about rare opportunity to be in contact with physician(3.78±1.09)'; 'delay in emergent treatment required for infant patients(3.75±1.31)'; 'delay in the general treatment of infant patients(3.72±1.32)'. Factors of the stress level includes the followings: 'care and medical treatment'(3.46±.72); 'body and diseases'(3.41±.97)'; 'lack of information and supportable resources (3.25±.77)'; and so on. 3. For the stress level according to general characteristics, there were statistically significant differences in the result of the condition of infant patients, medical treatment(P<.01), religion, the procedure of treatment(P<.05). With little preceding studies for infant patients hospitalized in emergency department, this study looked through the level of stress recognized by the parents of infant patients. Based on the comprehension on the parents with infant patients and the knowledge on stress factors recognized by the parents, it is expected that we can seek the methods of care intervention such as explanation of care and treatment procedures, unit policies, continuous interest and emotional supports as well as the provision of information to understand the responses of parents and reduce accompanied stresses.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.836-843
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• 2005

Objective : Liver cirrhosis is a disease of the liver in which normal cells are replated by scar tissue. Chronic liver disease and liver cirrhosis are the foutth ranked causes of death in Korea. However, clinical data on liver cirrhosis is not accumulated in oriental medicine. Therefore, clinical characteristics of 33 liver patients admitted to Hana Oriental Hospital from May 2004 to May 2005 were studied. Methods : Clinical characteristics of liver cirrhosis, such sex, age, causes, Child-Pugh class, chief complain, abdomen ultrasonography, disease duration, past history, blood test and urinalysis were reviewed. Results : The results of this study were as follows: 1 The distribution of sex and age in our study is similar to already reported statistics. 2. Hepatitis B and alcohol are the major factors to cause the liver cirrhosis. Diabetes and hypertention contribute more to cause than they have in previous histories. 3. Major symptoms are following: fatigue 87.9%, ascites 84.8%, jaundice 78.8%, leg edema 72.7%, dyspepsia 45.5%. 4. Most liver cirrhosis patients have pancytopenia. Standard Deviation accentuates the big differences between total bilirubin and serum amonia. 5. In urinalysis, Urobilinogen 19 patients (57.6%), bilirubin 12 patients (36.4%), blood 15 patients (45.5%) are positive. 11 cases of 15 in blood positive results scored $3{\sim}4+$. Contusions : In oriental medicine, it will be necessary to research and develop oriental medical therapies for liver disease including liver cirrhosis.

• Child Health Nursing Research
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• v.10 no.1
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• pp.98-107
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• 2004

Purpose: This study was to confirm the effect of acupressure on the emesis control and the weight change among pediatric cancer patients receiving anti-cancer chemotherapy. Method: Forty pediatric cancer patients, receiving the induction stage of chemotherapy with MTX and vincristine, were divided into control(n=20) and the intervention group(n=20). Both groups received regular anti-emesis medication, but the intervention group was added acupressure maneuver for 5 minutes on P6 point for 3 times a day for 5days: before chemotherapy, lunch and dinner by investigator during the hospitalization and by mother at home. The instruments for this study were Rhode's(1986) Index of nausea, vomiting and retching(INVR), Cas electric scale and pamphlet developed by researcher. Result: Significant differences in the degree of nausea and vomiting were observed between the control and the intervention group as measured by INVR(t=4.73; p=.01). Repeated measures ANOVA also shows that the group effect was significant(F=22.39, P=.01) as was the time effect(F=380.35, P=.01). The group by time interaction was also significant(F=5.27, P=.01). Acupressure maneuver was apparently effective in reducing the degree of chemotherapy-induced nausea and vomiting. There were also statistically significant weight loss noted in the control group than the intervention group(t=5.42, p=.01). Conclusion: Acupressure on P6 point shows an effective adjunct maneuver in reducing the degree of nausea and vomiting and conserving the weight in pediatric cancer patients. Therefore, it is proposed that acupressure should be applied as supportive nursing intervention strategies to relieve chemotherapy induced nausea and vomiting and to prevent weight loss in pediatric cancer patients.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.