• 한국보건간호학회지
• /
• 제27권2호
• /
• pp.254-266
• /
• 2013

Purpose: This study examined the characteristics of in-home injuries of children in low-income families and sought to identify the factors affecting parental in-home injury prevention practices. Methods: A cross-sectional descriptive survey design was applied, using questionnaires on in-home injury characteristics in children, parental in-home injury prevention practices, parental perceptions and knowledge on childhood injuries, and the Parental Stress Index. We queried 169 parents of children less than 5years of age who were enrolled in Nutrition Plus Projects at community health centers. Results: Overall, 92.7% of children had experienced in-home injuries, with sliding crashes and bumping injuries as the most frequent type of injury. The recovery rate with a scar after injury was 26.3%. Parental practices for in-home injury prevention were higher according parental age, educational status, and previous learning experiences regarding in-home safety and injury prevention. The two most significant factors affecting parental in-home injury prevention practices were age and parental perception of childhood injuries as being controllable and preventable. Conclusions: Considering the high risk of in-home childhood injuries in low-income families, safety education and the promotion of injury prevention practices for parents are recommended. The strategy to enhance the parental perception on preventing childhood injuries needs to be addressed.

• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.87-96
• /
• 2009

Purpose: Injuries are the most important cause of morbidity and mortality in the childhood population worldwide. Thus, this study was down to investigate the type and the severity of injuries according to the age group in childhood. Methods: A survey of injury information and a chart review were done on 378 children (257 boys, 121 girls) who visited the Emergency Departments of Asan Medical Center from March 1, 2009, to March 31, 2009. To determine differences in injury mechanism, accident place, injury site, New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS), we divided the 378 patients into 4 group: under 1 year, 1 to 4 years, 5 to 9 years, and 10 to 15 years. Results: The mean (${\pm}SD$) age of the study group was 5.1 (${\pm}4.4$) years. Two year olds formed the largest group of injured children, with 77 cases (20.4% of the total). The most common cause of injury in childhood was being hit by an object (26.2%). Falls were frequent in the under-1-year group (22.2%) and slip downs (30.1%) were more frequent in 1-to-4-year group. More than half (53.4%) of the injuries occurred in the home, and the most common places of home-related injuries were the living room (41.1%) and the bedroom (31.2%). The mean (${\pm}SD$) NISS was 1.5 (${\pm}1.8$), and traffic accidents had the highest NISS ($2.8{\pm}5.1$). Injuries occurred most frequently during the evening. The peak period was 4:00 PM to 8:00 PM (33.7%). Conclusion: Patterns of childhood injury by age group were considerably different, and less severe and nonhospitalized injuries were common. Thus, need to improve surveillance of a variety of injuries, promote intersectional collaboration, build institutional capacities and mobilize community support and policy as an investment in prevention.

• Kidney Research and Clinical Practice
• /
• 제37권4호
• /
• pp.347-355
• /
• 2018

Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

• Child Health Nursing Research
• /
• 제5권3호
• /
• pp.349-357
• /
• 1999

Injuries are important causes of death and disability. The Purpose of this study was to determine how often preschoolers have injuries and what factors affect the injury occurrences. The sample consisted of 360 Preschoolers who were registered at eight nurseries located in Sedaemoongu. Seoul. The data were analyzed using the SAS PC statistical package. The results of the study are as follows: During last 12 months 73.1% of 360 preschoolers had accidental injuries In an analysis of the location where the injury took place, showed that the most places were in the nursery(17.3%) and around home(14.4%), and the most place inside home were in the bedroom(13.9%) and living room(13.9%). There were the diverse and injurious risks inside the home as well as around home. The most frequent type of injury was abrasion(27.5%) and most children injured their legs(28.3%). They were treated most frequently at home(52.8%) and usually emergency treatment was performed by family members with disinfection being the main type of first aid To identify factors related to injury occurrence, multiple logistic regression was performed and the main factors were the age of child, active tendency, and mother's education level.

• Clinical and Experimental Pediatrics
• /
• 제64권12호
• /
• pp.608-618
• /
• 2021

Hypoxic-ischemic encephalopathy (HIE) is the most common cause of neonatal encephalopathy with a global incidence of approximately 1 to 8 per 1,000 live births. Neonatal encephalopathy can cause neurodevelopmental and cognitive impairments in survivors of hypoxic-ischemic insults with and without functional motor deficits. Normal neurodevelopmental outcomes in early childhood do not preclude cognitive and behavioral difficulties in late childhood and adolescence because cognitive functions are not yet fully developed at this early age. Therapeutic hypothermia has been shown to significantly reduced death and severe disabilities in term newborns with HIE. However, children treated with hypothermia therapy remain at risk for cognitive impairments and follow-up is necessary throughout late childhood and adolescence. Novel adjunctive neuroprotective therapies combined with therapeutic hypothermia may enhance the survival and neurodevelopmental outcomes of infants with HIE. The extent and severity of brain injury on magnetic resonance imaging might predict neurodevelopmental outcomes and lead to targeted interven tions in children with a history of neonatal encephalopathy. We provide a summary of the long-term cognitive outcomes in late childhood and adolescence in children with a history of HIE and the association between pattern of brain injury and neurodevelopmental outcomes.

• Journal of Preventive Medicine and Public Health
• /
• 제37권3호
• /
• pp.274-281
• /
• 2004

Objectives : This study was performed to investigate the injury rates and risk factors for preschool children in Daegu city and Kyungpook province. Method : A questionnaire survey about medically attended injuries during the preschool period was performed in nine primary schools located in Daegu city, Pohang city and Goryung County. The overall injury rate was estimated using person-year. The causes and patterns of the injuries, and their risk factors were examined. Result : A total of 469 medically attended injuries were reported in 330 of the 959 study subjects during the preschool period. The overall annual injury rate was 7.5 per 100 children. The injury rate increased sharply during the period from infant (2.4) to 1 year of age (7.5), and the peak injury rate (9.2) was reported for 5 year olds. The most common causes of injuries were falling (36.0%), followed by being struck by an object (23.7%), and traffic accidents (14.1%). Among the traffic accidents, 72.8% occurred while playing on the road, riding a bicycle or roller-skating. A proportional hazard model showed that males (hazard ratio=1.49, p<0.001 compared with female) and the mother's higher education level (hazard ratio of college or higher= 1.51, p=0.013; high school=1.32, p=0.085 compared with those of middle school or lower) were significant risk factors of childhood injury. Conclusion : The results of this study suggested that efforts for children's safety should be made, especially from the toddler stage, and in male children. To develop a more specific childhood injury prevention program, a surveillance system for injuries should be established. Further study of the relationship between mother's occupation and injury rates is also needed.

• Childhood Kidney Diseases
• /
• 제23권1호
• /
• pp.48-52
• /
• 2019

The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

• Childhood Kidney Diseases
• /
• 제19권2호
• /
• pp.79-88
• /
• 2015

Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as one of the most promising biomarkers of renal epithelial injury. Numerous studies have presented the diagnostic and prognostic utility of urinary and plasma NGAL in patients with acute kidney injury, chronic kidney disease, renal injury after kidney transplantation, and other renal diseases. NGAL is a member of the lipocalin family that is abundantly expressed in neutrophils and monocytes/macrophages and is a mediator of the innate immune response. The biological significance of NGAL to hamper bacterial growth by sequestering iron-binding siderophores has been studied in a knock-out mouse model. Besides neutrophils, NGAL is detectable in most tissues normally encountered by microorganisms, and its expression is upregulated in epithelial cells during inflammation. A growing number of studies have supported the clinical utility of NAGL for detecting invasive bacterial infections. Several investigators including our group have reported that measuring NGAL can be used to help predict and manage urinary tract infections and acute pyelonephritis. This article summarizes the biology and pathophysiology of NGAL and reviews studies on the implications of NGAL in various renal diseases from acute kidney injury to acute pyelonephritis.

• Childhood Kidney Diseases
• /
• 제21권1호
• /
• pp.31-34
• /
• 2017

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin's lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

• Childhood Kidney Diseases
• /
• 제15권2호
• /
• pp.116-124
• /
• 2011

Acute kidney injury (AKI) can result in mortality or progress to chronic kidney disease in hospitalized patients. Although serum creatinine has long been used as the best biomarker for diagnosis of AKI, it has some clinical limitations, especially in children. New biomarkers are needed for early diagnosis, differential diagnosis, and reliable prediction of prognosis in AKI. Up to the present, candidate AKI biomarkers include neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), livertype fatty acid-binding protein (L-FABP), matrix metalloproteinase-9 (MMP-9), and Nacetyl-$\ss$-D-glucosaminidase (NAG). However, whether these are superior to serum creatinine in the confirmation of diagnosis and prediction of prognosis in AKI is unclear. Further studies are needed for clinical application of these new biomarkers in AKI.