• 대한유전성대사질환학회지
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• 제17권2호
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• pp.63-68
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• 2017

고셔병은 리소좀축적병으로 lysosomal hydrolase glucocerebrosidase 결여로 간비장비대, 골격계 증상, 빈혈, 혈소판 감소증의 증상을 나타내는 드문 상염색체 유전 질환이다. 본 증례에서는 2세 여아에서 간비장비대, 다리 통증, 성장부진이 관찰되어 시행한 단순 방사선 촬영 검사에 Erlenmeyer flask 변형을 확인하여 고셔병을 의심하였고 효소 분석 및 유전자 검사를 통해 확진하였다. 환아에서 한국인 비신경형 고셔병에서만 관찰되는 G46E 돌연변이를 확인하였고 1년 간의 효소 대체 요법을 통해 성장, 혈액학적 지표, 간비장비대 및 골증상의 호전을 확인하였기에 본 증례를 보고하는 바이다.

• Child Health Nursing Research
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• 제25권2호
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• pp.234-243
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• 2019

Purpose: The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetes-related attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation-behavior skills model. Methods: Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children's hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05. Results: The mean score of self-management in adolescents with type 1 diabetes mellitus was $61.23{\pm}10.00$ out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (${\beta}=.504$, p<.001) and family support (${\beta}=.188$, p<.001) were significant predictors of self-management. Conclusion: It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제4권1호
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• pp.46-53
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• 1993

본 연구는 $1990 1 1{\sim}1992 12 31$ 기간 중 서울대학 어린이 병원 소아정신과와 중앙 대학부속 용산병원 소아청소년 크리닉을 방문한 자폐아동 중에서 1986년 및 1988년에 출생한 환자를 대상으로 하여 출생계절 및 출생순위, 자폐아 출산 당시의 산모 연령에 어떤 특이점이 있는지를 알아보기 위해 일반 인구집단의 출생자료와 비교하여 다음과 같은 결론을 얻었다. 1) 자폐아군은 총 357명이었으며 이중 남아가 319명 (89.4%), 여아가 38명(10.4%)으로 남녀 성비는 8.4:1이었다.2) 자폐아군의 월별분포나 계절별분포에 있어 대조군과 차이가 없었다. 3) Slater 및 Greenwood-Yule 방법에 의한 자폐아군의 출생순위를 대조군과 비교 분석한 결과 통계적으로 유의한 차이는 없었다.4) 자폐아군은 일반 대조군에 비해 출생 당시의 산모의 연령이 통계적으로 의미있게 높았다(p<01) 5) 출산의 위험도가 높은 임신은 일반 대조군에 비해 자폐아군에서 통계적으로 의미있게 많았다(p<01)

• 지역사회간호학회지
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• 제13권1호
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• pp.89-97
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• 2002

Purpose: The purpose of this study is to explore the validity of the application of the Denver II developmental screening test to Korean children. This screening test. which was developed and standardized in United States. was designed to screen for developmental delay in Korea. and to compare the levels of development of Korean children with the development of children from the U.S. Method: Quota sampling. NP To facilitate field sampling. the age range used from 0 to 6 years old. was split into 10 different age groups. Sample size was estimated according to residence. 1.054 children were recruited from Seoul's metropolitan. urban and rural areas. NP To fill the quota established. the Recruitment and testing of children was done at public health centers, pediatric outpatient clinics of general hospitals and a child care center. The 25, 50, 75 and 90 percentiles were identified by using logistic regression analysis and were calculated as norms. The items in which the ages of both 50 and 90 percent passing differed more than 20 percent by the calculation was identified for comparison. NP Result: There were significant differences found in 45 items between Korean children and the children from the City of Denver as it relates to age differences. 90% of the sample passed items among 125 items from 4 sectors, e.g., personal- social. fine motor adaptive, language, and gross motor sectors. Korean children were found to be advanced in 9 items, whereas there were significant differences found in 38 items in our comparison of the two countries for age differences when 50% of sample pass items. Korean children were found to be advanced in 16 items. NP Conclusion: The result showed that there was a discrepancy in the developmental norms. It could be explained by the differences in the developmental environment. including child rearing patterns and ethnicity. Therefore, a restandardization of the Denver Screening Test is necessary as it relates to its application on Korean children. This restandardization is necessary in order to avoid both under and over-referrals of children with developmental abnormality. The modification of items in the language sector is especially suggested.

• Clinical and Experimental Pediatrics
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• 제54권7호
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• pp.277-281
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• 2011

Failure to thrive (FTT) is a term generally used to describe an infant or child whose current weight or rate of weight gains is significantly below that expected of similar children of the same age, sex and ethnicity. It usually describes infants in whom linear growth and head circumference are either not affected, or are affected to a lesser degree than weight. FTT is a common problem, usually recognized within the first 1-2 years of life, but may present at any time in childhood. Most cases of failure to thrive involve inadequate caloric intake caused by behavioral or psychosocial issues. The most important part of the outpatient evaluation is obtaining an accurate account of a child's eating habits and caloric intake. Routine laboratory testing rarely identifies a cause and is not generally recommended. FTT, its evaluation, and its therapeutic interventions are best approached by a multi-disciplinary team includes a nutritionist, a physical therapist, a psychologist and a gastroenterologist. Long term sequelae involving all areas of growth, behavior and development may be seen in children suffering from FTT. Early detection and early intervention by a multidisciplinary team will minimize its long term disadvantage. Appropriate nutritional counseling and anticipatory guidance at each well child visit may help prevent some cause of FTT.

• 대한예방한의학회지
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• 제22권1호
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• pp.1-14
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• 2018

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.152-161
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• 2019

Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.98-105
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• 2005

연구 목적 : 국내에서는 아스퍼거 장애를 평가하고 진단하는 구조화된 검사 도구의 개발이 거의 이루어지지 않은 상태로, 아스퍼거 장애에 대한 진단적 타당도의 검증 및 향후 연구의 활성화를 위해 본 연구에서는 한국판 아스퍼거 증후군 진단 척도(the Korean version of Asperger's Syndrome Diagnostic Scale)의 신뢰도와 타당도를 검증하는 연구를 수행하였다. 방법 : 소아정신과 외래를 방문한 아동들 중 DSM-IV 진단기준과 소아정신과 의사에 의해 아스퍼거 장애, 전반적 발달 장애(PDD)와 비전형 전반적 발달 장애(PDD NOS), 의사소통 장애로 진단된 아동을 대상으로 그들의 부모들에게 한국어로 번역한 ASDS를 실시하였다. 총 55명이 연구에 포함되었으며(아스퍼거 장애 15명, PDD와 PDD NOS 20명, 의사소통 장애 20명), 연령의 범위는 5세 1개월부터 15세 6개월까지였다. 공존 타당도 및 변별 타당도를 알아보기 위하여 또 다른 아스퍼거 장애 질문지와 자폐 증상을 평가하는 K-CARS를 함께 실시하였다. 결과 : 자료 분석 결과, K-ASDS의 내적 합치도는 Chronbach's $\alpha=0.88$로 높게 나타났으며, 각 하위척도별 내적 일치도 또한 높았다. K-ASDS와 아스퍼거 장애 질문지 간의 상관도 통계적으로 유의미하였고, 하위 척도 상에서 Asperger disorder, PDD, Communication disorder 집단 간의 차이도 유의미하였다. 판별 분석 결과, K-ASDS가 자폐 장애와 의사소통 장애로부터 아스퍼거 장애를 유의미하게 구분해주는 판별 함수를 얻었으며, 이들 장애를 구분해주는 전체 정확 판별율은 $71\%$였다. 결론 : 본 연구 결과, 한국판 ASDS의 신뢰도와 타당도가 입증되었으며, 아스퍼거 장애 아동들을 평가하고 진단하는데 유용하게 사용될 수 있을 것이다.

• 대한간호학회지
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• 제40권2호
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• pp.225-235
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• 2010

Purpose: The aim of this study was to identify factors which influence breastfeeding adaptation from among the following: parity and feeding behavior, social support, psychological, and demographic factors. Methods: The respondents were 179 breastfeeding mothers. Data were collected from June 2 to 19, 2009 at two community health centers and one pediatric outpatient department. Data were analyzed using the SPSS program and included descriptive statistics, t-test, ANOVA, correlation, and multiple regression. Results: The major findings of this study were: 1) Significant differences in the level of breastfeeding adaptation were related to number of children, current problems related to breastfeeding, and lay supporters. 2) Level of breastfeeding adaptation was significantly related to marriage satisfaction, proportion of breastfeeding, length of previous breastfeeding, planned length of breastfeeding, parenting stress, and encouragement to breastfeed given by medical personnel. 3) Regression analysis showed that parenting stress, marriage satisfaction, current problems related to breastfeeding, and proportion of breastfeeding explained 44.3% of variance for breastfeeding adaptation. Length of previous breastfeeding also explained 9.7% of breastfeeding adaptation among mothers who had breastfed an elder child. Conclusion: Mothers with lower marriage satisfaction, breastfeeding problems, and higher parenting stress require more help from their family and nurses for breastfeeding adaptation. Future research should include variables, such as mother's and baby's behavior related to breastfeeding, knowledge about breastfeeding, and attitude toward breastfeeding.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권2호
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• pp.112-119
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• 2015

Objectives : The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). Methods : Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. Results : Fifty-eight subjects with ADHD (41 boys, $7.7{\pm}1.3years$), 21 SIB (8 boys, $8.2{\pm}1.8years$), and 22 TC (8 boys, $8.5{\pm}2.1years$) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). Conclusion : These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.