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소아청소년 코로나바이러스감염증-19 대응지침 (Guidelines for Coronavirus Disease 2019 Response in Children and Adolescents)

  • 김기환;조은영;김동현;김한울;박지영;은병욱;조대선;최수한;최재홍;한미선;최은화;김종현;대한소아감염학회
    • Pediatric Infection and Vaccine
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    • 제27권1호
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    • pp.24-34
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    • 2020
  • 대한소아감염학회와 질병관리본부 중앙방역대책본부는 소아청소년 코로나바이러스감염증-19 (coronavirus disease 2019, COVID-19) 대응지침을 발표하였다. 사례정의 및 조치사항을 신생아, 영아, 소아청소년에 맞추어 정리하였으며, 보호자 관리에 대한 지침을 마련하였다. 본 종설에서는 우리나라 소아청소년 COVID-19 대응지침의 내용을 소개하고자 한다.

Characteristics and Treatment Outcome of Intracranial Aneurysms in Children and Adolescents

  • Nam, Sun Mo;Jang, Donghwan;Wang, Kyu-Chang;Kim, Seung-Ki;Phi, Ji Hoon;Lee, Ji Yeoun;Cho, Won-Sang;Kim, Jeong Eun;Kang, Hyun-Seung
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.551-560
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    • 2019
  • Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.

어린이병원 신규간호사를 위한 간호역량 향상 교육프로그램 개발 및 효과검증 (The development and evaluation of a pediatric nurse education program to improve nursing competency for newly graduated nurses in a children's hospital)

  • 신혜경;김효영;김현정;김민경;신현주;이후연;한지희;이혜정
    • 한국간호교육학회지
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    • 제28권2호
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    • pp.179-192
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    • 2022
  • Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation. Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program. Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children's hospital. The categories derived from the focus group interviews were "getting special guidance," "better care," "becoming a nurse at a children's hospital" and "winning together." Conclusion: It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.

Recent Trends in the Endoscopic Management of Variceal Bleeding in Children

  • Kim, Seung Jin;Kim, Kyung Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권1호
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    • pp.1-9
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    • 2013
  • Variceal bleeding results in significant morbidity and mortality in both children and adults. The guidelines for the management of variceal bleeding are well established in adults but not in children as there have been insufficient pediatric studies of this disorder. In addition, the adult guidelines for treatment of variceal bleeding cannot be applied directly to children as the etiology and natural course of this disease differs between children and adults. Examples of recommended treatments in children include endoscopic variceal ligation as secondary prophylaxis for biliary atresia whereas a meso-Rex shunt operation for extrahepatic portal vein obstruction. In this review, we discuss prophylaxis options and some technical aspects of endoscopic management for variceal bleeding in children.

한국형 양극성 장애 약물치료 알고리듬 2018 : 소아/청소년 (Korean Medication Algorithm for Bipolar Disorder 2018 : Children and Adolescents)

  • 심세훈;박원명;윤보현;전덕인;서정석;김원;이정구;우영섭;정종현;김문두;손인기;송후림;민경준
    • 우울조울병
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    • 제16권3호
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    • pp.109-122
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    • 2018
  • Objectives : The objective of this study was to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014: Children and Adolescents. Methods : We performed the survey, using a questionnaire comprising 22 questions according to each situation, in children and adolescents with bipolar disorder. Results : First-line pharmacotherapeutic strategies for manic episode in children with bipolar disorder were a combination of mood stabilizer (MS) and an atypical antipsychotics (AAP), monotherapy with an AAP, risperidone, and aripiprazole. Aripiprazole was selected as first-line medication for depressive episode in children with bipolar disorder, and aripiprazole, and risperidone were selected as first-line at high-risk children. First-line pharmacotherapeutic strategies for manic episode in adolescents were a combination of MS and an AAP, monotherapy with an AAP valproate, lithium, risperidone (Treatment of Choice, TOC), aripiprazole, and quetiapine. First-line pharmacotherapeutic strategies for depressive episode in adolescents, were a combination of an atypical antipsychotics and lamotrigine, valproate, aripiprazole (TOC), risperidone, and quetiapine. For depressive episodes in adolescents at high risk for bipolar disorder, valproate, aripiprazole (TOC), and risperidone were selected as first-line medication. Conclusion : We expect that the present KMAP-BP 2018-children and adolescents, is useful for clinicians to treat children and adolescents with bipolar disorder.

주의력결핍-과잉행동장애 초등학생에서 불안증상이 아동의 행동 및 주의력과 가지는 관련성에 관한 연구 (Associations of Anxiety Symptom with Behavior and Attention in Elementary School Children with Attention-Deficit/Hyperactivity Disorder)

  • 신준영;백기청;이경규;이석범;이정재;김도현;최재원;김경민
    • 대한불안의학회지
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    • 제15권2호
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    • pp.101-108
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    • 2019
  • Objective : This study aimed to investigate the associations of anxiety symptoms with behavior and attention in elementary school children with attention-deficit/hyperactivity disorder (ADHD). Methods : A total of 195 elementary school children with ADHD participated in the study. The Korean Version of ADHD Rating Scale (K-ARS) and Behavior Assessment System for Children(BASC-2) were used to measure the children's behavior. Anxiety and attention was assessed with State-Trait Anxiety Inventory for Children (STAIC) and ADHD Diagnostic System (ADS), respectively. Children with ADHD were categorized to two groups of ADHD with low anxiety (ADHD-LA) and ADHD with high anxiety (ADHD-HA) according to the total STAIC scores. Scores on K-ARS, BASC-2 and ADS were compared between two groups of ADHD-LA and ADHD-HA. Results : The Scores on K-ARS total and both subscales in ADHD-HA group were significantly higher than ADHD-LA group. Scores on the BASC-2 subscales including hyperactivity, aggression, conduct problem, anxiety, depression, somatization, withdrawal, attention problems were also significantly higher in ADHD-HA group compared to ADHD-LA group. In contrary, scores on ADS subscales were not significantly different between the both groups. Conclusion : Our study identified that the anxiety accompanied with ADHD was associated with the negative behavioral aspect in children with ADHD. However, the performances on attention task were not affected by the anxiety comorbid with ADHD. Future studies to reveal underlying mechanism are needed for further understanding the association with anxiety and ADHD.

천공지 유리 피판술을 이용한 소아 사지 연부조직 결손의 재건 (Soft Tissue Reconstruction of Children's Extremity with Perforator free Flap)

  • 김학수;김경철;김성언
    • Archives of Reconstructive Microsurgery
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    • 제16권1호
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    • pp.14-22
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    • 2007
  • Perforator free flap (PFF) is currently a major reconstructive option for soft tissue reconstruction in adults. Although PFFs have been used commonly, most reconstructive surgeons still hesitate to perform PFFs in children. The main cause of concern is the perceived high failure rate related to the small diameter of children's perforator vessels. We present 8 consecutive cases of successful transfer of thoracodorsal artery (TDA) & anterolateral thigh (ALT) perforator flap in children. Between 2003 and 2005, 8 children(4 to 13 years old) with soft tissue defects of the extremities were reconstructed with TDA & ALT PFFs. All flaps completely survived. There were no problems relating to vascular spasm or occlusion. Range of motion of reconstructed extremities were fully recovered. Among 8 patients, only 1 patient was performed an additional flap thinning procedure. 8 cases of TDA & ALT perforator flaps were successfully transferred in children. PFF is an excellent option in reconstruction of children as well as in adults because of its thinness, long pedicle length, least donor site morbidity and acceptable donor site scar.

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한국판 소아신체화척도 개발을 위한 예비연구 : 문항구성과 신뢰도 및 타당도 검증 (Development of the Korean Somatization Scale for Children: An Investigation of Reliability and Validity)

  • 이소영;박준호;정한용
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제19권3호
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    • pp.168-174
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    • 2008
  • Objectives: The purpose of this study was to develop the Korean Somatization Scale for Children (KSS-C) and to evaluate the reliability and validity of this scale. Methods: Sixty-five children and adolescents with somatic symptoms were evaluated the KSS-C, Child Version, the Children's Depression Inventory (CDI), and the State-Trait Anxiety Inventory for Children (STAIC). 65 parents of the subjects evaluated the KSS-C, Parent Version and Korean version of the Child Behavior Checklist (K-CBCL). Psychometric properties and associations with the internalizing symptoms were. Results: Three factors were extracted by factor analysis. KSS-C was significantly correlated with the CDI, the STAIC, and the internalization, externalization and somatization scale of the K-CBCL. The KSS-C, Parent Version was significantly correlated with the KSS-C, Child Version. Frequently reported somatic symptoms in children were fatigue, headache, low energy, stomachache, and nausea. Conclusion: Both KSS-C, Child Version and KSS-P, Parent Version were valid and reliable instrument assess somatic symptoms in Korean children and adolescents.

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Disseminated Juvenile Pilocytic Astrocytoma in Childhood

  • Kima, JI-Hye;Dennis WW Shaw;Richard Ellenbogen;Geyer J Russel
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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    • pp.38-39
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    • 2003
  • To evaluate the clinical characteristics and outcome of the patients with disseminated pilocytic astrocytoma compared to non-disseminated disease and to discuss treatment options for disseminated disease. We Identified patients with disseminated pilocytic astrocytoma from our Tumor Registry over 21 years of period and reviewed medical records and neuroimages to determine location of the tumor, pattern of dissemination, clinical characteristics, treatment, and outcome. 24 controls without dissemination, matched for age at diagnosis, tumor histology, and primary location were selected from the same registry and case/control comparison was done using Kaplan-Meier survival analysis.

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Catastrophic Intramedullary Abscess Caused by a Missed Congenital Dermal Sinus

  • Dho, Yun-Sik;Kim, Seung-Ki;Wang, Kyu-Chang;Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • 제57권3호
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    • pp.225-228
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    • 2015
  • Congenital dermal sinus (CDS) is a type of occult spinal dysraphism characterized by a midline skin dimple. A 12-month-old girl presented with fever and ascending quadriparesis. She had a midline skin dimple in the upper sacral area that had been discovered in her neonatal period. Imaging studies revealed a holocord intramedullary abscess and CDS. Overlooking CDS or misdiagnosing it as benign sacrococcygeal dimple may lead to catastrophic infection and cause serious neurological deficits. Therefore, further imaging work-up or consultation with a pediatric neurosurgeon is recommended following discovery of any atypical-looking dimples in the midline.