• Acute and Critical Care
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• v.33 no.4
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• pp.276-279
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• 2018

In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an $i-gel^{(R)}$ (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an $i-gel^{(R)}$. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1217-1223
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• 2003

Purpose : This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. Methods : This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. Results : The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). Conclusion : Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.531-548
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• 1991

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.3
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• pp.448-455
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• 2009

For prevention of ECC, the Korean Academy Of Pediatric Dentistry(KAPD) advocate that Children should be seen as early as 6 months of age after the first tooth erupts, or 12 months of age. Pediatrics have increased access to new mothers and children 6 to 12 months while dentists does not see young children unless there are urgent problems. Therefore, they have an opportunity to impact infant oral health care. This study's purpose was to examine pediatricians' awareness and experience about infant oral health care. For the study, we surveyed of 150 pediatricians in korea. The survey comprised 10 questions related to infant oral health care and the recommended age a child go for their first dental visit. The results were as follows: 1. Most respondents had been referred children to a dentist for treating ECC and more than half of respondents reported that they did not do oral examination in their practice. 2. The majority of surveyed pediatricians are not advising patients to see the dentist by 1 year of age. 3. The surveyed pediatrician's awareness of infant oral health care is insufficient. The oral health education should be reinforced. 4. There is a need for increased infant oral health care education in the medical and dental communities.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.1
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• pp.38-53
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• 2001

The main purpose of this study was to present the basic materials that help the nursing of the infants and consultation of childcare by examinating the knowledge and practice of the mothers about the weaning diet. The data for this study was collected from 205 mothers with infants(6-36 months) who visited two hospitals or one university hospital in Seoul, who were living in one apartment Suwon area between July. 7. and September 10, 2000. The 57 questionnaires were used for collecting the data and SAS program was used to analyse the data. The results are as follows. 1. The items of low score in the result of the knowledge data were as follows. [Initial weaning time, the important nutritional problem in infant, considering factor during feeding, the relation of proper weaning food & age, the time of used by cup, to apply of proper spicies in weaning food, the time of completing weaning, the time of stopping weaning at abnormal sign, and the inappopriate reason of dry mixed powdered food (Sunsik) as a weaning food.] 2. Higher educated mothers presented more high score than lower educated mothers in the knowledge about the weaning. (p<0.05) 3. Before the weaning, more mothers were using the commercial milk (51.2%) than the breast milk (13.2%). 4. Mothers get the knowledge about the weaning from the infants care book of cook books(26.4%). 68% of mothers had not received any consulting service with regard to the weaning, 10.2% of them consulted Pediatrician about the weaning and 0.5% of them with nurse. 5. Most mothers began supplymentary food, from four to six months (65.4%). the ratio was about the same as the ratio of mothers who knEw the appropriate time for the introduction of supplymentary food(83.2%) 6. The main solid food was commercial food, not home-prepared food. 7. Higher educated mothers used home-prepared weaning food more often than lower educated mothers(P<0.05). 8. The used rate by spoon was 57.4%, but the rate of mother's knowledge data was 95.0%. 9. The time of completing the weaning was in 12-18 months(53.8%). It is similar to the mother's knowledge data(52.7%) Conclusion ; According to knowledge data, it turns out that most mothers know moderatly about the weaning (everage 60/100). However their knowledge and practice on the methods & procedures on the weaning were inadquate. Especially, most mothers did not consult with those qualification about the weaning. Therefore, the role of the nurse as a provider of information on the weaning should be emphasized with varied educational programs in many health care center.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.452-460
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• 2016

Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin's B-cell lymphoma found primarily in the pediatric population. In the oral cavity, this tumor can grow rapidly and often brings about facial swelling or development of an exophytic mass involving the jaws. A 5-year-old boy was referred for swelling and pain in the left mandibular area. The patient showed diffuse swelling on the left side of the mandible and firm-moderate tenderness upon palpation. An intraoral examination showed moderate mobility and sensitivity to percussion on the left primary first and second molars, without severe caries. A radiographic examination revealed complete loss of the lamina dura on the left primary second molar and permanent first molar. There was a radiolucent osteolytic lesion and destruction of the cortical bone of the left mandibular body. Based on the clinical, radiographic, and immunohistochemical findings, the patient was diagnosed with BL, and was referred to a pediatrician for systemic evaluation and intensive chemotherapy. Even before the completion of chemotherapy, the swelling resolved and the displaced teeth were relocated to a normal position. This patient showed a good prognosis due to prompt diagnosis and intensive chemotherapy. Early diagnosis and referral for treatment can prevent the development of BL.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.257-264
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• 2018

Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span. A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oralrehabilitation with a removable partial denture was initiated. Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development. Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.352-358
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• 2020

Glanzmann's thrombasthenia (GT) is a rare, autosomal recessive inherited congenital disorder, characterized by impaired blood coagulation due to platelet dysfunction. It was first reported by the pediatrician Glanzmann in 1918. GT affects both males and females, and it is more common in regions of the Middle East, India, and France, where intermarriage is common. It has an incidence of about 1 in 1,000,000 people. In South Korea, according to the Division of Rare Diseases, Korea Centers for Disease Control and Prevention, around 200 cases have been reported in 2018. Clinical symptoms include petechia, ecchymosis, epistaxis, and gingival bleeding. The spontaneous loss of deciduous teeth can result in excessive bleeding with that blood transfusion should be considered. Preventing hemorrhages and hemostasis are most important factors in dental treatment. Local bleeding can be controlled by compression, but platelet transfusion can be required by prolonged bleeding. Pediatric dentists can minimize the gingival bleeding by control of the oral hygiene to prevent gingivitis and dental caries. The importance of oral hygiene and periodic recall check-up should be emphasized. During dental treatment, the examination and the treatment plan of patient should be modified to prevention of hemorrhages carefully. A 6-year-old girl with GT was referred for the treatment of dental caries, and resin restoration was performed under nitrous oxide inhalation sedation. After treatment, compression was required for the bleeding control.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.54-60
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• 1998

Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.593-600
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• 1996

This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.