• 제목/요약/키워드: Korean pediatrician

검색결과 88건 처리시간 0.028초

2형 당뇨병 및 대사증후군 (Type 2 diabetes mellitus and metabolic syndrome)

  • 황진순
    • Clinical and Experimental Pediatrics
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    • 제49권7호
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    • pp.710-717
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    • 2006
  • Type 2 diabetes mellitus in children and adolescents has been increasing for last 10 years. The increase in frequency of type 2 diabetes appears to parallel the increase in prevalence and severity of obesity in children and adolescents. The metabolic syndrome, cluster of potent risk factors for atherosclerotic cardiovascular disease and type 2 diabetes, consists of insulin resistance, obesity, hypertension and hyperlipidemia. The atherosclerotic cardiovascular disease are rarely seen in the young, but the pathologic processes and risk factors are associated its development have been shown to begin during childhood. In pediatrician it is important to recognize early and treat aggressively for prevention of future cardiovascular disease in children and adolescents with metabolic syndrome.

림프절 종대 (Lymphadenopathy)

  • 정낙균
    • Clinical and Experimental Pediatrics
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    • 제51권8호
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    • pp.797-803
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    • 2008
  • Lymphadenopathy is a common problem in children and adolescents. A wide variety of diseases and conditions may present as lymphadenopathy and an understanding of these conditions is essential to determine the most appropriate diagnostic work-up for each patient. A detailed history and physical examination with careful attention to the anatomical regions drained by the involved lymph node or mass often leads to the appropriate diagnosis. A majority of these children will prove to have a benign disorder; however, it is important for the pediatrician to have an appreciation for the malignant diseases or serious systemic illnesses that may initially present with lymphadenopathy, to ensure the timely diagnosis of a serious disease.

소아기 수면 장애 (Sleep disorders in childhood)

  • 차병호
    • Clinical and Experimental Pediatrics
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    • 제50권8호
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    • pp.718-725
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    • 2007
  • Sleep disorders are very common among pediatric patients. Its prevalence is between 10% and 45% in preschool- and school-aged children. However parents commonly do not concern about their children's sleeping habits and for many pediatricians, there is not part of the routine office visit about a childs sleep. Sleep disorders were classified by International Classification of Sleep Disorder (ICSD) as dyssomnias, parasomnias, sleep disorders associated with mental, neurologic, or other medical disorders, and proposed sleep disorders. There are lots of differences in the causes, manifestations, and managements of sleep disorders between children and adult. The sleep disorders in childhood may manifest themselves as bedtime resistance, refusal to go to bed at a parentally described time, sleep-onset delay, inability to fall asleep within a reasonable time, prolonged nighttime awakening, and inability to return to sleep without assistance after waking during the night, and so have wide-ranging influences on children's behavior, mood, school performance, and family life. It's very important for pediatrician to concern about the sleep disturbances in childhood and so the problems of sleep in children should be early detected and managed.

한 농촌지역에서 실시한 소아 급성호흡기감염 관리사업의 평가 -항생제 사용을 중심으로- (Evaluation of Acute Respiratory Infections(ARI) Control Programme in a Korean Rural Community -The Patterns of Antibiotic Prescription-)

  • 이영성;김창엽;김용익;신영수;고재욱
    • 농촌의학ㆍ지역보건
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    • 제18권2호
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    • pp.105-119
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    • 1993
  • The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

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의료공급자 단체에 대한 공정거래법상 사업활동제한 적용 -달빛어린이 병원 사건을 중심으로- (Antitrust Regulation on the Restriction of Business Activities by Healthcare Providers' Organization)

  • 정재훈
    • 의료법학
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    • 제19권2호
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    • pp.75-98
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    • 2018
  • 최근 서울고등법원은 대상판결(서울고판 2018. 4. 5, 2017누58580)을 통하여 대한소아청소년과 의사회의 소아과병원이나 소아과의사에 대한 제한 행위가 독점규제 및 공정거래에 관한 법률(이하 '공정거래법'이라고 한다) 제26조 제1항 제3호에 위반되는 지에 관하여 공정거래위원회(이하 '공정위'라고 한다)의 처분을 취소함으로써 이를 부정하였다. 대상판결은 종전에 확립된 대법원 판결에 따라 공정거래법 제26조 제1항 제3호에 있어서도 경쟁제한성이 필요하다는 전제에서 사업활동제한 행위가 성립하는지, 그 행위에 경쟁제한성이 있는지 등을 중심으로 심리하였다. 대상판결에 대하여는 다음과 같은 분석이 가능하다. 첫째, 공정거래법 제26조 제1항 제3호의 '제한'은 '과도한 제한'으로 해석하는 것이 바람직하다. 사업자단체가 구성원에 대하여 제한을 가하는 것은 원칙적으로 허용되지만, 예외적으로 공익적 차원에서 공정위가 규제를 한다는 취지에서 제한적으로 해석하는 것이 상당하다. 둘째, 대상판결은 원고의 행위가 구성사업자의 가격, 수량, 품질 등을 제한하여 경쟁제한성이 인정된다고 보기 어렵다고 판단하였다. 대상판결은 종전에 확립된 대법원 판결에 따라 공정거래법 제26조 제1항 제3호에 있어서도 경쟁제한성이 필요하다는 전제에 선 것으로 수긍할 수 있다. 그런데, 의료시장의 가격이 정부에 의하여 강력하게 통제되는 상태에서 경쟁제한성 판단을 위한 핵심적인 논제는 공급량 감소의 문제로서, 공급량이 경쟁제한효과를 유발할 정도로 감소하였음이 수량적으로 증명된다면 경쟁제한효과를 인정하는데 어려움이 없을 것이지만, 이는 일반적으로 증명하기 어려우며, 실제 이 사건에서 공정위가 공급량 감소를 증명할 유력한 증거를 제출하지 못한 것으로 보인다. 다른 한편, 공정거래법상 경쟁제한성은 경쟁제한의 우려가 있는 경우에도 인정되므로, 이 사건에서 경쟁제한효과가 발생할 우려가 있었는지의 증명이 문제된다. 이 사건은 공급량을 줄이기 위한 직접적인 의도와 목적이 드러나고 경험칙상 공급량이 지속적으로 감소할 것임을 인정할 수 있는 사건임에 비추어 대상판결의 논지에 대하여는 동의하기 어렵다. 대상판결이 사업자단체 규제를 통하여 경쟁제한성의 근본적인 문제를 다룬 것은 이론적인 측면에서나, 실무적인 측면에서나 의미가 있다. 대상판결은 경쟁제한성의 이해, 경쟁제한효과의 판단, 경쟁제한효과의 증명 수준 등에 관하여 의료서비스의 공급량을 매개로 하여 흥미로운 판단을 하였고, 대법원이 이를 어떻게 판단할지에 관하여 관심이 집중되고 있다.

아토피피부염 영아의 영양장애 사례보고와 채식주의에 관한 고찰 (Marasmus and Kwashiorkor by Nutritional Ignorance Related to Vegetarian Diet and Infants with Atopic Dermatitis in South Korea)

  • 정상진;한영신;정승원;안강모;박화영;이상일;조영연;최혜미
    • Journal of Nutrition and Health
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    • 제37권7호
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    • pp.540-549
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    • 2004
  • Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

소아과 의사에 의해 시행된 복부 초음파 검사 1,000예에 대한 분석 (Analysis of 1,000 Cases of Abdominal Ultrasonography Performed by a Pediatrician)

  • 배상인;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.28-35
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    • 2007
  • 목 적: 소아에서 초음파 검사는 복부 질환의 진단에 중요한 역할을 한다. 소아의 특성을 잘 알고 있는 소아과 의사에 의해 시행된 복부 초음파 검사의 경험을 분석하였다. 방 법: 2003년 1월부터 2005년 6월까지 부산대학교 병원 소아과에서 복부 질환의 증상으로 내원하여 복부 초음파 검사를 받았던 1,000명의 환자를 대상으로 병력지와 초음파 검사 소견을 후향적으로 분석하였다. 초음파 검사는 1명의 소아과 의사에 의해 시행되었으며 초음파 기기는 Sequoia System$^{(R)}$을 이용하고 3종류의 탐촉자를 사용하였다. 결 과: 남아가 584명(58.4%), 여아가 416명(41.6%)이었고, 평균 연령은 $4.7{\pm}4.0$세였다. 1세 미만이 274명 (27.4%), 1~5세가 310명(31.0%), 6~10세가 267명(26.7%), 11세 이상이 149명(14.9%)이었다. 내원 시 주증상은 복통이 439명(43.9%)으로 가장 많았고, 구토, 간 효소치의 증가, 황달, 설사, 복부팽만 등이 있었다. 검사 결과 정상 소견이 421명(42.1%), 비정상 소견이 579명(57.9%)이었다. 비정상 소견으로는 장간막 림프절염이 182명(31.5%)으로 가장 많았고, 그 외 지방간, 간염, 간비종대, 장중첩증 등이 있었다. 복통으로 검사한 경우는 장간막 림프절염이 32.6%로 가장 많았고, 그 외 장중첩증, 급성 충수돌기염, 요로결석, 급성 췌장염, 담석 등이 있었다. 구토로 검사한 경우는 장간막 림프절염이 12.7%명으로 가장 많았고, 그 외 특발성 유문협착증, 급성 충수돌기염, 장폐쇄증 등이 있었다. 간효소치 상승으로 검사한 경우는 지방간이 30명(25.4%)으로 가장 많았고, 그 외 간염, 총 담관낭, 간외 담도 폐쇄, 간경변증 등이 있었다. 비뇨생식계 질환과 관련된 55예의 초음파 검사 소견 중에서는 수신증이 25명 (45.4%)으로 가장 많았고 신결석, 낭종성 신질환, 종양 등이 있었다. 결 론: 소아에서 복부 초음파 검사는 복부 질환의 진단에 있어서 간편하고, 신속하며, 비침습적이며, 선별검사로 진단적 가치가 높다. 소아에서 복부 초음파 검사는 소아과 의사가 검사할 경우 보다 빨리 그리고 필요할 때 즉시 시행할 수 있으며, 환자의 경과 관찰을 위한 검사에도 효율적이다.

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Adolescent nutrition: what do pediatricians do?

  • Ryoo, Eell
    • Clinical and Experimental Pediatrics
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    • 제54권7호
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    • pp.287-291
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    • 2011
  • Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies and the lack of community interest. And the nutrition guidelines that is suitable for Korean adolescent leaves something to be desired, and the pediatrician's concern is lacking yet. In the Korean dietary reference intakes 2010 that was revised according to the 2007 Korean National Growth Chart and 2007 Korean National Health and Nutrition Examination Survey, the range for adolescents is changed to the age 12-18 and dietary reference intakes of some nutrients mainly with vitamin D is changed. Recently several researches, about how school nutrition policies and media effect on eating habits and the weight concerns, and influences of public nutrition policies and fast food commercials have been actively studied to improve adolescent nutritive conditions. In this review, I summarize the dietary reference intakes for Korean adolescents that were revised in 2010, and current studies about the adolescent nutrition.

Predictors of the Utilization of Oral Health Services by Children of Low-income Families in the United States: Beliefs, Cost, or Provider?

  • Kim Young Ok Rhee;Telleen Sharon
    • 대한간호학회지
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    • 제34권8호
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    • pp.1460-1467
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    • 2004
  • Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application

  • Lim, Jung Sub
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.286-293
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    • 2010
  • Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD) of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD) Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.