• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.44-54
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• 2008

Chronic functional constipation is a common problem in childhood, with soiling a significant issue. It presents a management problem for pediatrician, and parental concern is high. About 5% of pediatric patients is known to have constipation and/or encopresis which is the second most referred disease in pediatric gastroenterology clinic, accounting for up to 25% of all visits. The etiology of constipation was based on initiation factors including vicious cycle concept, genetic factors, psychological factors, dietary influences and histologic abnormalities of colon. Emphasis is placed on the evaluation and management options that are available to the treating pediatrician. Careful history taking is most important to diagnose functional constipation. In addition, diagnostic tests such as plain abdominal radiograph, colonic transit study, anorectal manometry, barium enema were helpful to diagnose the constipation. Childhood constipation can be very delicate to treat. It often requires prolonged supports by physicians and parents, demystification, medical treatment and especially with the child and parent's cooperation.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1133-1135
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• 2008

The ultimate goal of the term alteration to pediatrics is that not only infants and children but also adlescents are subjet to pediatrics. At 27, June, 2007 the term pediatrics was altered to pediatrics (children and aoldescent medicine). From now on the roles of pediatricians for adolescents are needed and adolescent medicine should be reorganized in Korea. Although the numbers of children are decreased in the times of low birth rate, the efforts of pediatricians try to enlarge the range of treatment for adolescents are need.

• Clinical and Experimental Pediatrics
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• 제52권7호
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• pp.737-744
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• 2009

Metabolic syndrome (MS) in children and adolescents has become a global public health problem. MS among Korean children and adolescents has been increasing significantly over the past decade. This paper aims to provide the currently available information on the MS in children and adolescents. This review focuses on the definition, diagnostic criteria, epidemiology and pathophysiology which may be helpful for the pediatrician in early identification and management of the MS in children and adolescents.

• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.14-19
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• 2007

Advances in neonatal care have been responsible for the improved survival of prematurity but have not resulted in decreased morbidity. Once the high-risk infants is discharged from the hospital, his or her many special care needs do not cease. A well-coordinated multidisciplinary approach is essential in the follow-up care of these infants. Special attention must be given to their growth and nutrition, immunization, vision and hearing, and sequelae of illnesses experienced during the neonatal period. The role of pediatrician in helping these infants attain their full physical, neurodevelopmental, emotional, and psychosocial potential by providing optimal care is invaluable.

• Clinical and Experimental Pediatrics
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• 제50권9호
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• pp.841-847
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• 2007

Acute liver failure (ALF) is a very rare but devastating illness in children. Specific treatment to recovery is often not available, and the underlying cause of the liver failure is often unknown and diverse especially in children. Liver transplantation has increased the chance of survival; however it needs an optimal timing to reach the best result which is not familiar to pediatrician. This article discusses the current knowledge of the epidemiology, backgrounds and factors to be considered before establishing the treatment of ALF in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권1호
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• pp.1-10
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• 2007

Outcome of liver transplantation for children with end liver disease has been improved markedly during last two decades. Improvement of immunosuppressive agent and its strategy to use in children, development of innovative surgical technique, and better understanding of the course of liver transplantation attributed to better outcome of pediatric liver transplantation. Therefore this review article will focus on the problems which can occur during pre- and post-transplantation period, current strategy to use immunosuppressive agent for the better understanding of pediatrician who is not involved in transplantation but takes care of the children pre- and postoperatively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.93-101
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• 2008

보호자와 의사관계에서 가장 중요한 것은 신뢰이며, 특히 소아청소년과 좋은 관계를 유지하며 원칙적이면서도 구체적인 방법을 같이 의논하여 결정한다. 보호자가 이미 알고 있는 단편적인 의학지식을 잘 엮어서 통합하여 주고, 신체활동과 함께 상담하여야 한다. 1. 에너지 소비와 섭취의 균형을 유지해야하는 원칙을 강조한다. 맛있는 음식이 있을 때 과식하는 것은 사실 당연하다. 많이 먹었을 때 많이 움직여야 한다는 것을 강조한다. TV시청시간과 컴퓨터사용시간을 2시간 이하로 제한하고, 신체활동은 1시간 이상 될 때까지 증가한다. 2. 치료의 목적은 건강한 식습관으로 개선하여 평생 건강하게 지내는 것이 목적이다. 단순히 절식하는 것이 아니며 평생 건강할 수 있도록 좋은 습관으로 개선하는 것이다. 3. 건강하게 음식을 선택하는 방법을 교육한다. 소아청소년 비만은 성인비만으로 연결되며, 결국에는 대사증후군으로 당뇨나 고혈압 등 합병증이 오게 되므로, 음식을 어떻게 선택하는 것이 건강한지 설명한다. 4. 야채와 과일 섭취를 권장한다. 5. 음료수도 음식과 같이 생각하여 달콤한 음료수를 먹지 않는다. 6. 칼슘섭취를 위하여 저지방이나 무지방우유를 권한다. 7. 가족과 함께 식습관을 개선하다. 아침 먹기, 밤늦게 먹지 않기, 모든 음식 천천히 먹기, 씹지 않고 물과 함께 삼키지 않는지 확인하고 개선한다. 가족과 함께 식사하는 횟수를 늘린다. 부모는 자녀의 모범이 되어야 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권3호
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• pp.225-232
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• 2019

Purpose: To evaluate intra- and inter-observer variability and guideline adherence amongst pediatricians in treating children aged between 4 and 18 years referred with recurrent abdominal pain (RAP) without red flags. Methods: The first part of the study is a retrospective single-center cohort study. The diagnostic work-ups of eight pediatricians were compared to the national guidelines. Intra- and inter-observer variability were examined by Cramer's V test. Intra-observer variability was defined as the amount of variation within a pediatrician and inter-observer variability as the amount of variation between pediatricians in the application of diagnostic work-up in children with RAP. Prospectively, the same pediatricians were requested to provide a report on their management strategy with a fictitious case to prove similarities in retrospective diagnostic work-up. Results: A total of 10 patients per pediatrician were analyzed. Retrospectively, a (very) weak association between pediatricians' diagnostic work-ups was found (0.22), which implies high inter-observer variability. The association between intra-observer diagnostic was moderate (range, 0.35-0.46). The Cramer's V of 0.60 in diagnostic work-up between pediatricians in the fictitious case implied the presence of a moderately strong association and lower inter-observer variability than in the retrospective study. Adherence to the guideline was 66.8%. Conclusion: We found a high intra- and inter-observer variability and moderate guideline adherence in daily clinical practice amongst pediatricians in treating children with RAP in a teaching hospital.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.116-126
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• 2023

Purpose: This study aimed to evaluate the prevalence and risk factors of infant dyschezia as well as pediatrician awareness regarding this disease in Indonesia. Methods: This is a two-part cross-sectional study, which was divided into study A and B. Study A: Parents whose infants were under 9 months old and attended well-baby clinics were recruited at two randomly selected primary health centers. Parents also provided information on the infant's previous medical history, and socio-demographic and family details. The Rome IV criteria was translated and validated to be used for diagnosis of infant dyschezia. Study B: Randomly selected pediatricians were surveyed by using a questionnaire to evaluate their knowledge regarding infant dyschezia. Results: The prevalence of infant dyschezia based on the result of this study was 11.8%. Three risk factors had a significant relationship with infant dyschezia i.e., the number of children in the family (odds ratio [OR], 5.619; 95% confidence interval [CI], 2.194-14.390; p<0.001), complementary food diet (OR, 4.238; 95% CI, 1.902-9.443; p<0.001), and social-emotional disturbance (OR, 5.670; 95% CI, 2.550-12.609; p<0.001). The percentage of pediatricians correctly diagnosed infant dyschezia was 71.5%. Most pediatricians agreed that they did not perform any diagnostic testing (79.7%) and only provided education in cases of infant dyschezia (58.5%). Conclusion: The prevalence of infant dyschezia identified in our study was higher than that in other neighboring Asian countries, with the highest prevalence observed in infants 7-9 months old. Being an only child, receiving complementary food diet, and sociao-emotional disturbances were significant risk factors of infant dyschezia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권2호
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• pp.141-147
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• 2011

목적: 초음파 검사는 복통 환자의 선별 검사로 널리 사용되고 있다. 소아의 복통 환자에서 소아청소년과 의사에 의해 시행된 초음파 검사의 유용성에 대해 조사하였다. 방 법: 2008년 11월부터 2010년 6월까지 복통을 주소로 복부 초음파 검사를 받았던 소아 환자의 의무기록을 후향적으로 분석하였다. 결 과: 대상 환자는 628명(남자 325명, 여자 303명)이었고, 평균 연령은 $8.08{\pm}4.61$세였다. 급성 복통이 427명(68.0%), 1개월 이상의 만성 복통이 201명(32.0%)이었다. 복통의 위치는 미만성 36.9%, 배꼽주위 24.4%, 상복부 21.0%, 우하복부 8.1%, 하복부 3.0%, 우상복부 2.9%, 좌하복부 2.4%, 좌상복부이 1.3%였다. 327명(52.1%)에서 특이 소견이 없었고, 이상 소견이 있었던 301명(47.9%) 중 장간막 림프절염 170명, 소장염 또는 대장염 55명, 장중첩증 19명, 급성 충수돌기염 16명, 담관낭종 10명, Henoch-Sh$\ddot{o}$lein purpura 8명, 췌장염 2명이었다. 39명(6.2%)에서 복부 컴퓨터 단층 촬영 또는 자기공명촬영 검사가 병행되었는데 33명에서 동일한 결과가 나왔다. 복부 컴퓨터 단층 촬영을 통해 충수돌기염 2명, 췌장염 1명, Henoch-Sch$\ddot{o}$nlein purpura 1명이 진단되었다. 그러나 복부 초음파 검사에서 충수돌기염이 의심되었던 2명은 복부 컴퓨터 단층 촬영에서 진단이 되지 않았으나 수술을 통해 최종 충수돌기염으로 확진되었다. 전체 환자 중 624예(99.4%)에서 초음파 검사 결과와 최종 진단이 일치하였다. 결론: 소아과 의사에 의한 초음파 검사는 소아 복통의 감별진단에 신속하고 정확한 정보를 줌으로써 선별 검사로써 가치가 높으며 비침습적이고 방사선 조사가 없는 장점이 있다.