• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권4호
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• pp.232-236
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• 2022

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.11-18
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• 2008

소아의 급성 복통은 많은 환자들이 복통의 성격에 대해 적절히 표현하지 못하므로 진단에 어려움을 겪는 경우가 많다. 연령별 급성 복통의 원인들을 잘 숙지하고, 복통의 위치에 따른 진단적 접근을 시행한다. 가장 우선적으로 외과적 복통 여부를 가능한 빠른 시간 내에 감별해야 하며, 다음으로 장 폐쇄, 궤양성 질환, 간담도계 질환 등을 확인해야 한다. 이 때 주의해야 할 것은, 환자의 복통이 완전히 좋아질 때까지 반복적인 문진과 진찰을 게을리 하지 않아야 하는 것이다. 이렇게 함으로써 진단이 지연되거나 피할 수 없는 오진으로 인해 발생하는 환자의 고통을 최소한으로 줄일 수 있을 것이다. 끝으로, 지금까지 금기시 해왔던 급성 복통 환아들에 대한 통증 치료에 대한 인식의 전환이 필요한 때이다.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.911-921
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• 2008

Learning disabilities (LD) are heterogeneous group of disorders with evidences of genetic or familial trait, intrinsic to the individual and presume to be due to central nervous dysfunction. Learning disabilities and attention deficit hyperactivity disorder (ADHD) are the two of the most common disorders in the population of school-age children. Typically academic achievements in children with learning disabilities are significantly lower than expected by their normal or above normal range of IQ. Although academic and cognitive deficits are hallmarks of children with LD, those children are also at risk for a broad range of behavioral and emotional problems. Almost all cases meet criteria for at least one additional diagnosis such as ADHD, developmental coordination disorder, depression, anxiety, obsessive compulsive disorder, tic disorder, among which ADHD is particularly predominant. Because of the response to the therapeutic intervention program is promising and positive when applied early, it is critical to recognize patients as early as possible. Pediatricians often are the first to hear from parents worried about a childs academic progress. It is not the responsibility of pediatrician to make a diagnosis, referring children for a diagnostic evaluation of LD is a reasonable first step. Pediatricians can make early referral of suspicious children by asking some serial short questions about basic and processing skills. With a basic knowledge about the clinical characteristics, diagnostic and therapeutic procedures of LD, pediatricians also can provide primary counseling and education for parents at their outpatient clinical settings.

• 대한유전성대사질환학회지
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• 제14권1호
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• pp.10-18
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• 2014

Recent advances in the diagnosis and treatment of inborn errors of metabolism have improved substantially the prognosis of many of these diseases, if diagnosed early enough before irreversible damage occurs. This makes it essential that the practicing pediatrician, especially neonatologists be familliar with the clinical presentations and systematic approaches of these disorders. Characteristic clinical presentations, methods of systematic approach and typing of various disorders is discussed in this review. The signs of neurological dysfunctions of many IEMs manifesting in the neonatal period is very nonspecific, such as poor feeding, poor sucking, apnea or tachypnea, vomiting, hypertonia, hypotonia, seizure, letharginess, consciousness change and coma. Many other non-metabolic severe disorders of neonatal period such as neonatal sepsis and intracerebral hemorrhage share these nonspecific symptoms. Hyperammonemia, metabolic acidosis, ketosis and hyperlatic acidemia are observed in many of these conditions but there are exceptions in which conditions all basal laboratory tests are normal, such as NKH, sulfite oxidase deficiency and peroxisomal disorders. According to the results of basal laboratory tests, IEMs in the neonatal period can be categorized in to 6 types. Grouping of IEMs into 6 types will make confirmatory tests and early emergency treatment more efficient.

• 호스피스학술지
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• 제5권2호
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• pp.54-63
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• 2005

The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

• 한방재활의학과학회지
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• 제31권4호
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• pp.145-156
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• 2021

Objectives This study aims at using information about treatment satisfaction obtained from surveying pediatric traffic-accident patients to guide future improvement in the quality of traditional Korean medical services. Methods The survey included 95 pediatric patients treated for traffic-accident injuries at a traditional Korean medical institution. The questionnaire was developed from a similar satisfaction survey for adult traffic-accident patients and approved by a traditional Korean pediatrician. The year-long survey ran from April 2020 to April 2021. The collected data were analysed using t-tests, one-way analysis of variance, and cross-tabulation. Results Of the pediatric traffic-accident patients surveyed, the highest percentage of children were aged between 1 and 7 years (70.5%). Just over half the patients (55.8%) complained of sleeping difficulties, and 54.7% exhibited symptoms of anxiety and fear. Almost all the patients surveyed (97.9%) reported an improvement in their symptoms after undergoing traditional Korean medical treatment. The degree of satisfaction with the treatment correlated with the alleviation of symptoms. Approximately 83.2% of respondents reported 'difficult-to-administer treatment for children' and rated their satisfaction degree comparatively lower than those patients with no reported treatment difficulties. The most struggling treatment was herbal medicine (42.1%), highlighting the need for improvement in the adaptability of herbal medicine to the treatment of pediatric patients. Conclusions Treatment acceptance by pediatric traffic-accident patients affects reported treatment satisfaction. It is important to improve treatment experience and adaptability to pediatric patients to improve the perceived quality of traditional Korean medical services.

• 대한한방소아과학회지
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• 제31권3호
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• pp.46-63
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• 2017

Objectives The Korean Medicine (KM) PHR platform is a personalized healthcare service which allows individuals to keep and manage their own health records. When parents are reporting for their children from their memories, there is high possibility of recall errors. In these cases, it could be useful for doctors to collect the patient's symptoms through PHR platform. In this study, we aimed to investigate the clinical significance of the PHR by using the KM PHR platform in the pediatric clinic. Methods The PHR platform was used to collect child health information from parents and child care teachers. The collected data were analyzed in comparison with the results of screening by pediatrician. Results A total of 58 children were recruited, 44 of which health information were collected from their parents and their child care teachers. The remaining 14 children's health information were collected from their parents only. As a result the parents tended to perceive their children weaker than the child care teacher. Compared to other organs, there was a only significant difference in the heart weakness score and spleen weakness score in the comparison of the weak and healthy children. Conclusions Although the study was conducted on a small group of subjects, and used PHR platform developed specifically for adults to indirectly input child's symptoms, and analyzed their health information, there was a difference in health records between information providers. Development of PHR platform for children is needed to collect more reliable information.

• 대한한방소아과학회지
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• 제24권1호
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• pp.104-116
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• 2010

Objectives The Medical record consist of symptoms, the cause of a disease, diagnostic studies, medical treatment, prescription, and so on. Doctors can use medical records as data for diagnosis, treatment, and education. Therefore, medical records are beneficial. Methods Translating $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ into modern Korean, and studying the medical records of Qian Yi(錢乙)'s Medical concept in $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ were examined. Results Regarding the diagnosis of the pediatric diseases, Si Zhen He Can(四該合參), consider in the eye exam closely. In addition, he closely combined the concept of Wu Zang Bian Zheng(五藏辨證), and diagnosis the pediatric diseases. Wu Zang Bian Zheng(五藏辨證). what Qian-Yi(錢乙) established method was based on Zheng Ti Guan(整體觀) in Huang Di Nei Jing(黃帝內經). Qian-Yi(錢乙) took a close look on Chuang Zhen(瘡疹) which had been an inadequate field in those days. He criticized on the habitual misuse of medications. He treated Ji Jing(急驚) and Man Jing(慢驚) separately; Ji Jing(急驚) as Liang Xie(凉瀉) and Man Jing(慢驚) as Wen Bu(溫補). He proposed Zong Gan Zhu Feng and Xin Zhu Jing(縱肝主風, 心主驚) theory and formulated Jing Feng(驚風) theory as well. He emphasized the treatment to Gong Bu Shang Zheng, Bu Bu Zhi Xie, Xiao Bu Jian Shi(攻不傷正, 補不滯邪, 消補兼施) because he had a clear demonstration to Han Re Xu Shi(寒熱虛實) of the five viscera in the field of Fang yao(方藥). Conclusions Understanding $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ and its medical records of Qian Yi(錢乙)'s medical concept had quintessential meaning to both modern pediatrician and oriental medical doctors of all medical fields in treating children.

• 여성건강간호학회지
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• 제6권3호
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• pp.348-357
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• 2000

The purpose of this study was to investigate encouragement experience on breastfeeding of health professionals, and the support in their hospitals on breastfeeding. A questionnaire on breastfeeding was administered to the obstetricians, pediatricians and nurses at the department of pediatrics or obstetrics of university hospital and private hospital in Seoul and Choong-Chung Province in South Korea. Total numbers of study subjects were 346 (pediatrician 67, obstetrician 41, nurse 238). Data was statistically analyzed according to descriptive statistics, Chi-square test and multivariant analysis. The results were as follows : 1. Most of the respondents (93.6%) had a knowledge regarding breastfeeding which had more advantage than formula-feeding. But their experience to educate the mother about breastfeeding was very limited (34.8%). The major problems were insufficient concern of healthcare professionals, no trained personnel's and lack of education programs on breastfeeding. 2. Most of the respondents (82%) had learned breastfeeding management in class at the university. But 2/3 of them had not been educated on breastfeeding management after graduation. 3. More than half of the hospitals had no breastfeeding education programs. And they recommended the formula-feeding to the mothers. 4. Seventy percent of the respondents recognized that breastfeeding information offered to the mothers in their hospitals might help to increase the rate of breastfeeding. But only 40% of hospital had offered breastfeeding information using pamphlets or brochures. In our study, a majority of respondents had not been educated on breastfeeding after graduation. A personal experience in breastfeeding is known predictor of confidence in breastfeeding. Educational programs may have an effect to change the health professionals behavior. Therefore, it is necessary to assist health professionals in obtaining more knowledge about breastfeeding. Continuing education programs to health professionals should be offered by nation and regional organization.

• 대한소아치과학회지
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• 제37권4호
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• pp.545-550
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• 2010

Freeman-Sheldon Syndrome(FSS)은 드물게 발생하는 선천성 유전 질환으로 휘파람을 부는 듯한 특징적인 안모로 인해 'Whistling face syndrome'으로 불리워진다. 또한 편평한 안모, 긴 인중(philtrum), 낮은 비연골이 나타나 두드러진 안면이상을 보이고, 내반족(club foot, 內反足), 손가락의 관절구축(joint contracture)으로 인한 풍차 모양의 손을 가지며, 지능은 보통 정상이다. 본원에 내원한 환아는 이 질환의 특징적 양상인 구강 주위 근육의 수축으로 소구증 및 개구제한, 높은 구개 및 부정교합, 치열의 심한 총생을 보여 구강위생이 매우 불량하였고 치과치료에 비협조적이었다. 소아치과적 행동조절 및 구강위생관리, 섭식장애의 상담으로 치과적 문제는 다소 개선되었으나, 안과 및 정형외과, 신경정신과, 교정과, 마취과적 문제로 인해 다양한 협진이 필요하며 계속적인 관찰 및 치료가 요구되기에 이를 보고하는 바이다.