• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.417-419
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• 2012

Tumors of the central nervous system are common in the pediatric population and constitute the second most prevalent tumor type in children. Within this group, spinal cord tumors are relatively rare and account for 1 to 10% of all pediatric central nervous system tumors. We describe a very rare case of an intradural extramedullary spinal cord tumor with a subcutaneous mass and discuss its clinical presentation, pathogenesis, and treatment. A male infant was delivered normally, with uneventful development. At 16 days post-delivery, his family took him to a pediatrician because of a mass on his upper back. Magnetic resonance imaging of the thoracic spine revealed a well-demarcated soft-tissue mass with central cystic change or necrosis at the subcutaneous layer of the posterior back (T2-7 level). Another mass was found with a fat component at the spinal canal of the T1-3 level, which was intradural extramedullary space. After six weeks, the spinal cord tumor and subcutaneous mass were grossly total resected; pathologic findings indicated an atypical myxoid spindle cell neoplasm, possibly nerve sheath in type. The final diagnosis of the mass was an atypical myxoid spindle cell neoplasm. The postoperative course was uneventful, and the patient was discharged after nine days without any neurological deficit. We report a rare case of an intradural extramedullary spinal tumor with subcutaneous mass in a neonate. It is necessary to monitor the patient's status by examining consecutive radiologic images, and the symptoms and neurological changes should be observed strictly during long-term follow-up.

• 여성건강간호학회지
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• 제6권4호
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• pp.516-527
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• 2000

The purpose of this study was to investigate belief and attitudes on breastfeeding of physicians and nurses. A questionnaire was mailed to 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). The results were as follows : 1. The main reasons not to educate breast feeding in the hospitals were a lack of interest of the health professionals, a lack of educators and education programs. 2. The respondents thought that the best ways for lactating mother to get advices about breastfeeding during the first month were to give a call to health professionals in the hospitals where she had been delivered, or call to relatives or friends. 3. Breastfeeding attitudes of physicians and nurses did not differ according to gender, job, or type of the hospitals they work. 4. Breastfeeding attitudes were related with personal breastfeeding experience, breastfeeding knowledge, extracurricular education experience, encouragement experience. Physicians and nurses should give appropriate advices and support to lactating mothers to increase breastfeeding rate. They were, however, ill-prepared to counsel breastfeeding mothers. Therefore, it is necessary to instruct breastfeeding in the curriculum of the medical and nursing schools, and incorporate clinically based breastfeeding training into continuing education workshops. Improved breastfeeding education is a critical step in ensuring that health professionals are adequately prepared for this important role.

• 한국임상약학회지
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• 제20권3호
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• pp.205-212
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• 2010

The prescription sheets for outpatients from July 2008 to June 2009 from 7 community pharmacies in Ulsan City were surveyed for the anti-inflammatory drug (AID) prescription pattern. The AID prescription rate of pediatricians and ENT physicians were 30.0% and 34.8%, respectively. The oral steroidal anti-inflammatory drugs (SAIDs) were prescribed as much as 3.9% by pediatricians and 10.3% by ENT physicians. The chiefly prescribed oral SAID was prednisolone in pediatric clinics and methylprednisolone in ENT clinics. Meanwhile the prescription rate of oral non-steroidal anti-inflammatory drug (NSAID) was 22.5% by pediatricians and 21.4% in ENT physicians. The most favorable NSAIDs were propionate derivatives in both clinics. In case of externally-applied SAIDs, the prescription rate of pediatricians was 3.6% and that of ENT physicians was 2.8%. Among them, nasal spray, inhalant and gargle formulations for upper respiratory infection (URI) treatment occupied 35.8% of externally-applied SAIDs in pediatric clinics and 59.7% in ENT clinics. Further, it was observed that ENT physicians favored much stronger SAIDs in Group III of ATC classification (75.4% of externally-applied SAIDs) than pediatricians (49.2%). In the survey of AID combination rate, pediatric clinics showed much lower rate (1.4% of total AID prescriptions) than ENT clinics (7.5%). Among them, the combination rate of oral SAID and oral NSAID by ENT physicians (52.2% of total AID combinations) was much higher than pediatricians (36.6%), which might be over-prescription of AID agents. In conclusion, the AID prescription rate as well as AID combination rate, especially in SAID prescriptions, was much higher in ENT than pediatric clinics, which implies the higher confidency on AID drugs of ENT physicians even though the severity of patient's symptom could be considered.

• 대한소아치과학회지
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• 제32권4호
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• pp.589-594
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• 2005

혈우병은 성염색체 열성 유전양식에 따라 유전되는 출혈성 질환으로서 응고인자의 결핍이나 결손에 의해 혈액응고 시간이 지연되게 된다. 과거에는 혈우병 환자의 치과치료시 과다출혈의 위험성 때문에 치과시술을 위해서는 입원하여 내과 전문의나 혈액 전문의가 출혈을 조절하도록 하여 치료하는 것이 바람직한 것으로 여겨졌으나, 최근의 혈액응고기전에 대한 이해와 의료기술 발전에 의해 출혈을 좀더 효과적으로 조절할 수 있게 되었다. 본과에 내원한 혈우병 B, 중증과 혈우병 A, 중증에 해당하는 환아에서의 관혈적인 치과치료를 시행하여 각각의 과정 및 치료원칙에 관하여 다음과 같이 보고하는 바이다. 1 혈우병 환자의 치료시에는 반드시 환자의 내과 소아과 또는 혈액 전문의와 상의하여 긴밀한 협조하에 치과 치료를 시행하도록 한다. 2. 환자의 치료방법은 환자의 전신상태와 협조도 및, 필요한 시술의 위험성 정도에 따라 결정하도록 한다. 3. 치과치료의 전과 후에 혈액응고인자의 투여 등으로 발생하는 불편과 합병증의 기회를 최소로 하기 위해 치료를 위한 내원 횟수를 가능한 한 줄여주는 것이 바람직하며, 치료 시에는 감염을 예방하고 지혈을 도울 수 있는 치료를 시행해야 한다.

• Nutrition Research and Practice
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• 제12권3호
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• pp.215-221
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• 2018

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

• 대한한방부인과학회지
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• 제24권4호
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• pp.174-185
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• 2011

Objectives: The purpose of this study is to investigate all postpartum care center in Seoul about its state of doctors' linkage and oriental medical treatment. Methods: From May 1st 2011 to July 10th 2011, survey was done using a selfmade questionnaire by phone or visit. There were 12 categories including the state of doctors' linkage in postpartum care centers, treatment form of oriental medical doctors, utilization of herbal medicine and so on. The data collected was analyzed using Excel 2007 FOR WINDOWS. Results: 1. The doctors' linkage with postpartum centers included pediatricians(96.1%), oriental medicine doctors(61.2%), and gynecologists(34.0%). Of those postpartum centers, 66% had both pediatrician and oriental medical doctor which were the vast majority. 2. Out of 70 postpartum centers providing herbal medicine, 9 of them were supplied of herbal medicine by herb sellers(not doctor). Where as, at 63 oriental medical doctors-affiliated centers, 85.7% of them had oriental medical doctors' examinations. 3. Out of 70 postpartum centers providing herbal medicine, personalized prescription amounted to 35(50.0%), same prescriptions amounted to 34(48.6%), and 1(1.4%) refused to answer. 4. Out of all the patients that received explanation about the effects of herbal medicine, 62.9% had them explained by oriental medical doctors. Conclusions: These findings suggests that oriental medical doctors are actively involved with postpartum care centers but problems surfaced regarding individualized prescription insufficiency and the lack of administration. In the near future, if the expertise expand in the areas of pediatrics as well as obstetrics and gynecology, oriental medicine will have a more solid role in postpartum care part.

• Clinical and Experimental Pediatrics
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• 제63권3호
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• pp.79-87
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• 2020

Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual processes involved in platelet production and hemostasis are genetically controlled; to date, mutations of more than 50 genes involved in various platelet biogenesis steps have been implicated in IPDs. Representative IPDs resulting from defects in specific pathways, such as thrombopoietin/MPL signaling; transcriptional regulation; granule formation, trafficking, and secretion; proplatelet formation; cytoskeleton regulation; and transmembrane glycoprotein signaling are reviewed, and the underlying gene mutations are discussed based on the National Center for Biotechnology Information database and Online Mendelian Inheritance in Man accession number. Further, the status and prevalence of genetically confirmed IPDs in Korea are explored based on searches of the PubMed and KoreaMed databases. IPDs are congenital bleeding disorders that can be dangerous due to unexpected bleeding and require genetic counseling for family members and descendants. Therefore, the pediatrician should be suspicious and aware of IPDs and perform the appropriate tests if the patient has unexpected bleeding. However, all IPDs are extremely rare; thus, the domestic incidences of IPDs are unclear and their diagnosis is difficult. Diagnostic confirmation or differential diagnoses of IPDs are challenging, time-consuming, and expensive, and patients are frequently misdiagnosed. Comprehensive molecular characterization and classification of these disorders should enable accurate and precise diagnosis and facilitate improved patient management.

• Child Health Nursing Research
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• 제8권1호
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• pp.55-66
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• 2002

It is an important task to give adequate nutritions to infants and to wean properly for rapid growth. This study was conducted to survey on doing the weaning activities of the first-time mother. This study was to provide basic data of health teaching and nursing intervention for the promotion of ideal weaning activities. Survey was done from January to February in 2001. Total 444 mothers who have first-time baby under twelve month old were interviewed in five community health center around contry (Seoul, Choung-ju, Asan, Cheon-an, Jeju). The results are summarized as follows; Starting time of weaning was common in four month old(40.4%). Most common daily weaning times by age showed once(under 3 months), twice(4 to 7 months), three times(8 to 12 months). The younger, the more commercial weaning products(p<0.01). Education level showed relatively positive relation with home-made weaning food(p<0.05). Items showed low scores in 4 to 7 months group were starting new food item, waiting at least one week interval to new food, feeding by milk bottle, allowing grasping spoon, consulting pediatrician for problems after weaning, starting from morning, regular schedule. Items showed low scores in 8 to 12 months group were feeding whole egg rather than yolk only up to 12 months, keeping weaning interval were increased, feeding by milk bottle, trying various cooking method, not giving commerical cooking and instant food and unproper raw milk feeding. In weaning activities by general factors, mother age, health status, marriage duration, monthly income were statistically significant (p<0.05). To improve good weening activities, targetting on low maternal age and poor health status, and low income group, developing teaching materials and training program for items showed low scores and proper weaning time, type of easy home-made food and easy cooking method should be provided. Further study on effect of nursing intervention to improve weaning activities are needed.

• Restorative Dentistry and Endodontics
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• 제42권2호
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• pp.146-151
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• 2017

X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.536-544
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• 2019

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.