• 한국산학기술학회논문지
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• 제18권3호
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• pp.657-665
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• 2017

본 연구의 목적은 핵의학검사를 하는 수검자(환자)의 유효선량(mSv)을 손쉽게 산출할 수 있는 전용 프로그램을 제작 보급하여 핵의학검사의 피폭선량 연구와 선량정보 공개를 위해 조력하고자 한다. 프로그램은 ICRP 80, 106 Report와 추록4에 수록되어 있는 방사성의약품의 방사능당 유효선량(mSv/MBq)을 Database로 만든 다음 5가지(Area, Clark, Solomon(Fried), Webster, Young) 소아주입량 산출법과 7가지 체표면적 산출법이 적용되도록 Microsoft의 Visual Basic(In Excel)으로 제작하였다. 프로그램은 수검자의 연령, 방사성핵종, 표지화합물, 그리고 인체주입량을 입력하면 유효선량(mSv)이 산출된다. 소아의 경우 연령 입력 시 소아산출법이 활성화 되며 적용할 소아산출법을 선택하면 된다. 그리고 소아산출법 중 Area법을 선택하는 경우 체표면적산출법을 고르는 선택창이 활성화 된다. 그런 다음 성인의 주입량을 입력하면 소아의 주입량과 유효선량(mSv)이 자동으로 산출된다. 본 연구에서 제작한 핵의학검사의 환자 유효선량 계산 프로그램은 실제 계측선량이 아니지만 핵의학 검사 시 받게 되는 인체의 내부피폭선량을 가장 근접하게 산출할 수 있는 도구로서 의미가 있다. 향후 프로그램의 활용도를 높이기 위해 모바일기기에서 사용할 수 있는 애플리케이션으로 제작하여 일반인도 쉽게 접근할 수 있도록 할 것이다.

• Nutrition Research and Practice
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• 제14권3호
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• pp.230-241
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• 2020

BACKGROUND/OBJECTIVES: Inadequate nutrition in infants and young children affects physical growth and neurocognitive development. Therefore, early nutritional intervention is important to promote catch-up growth in young children with faltering growth. The aim of this study was to evaluate the effect of nutritional supplementation with a pediatric concentrated and balanced nutritional supplement formula on promoting growth and improving nutritional status in children with nonorganic faltering growth. SUBJECTS/METHODS: Children aged 12-36 months whose body weight-for-age was < 5^th percentile on the Korean Growth Charts were enrolled. Children born premature or having organic diseases were excluded. Children were instructed to consume 400 mL of formula per day in addition to their regular diet for 6 months. Pediatricians and dietitians educated the parents and examined the subjects every 2 months. Anthropometric parameters were measured at baseline and at 2, 4, and 6 months, and laboratory tests were done at baseline and 6 months. The good consumption group included children who consumed ≥ 60% of the recommended dose of formula. RESULTS: Total 82 children completed the 6-month intervention. At baseline, there were no significant differences in all variables between the good consumption and poor consumption groups. Weight and weight z-scores were significantly improved in the good consumption group compared to the poor consumption group at the end of the intervention (P = 0.009, respectively). The good consumption group showed a significant trend for gaining weight (P < 0.05) and weight z-score (P < 0.05) compared to the poor consumption group during 6 months of formula intake. The concentration of blood urea nitrogen was significantly increased in the good consumption group (P = 0.001). CONCLUSIONS: Nutritional supplementation with a concentrated and balanced pediatric nutritional formula along with dietary education might be an effective approach to promote catch-up growth in children with nonorganic faltering growth.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.169-178
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• 2008

목 적: 건강한 모유 수유아의 경우 생후 6개월까지는 철분 결핍이 일어나지 않으며 6개월 이전에는 철분을 보충할 필요가 없다고 알려져 있으나, 최근 건강한 모유 수유아에서도 생후 6개월 이전에 철 결핍과 철 결핍성 빈혈이 발생한다는 보고가 있다. 따라서 본 연구에서는 생후 6개월과 12개월 영아들의 철 영양상태를 알아보고, 생후 2개월부터 조기 저용량 철분보충요법을 시행하여 철 결핍과 철 결핍성 빈혈을 예방하는데 효과가 있는지 알아보고자 하였다. 방 법: 2004년 8월부터 2005년 7월까지 만 1년간 충북대학교병원 산부인과에서 만삭으로 출생한 건강한 신생아 87명을 대상으로 하였다. 이들을 생후 2개월에 분유 수유군(A군), 모유 대조군(B군), 모유 보충군(S군, 철분 5 mg/일 보충)으로 나누어 출생 시(제대혈), 생후 6개월, 12개월에 저장철(ferritin), 혈청 철(iron), 총철결합능(total iron binding capacity, TIBC), 트랜스 페린 포화도(transferrin saturation rate, TFSAT)와 헤모글로빈(hemoglobin), 헤마토크릿(hematocrit), 평균적 혈구용적(mean corpuscular volume, MCV), 평균적혈구혈색소량(mean corpuscular hemoglobin, MCH), 적혈구분포폭(red cell distribution width, RDW)을 측정하였다. 결 과: 1) 생후 6개월에 측정한 저장철, 혈청 철, TFSAT, 헤모글로빈은 세 군 중 모유 대조군에서 가장 낮았으며, 총철결합능과 적혈구분포폭은 가장 높았다. 저장철 고갈, 철 결핍, 철 결핍성 빈혈의 빈도는 모유대조군에서 각각 33, 33, 30%로 분유 수유군의 0, 5, 8%나 모유 보충군의 1, 7, 5%보다 높았다. 2) 생후 12 개월의 저장철, TFSAT, 헤모글로빈, MCV, MCH는 세군 중 모유 대조군에서 가장 낮았으며, 총철결합능과 적혈구분포폭은 가장 높았으나, 혈청 철과 헤마토크릿은 세 군 간에 유의한 차이가 없었다. 저장철 고갈, 철결핍, 철 결핍성 빈혈의 빈도는 모유 대조군에서 각각 73, 64, 50%로 분유 수유군의 4, 4, 3%나 모유 보충군의 9, 9, 7%보다 높았다. 결 론: 철 결핍 상태와 철 결핍성 빈혈은 모유 수유아에서 분유 수유아에 비해 높은 빈도를 보였다. 또한, 철분 보충 없이 모유 수유만 했던 영아의 경우 생후 6개월에도 철 결핍과 철 결핍성 빈혈이 발생하였으며, 조기 저용량 철분보충요법은 모유 수유아에서 철 결핍과철 결핍성 빈혈을 예방하는데 효과가 있었다.

• 대한치과마취과학회지
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• 제12권1호
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• pp.45-50
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• 2012

The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.