• Journal of Trauma and Injury
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• v.37 no.3
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• pp.224-227
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• 2024

In Korea, helicopter emergency medical services (HEMS) with a physician on board were introduced in September 2011, funded by both central and regional governments. HEMS was integrated into the Korean emergency medical system to address the need for EMS in remote rural areas. The present report describes 16-month-old twins who fell from the fifth floor of an apartment building, located approximately 100 km from the nearest level I trauma center. Utilizing HEMS along with initial emergency management by an emergency physician, the patients were transported to the level I trauma center within the critical "golden hour." The children had sustained multiorgan injuries. Without intervention at the scene by an emergency physician, a fatal outcome was anticipated for both children. With the use of HEMS, one patient died, but the other survived with a good prognosis. The use of HEMS flights with an emergency physician on board may improve outcomes for pediatric patients with severe trauma in medically underserved rural areas.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.9-15
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• 2016

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

• Korean Journal of Clinical Pharmacy
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• v.20 no.2
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• pp.145-150
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• 2010

In order to investigate the antibiotic prescription pattern for upper respiratory infections (URI), the prescription sheets for outpatients from July 2008 to June 2009 were collected from 7 community pharmacies in Ulsan City, and the prescription pattern of Pediatric and ENT physicians was analyzed. The antibiotic prescription rates of Pediatric and ENT physicians were 63.8% and 61.7%, respectively. It was also observed that the oral antibiotic prescription was 95.6% in Pediatrics and 97.6% in ENT. The most favorable antibiotics by Pediatric physicians were penicillins (21.5%) penicillin-clavulanate (36.4%) and cephalosporins (16.5%), macrolides (11.6%), quinolones (3.5%), and nifuroxazide (3.5%). In case of ENT, the commonly prescribed antibiotics were also penicillin-clavulanate (47.6%), cephalosporins (31.6%), macrolides (11.9%) and sulfonamide (1.3%). The antibiotic combination rate was 7.6% in Peditrics and 1.9% in ENT, among antibiotic prescriptions. The combination of more than two oral antibiotics was examined as 66.8% in Pediatrics and 44.2% in ENT. The common oral antibiotic combination in Pediatrics was prescriptions of two ${\beta}$-lactam antibiotics (54.3%). Among them 83% was the combination of amoxicillin-clavulanate (7:1) and amoxicillin, which could be judged as antibiotic overuse. The next highly prescribed oral antibiotic combination was ${\beta}$-lactam/macrolide antibiotic combination probably for URI (11.3%) and ${\beta}$-lactam/nifuroxazide combination (10.0%) presumably for acute diarrhea. Comparatively the oral antibiotic combination prescribed by ENT physicians was negligible except one physician. In conclusion, the antibiotic over-prescription rate by antibiotic combination was much higher in Pediatrics than ENT, even though both clinical departments showed nealy the similar antibiotic prescription rates.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.377-382
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• 2012

Purpose: The purpose of this qualitative study was to understand the application of clinical reasoning throughout clinical and therapeutic knowledge of clinical pediatric physical therapists under physician prescriptions. Methods: Purposive sampling techniques were used in selection of nine clinical pediatric physical therapists in South Korea. Open and semi structured interviews were conducted, and were thoroughly examined and reviewed, followed by analysis of the clinical reasoning portion. Results: Pediatric physical therapists have been influenced by information gathering, physical function and evaluation of their patients, hypothesis-orientation, and re-evaluation and self-monitoring. Novice physical therapists were more dependent on physician prescriptions and parent's hope than the result of their own evaluation and critical pathway. Middle experienced pediatric physical therapists were more dependent on rapport with children and their parents. Highly experienced pediatric physical therapists were more reliant on hypothesis-orientation and self-monitoring. As reports on clinical experience of pediatric physical therapists have accumulated, clinical reasoning of pediatric physical therapists has been influenced by their experience, such as education, clinical pathology conference, their own clinical experience and rapport with patients and their parents than physicians' prescriptions. Conclusion: The findings of the current study are generally consistent with existing research on clinical reasoning. The results of the current study may be used by educators for enhancement of clinical reasoning abilities and knowledge of students or novices as well as development of a guide for use by suitable novices or students, and could provide important information for use in physical therapy practice and research.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.120-132
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• 2009

Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (${\kappa}$=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.233-239
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• 2013

Drug intoxication in children and adolescents is not uncommon in Korea. But the tendency of intoxication is changing with some factors, such as national surveillance system, Naderism and increasing concern among physicians. But the death rate of intoxication among adolescents is increasing in spite of decreasing total death rate of intoxication among children and adolescents. Therefore the physician must be concerned about the basic management of intoxication and figure out the common toxic substance among children and adolescents.

• Advances in pediatric surgery
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• v.15 no.2
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• pp.166-172
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• 2009

Labial adhesion in prepubertal girls is a common gynecologic problems. The labia minora are fused by thin transparent or thick fibrous membrane in the midline from the clitoris to posterior fourchet. The prevalence of labial adhesion may be even greater because many children with labial fusions are asymptomatic and these cases remain unreported. They are often unrecognized by physician and parents because most of symptomatic children complained urinary symptoms. The authors experienced 2 cases of labial adhesion in girls; one asymptomatic partial fusion and the other symptomatic complete fusion. These lesions were treated successfully by mechanical separation of labial adhesion and petroleum ointment (Vaseline) application without recurrence in follow-ups.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4359-4363
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• 2013

Background: Pediatric lymphadenopathy is a challenging medical situation for the child patient, the parents, and the physician. Although the bulk of masses will be benign the fear of malignancy is omnipresent. Therefore, the objective of this study was to identify the common cytopathological patterns of lymphadenopathy among Sudanese children. Methods: One hundred pediatric patients presenting with peripheral lymphadenopathy were included in the study, their ages ranging from 2 to 14 years, with a mean age of 7 years. Demographic characteristics, clinical manifestations and FNA materials were prospectively obtained. Results: FNA was performed in 100 cases (100%). There were no technical complications. All cases confirmed adequacy of specimen. Overall, FNA demonstrated 90 (90%) benign lesions and 10 (10%) malignant diagnosis. The benign lesions were reactive lymphoid hyperplasia (n=64), followed by benign granulomatous disease (n=26). Of the 10 cases diagnosed with malignancy, 7 (7%) were cases of non-Hodgkin`s lymphoma and the remaining 3 (3%) were Hodgkin's lymphomas. Conclusion: Pediatric lymphadenopathy is common in Sudan. CLA is the common frequent site. Lymphoma represents a major challenge in this setting.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.150-155
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• 2007

Mucopolysaccharidosis (MPS) is a disorder of storage in which there is excessive accumulation of glycosaminoglycans (GAGs) from lysosomal enzyme defect. Lysosomal accumulation of GAGs eventually results in cell, tissue and organ dysfunction. This patient may manifest mental retardation and physical disorders. This clinical report presents a girl with MPS having severe gingival hyperplasia. Gingivectomy was performed under general anesthesia. The pediatric dentist must be aware of oral manifestations present in the MPS. The approach to dental management will require teamwork between the dentist and the patient's physician.

• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.