• Childhood Kidney Diseases
• /
• v.15 no.2
• /
• pp.107-115
• /
• 2011

Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.1
• /
• pp.125-138
• /
• 1997

Along with recent economic prosperity, the consumption of commercially available beverages has increased dramatically. Beverages on the market are replacing tap water and constituting an increasing large proportion of the total daily fluoride intake. If such changes in the source of fluid intake are not taken into consideration, effective fluoride intake would become difficult in the fluoridated area while there would be confusion as to the basis for proper fluoride supplement prescription in the nonfluoridated area. So, dietary consultation is recommended for every pediatric patient. This study was conducted to provide the reference for dietary consultations on the subject of fluoride supplement using 72 beverages on the market. The fluoride content was measured and the fluoride intake from each age groups was calculated using fluoride ion specific electrode and HMDS-microdiffusion technique. 1. The average fluoride concentration of the 72 beverages was $0.23{\pm}0.10ppm$, from 0.0106ppm to 2.2050ppm. 2. Natural fruit juices, diluted fruit juices, carbonated beverages and mixed beverages showed average fluoride concentration of $0.15{\pm}0.66ppm$, $0.09{\pm}0.11ppm$, $0.15{\pm}0.23ppm$, $0.50{\pm}0.66ppm$, respectively. There were significant differrence between diluted friut juice drinks and mixed beverage, and between the carbonated beverages and mixed beverges(p<0.05). 3. Using available data on the daily total consumption of beverages and the relative consumption of beverages on the market according to age, daily fluoride intake for various age groups was calculated. According to the results, 2 to 3 year-old children need 0.13mgF/day, those between 4 and 6 year-old need 0.15mgF/day, and those between 7 and 10 year-old need 0.17mgF/day.

• Physical Therapy Korea
• /
• v.20 no.3
• /
• pp.62-73
• /
• 2013

Pediatric home-based physical therapy (PHBPT) provides professional rehabilitation programs at the patient's home, where the activities of daily life are actually performed. PHBPT also allows to avoid the difficulties of transporting children with disabilities to the clinic. Despite these advantages, PHBPT is not yet widely practiced in Korea. There is little objective information regarding the opinions of the main stakeholders on PHBPT. To investigate the awareness and demand of PHBPT among the main stakeholders, 41 pediatric physical therapists (PT) (of 60 contacted) were recruited from different regions of Korea on the basis of the regional population distribution. The recruited PTs completed their questionnaires and also participated in collecting questionnaires from 35 medical doctors (MD) with whom they worked and from randomly selected 201 parents of children with disabilities recruited. The overall response rate was 85.5%. The awareness of PHBPT differed between PTs (95.1%) and parents (67.2%) (p<.001). The survey showed that 82.9% of MDs had at least heard about PHBPT. Significantly more parents (83.5%) than MDs (57.1%), and 70.0% of PTs, wanted to start PHBPT service immediately (p<.001). Significantly more parents (90.0%) than PTs (73.2%) were willing to participate in PHBPT (p<.001). Opinions on the details of policies and procedures (i.e., necessity for prescription, treatment cost, and treatment frequency) differed among the respondent groups, but all favored a minimal qualification of 6~10 years of pediatric experience and a treatment session duration of 1 hour. These findings provide objective information to support health service administrators to understand the current demand and develop feasible policies and procedures of PHBPT in Korea.

• The Journal of Pediatrics of Korean Medicine
• /
• v.34 no.4
• /
• pp.77-100
• /
• 2020

Objectives The purpose of this study is to investigate recent clinical studies on the effect of herbal medicine for pediatric tonsillitis in China, and to seek better methods to treat and study for pediatric tonsillitis in Republic of Korea. Methods We searched clinical studies from the China National Knowledge Infrastructure (CNKI) by search formula (SU='扁桃体炎'+'扁桃炎'+'扁桃腺炎'+'乳蛾'+'喉蛾'+'蚕蛾'+'石蛾'+'珠蛾'+'肉蛾'+'乳蛾風'+爛乳風'+'tonsillitis') and (SU='中樂'+'中医樂'+'本草'+'湯'+'丸'+'散'+'方'+'顆粒'+'膠囊'+'自擬'+'herb'+'herbal'+'decoction'+'remedy'+'Chinese medicine'+'Korean medicine'+'kampo'+'formula'+'herbal drug'+'Chinese drug'+'plant'+'Chinese prescription'+'traditional medicine'+'Medicine, East Asian Traditional'+'Herbal Medicine') in professional search from January 2016 to August 2020. We analyzed the literature focusing on the treatment methods and results. Results Among 1464 searched studies, 35 randomized controlled trials were selected and analyzed. In most studies, the effectiveness of oral administration of herbal medicine on pediatric tonsillitis was significant. Most commonly used herbs were Fructus Forsythiae (連翹), Radix Glycyrrhizae (甘草), Radix Scutellariae (黃芩), Herba Menthae (薄荷), Fructus Arctii (牛蒡子), Radix Scrophulariae (玄蔘), Radix Platycodi (桔梗), Flos Lonicerae (金銀花), Radix Isatidis (板藍根), Radix Bupleuri (柴胡), Fructus Gardeniae (梔子), Rhizoma Belamcandae (射干), Radix et Rhizoma Rhei (大黃), Gypsum Fibrosum (石膏). Conclusions By analyzing the improvement of indicators such as total effective rate, cured rate, symptom disappearance time and symptom score, we found that herbal medicine treatment can help improve pediatric tonsillitis. However, additional studies are needed to solidify these findings.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.11 no.1
• /
• pp.27-31
• /
• 2011

We report two cases of accidental overdoses of intramuscular midazolam used for a conscious sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The pedodontist prescribed midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 2 ml (2 mg) by verbal order to hygienist. The hygienist instead of the pedodontist wrote a prescription for midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 2 ml (10 mg). The inexperienced nurse gave an injection to his buttock as prescription. The child fell into a deep sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The inexperienced pedodontist gave an injection to his buttock midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 3 ml (15 mg) instead of midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 3 ml (3 mg). The child fell into a deep sedation. Both cases had no complications, but the accidents happened as a result of the inexperienced dental staffs. The five times midazoalm instead of the intended doses was inadvertently given intramuscularly, fortunately caused no harm in our cases. However, the situations suggest that we should carefully check the dosage and review the correct procedures, even when using a drug that is considered to be familiar with most practitioners.

• Herbal Formula Science
• /
• v.27 no.2
• /
• pp.167-178
• /
• 2019

Objectives : This report describes 45 studies related to the use of Rhizoma dioscoreae main blended prescription from Donguibogam. Methods : The following conclusion were reached through investigations on the prescriptions that use Rhizoma dioscoreae as a key ingredient. Prescriptions that Rhizoma dioscoreae was taken as a monarch drug are utilized for 18 therapeutic purposes, for example, internal injury, stool disease, pediatric disease. In paticular, 24% of prescriptions appear in the chapter of internal injury, and 18% of those appear in the chapter of stool. Results : Prescriptions that utilize Rhizoma dioscoreae as the main ingredient are used in the treatment of indigestion, diarrhea and paralysis. Rhizoma dioscoreae is used in pathogenic factors such as water, water with damp, and used in pathology related to stomach system. Conclusions : The dosage of Rhizoma dioscoreae is 8li(about 0.29 gram) to 3jeon(about 11.25 gram), however 1jeon(about 3.75 gram) has been taken the most for clinical application. Sagunjatang and Siljangsan is the most useful base prescription which use the Rhizoma dioscoreae as the main ingredient.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.26 no.5
• /
• pp.249-265
• /
• 2023

Purpose: Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation. Methods: This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice. Outcomes included evaluation of the evolution of stool consistency and frequency; occurrence of colic, constipation, and diarrhea; and assessment of regurgitation severity. Infant crying, parental assessment of infant well-being, and parental satisfaction with the stool consistency were also evaluated. Results: In total, 190 infants (average age: 1.9±1.1 months) were included. After three months, stool frequency and consistency remained within the normal physiological range, with 82.7% of infants passing one or two stools per day and 90.4% passing loose or formed stools. There was no significant increase in the number of infants with diarrhea, whereas a decrease was observed in the number of infants with constipation after 1 month (p=0.001) and with colic after both 1 and 3 months (p<0.001). Regurgitation severity and crying decreased and parental satisfaction with stool consistency, formula acceptability, infant well-being, and sleep quality increased. Monitoring of adverse events did not reveal any safety concerns. Conclusion: Formulas containing LBG, prebiotics, and postbiotics were well tolerated and provided an effective strategy for managing infant regurgitation and gastrointestinal discomfort.

• Pediatric Infection and Vaccine
• /
• v.22 no.3
• /
• pp.136-142
• /
• 2015

The Korean Society of Pediatric Infectious Diseases (KSPID) has participated in the task force team consisting of government authorities as well as civil medical experts and facilities to block the spread of Middle East Respiratory Syndrome in 2015. KSPID posted the "Middle East Respiratory Syndrome (MERS) Pop-up" in the homepage of The Korean Pediatric Society and The Korean Society of Pediatric Infectious Diseases. KSPID also released the "Guidelines for testing for MERS in children and adolescents" and the "Instructions for the Operation of National Safe Hospital" for children and adolescents in a timely manner. Such actions were aimed to prevent unnecessary anxieties, studies and isolation of pediatric patients with respiratory symptoms and signs caused by other common microbial etiologies as being suspected for MERS patients. This strategy relieved the doctors and parents from unnecessary fear and prevented the loss of unnecessary health care costs, and has proven to be a well-judged guideline and management protocol as evaluated after the final end of MERS outbreak. KSPID and its members should support the presence of pediatric infectious disease (PID) specialists in every medium size hospitals in Korea by developing the need for consultation fees for PID consultation in the hospital based practice and promoting the potential for cost savings related to prevention of health care associated infections and optimal prescription of antimicrobial agents. KSPID and its members need to approach and develop a communication plan to political decision makers to demonstrate and convince them of the importance of a PID specialist service.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.22 no.2
• /
• pp.67-73
• /
• 2011

The purpose of licensing system is to ensure that the medicines are examined for safety, efficacy and quality. Nevertheless, off-label or unlicensed drug usages in pediatric practice is widespread in Korea and worldwide. Psychotropics are one of the most commonly used off-label or unlicensed drugs. The most valid approach to face this dilemma will be to have more evidences from pediatric pharmacological studies. Clinicians, in addition, need to monitor closely their off-label or unlicensed drug prescriptions to minimize the trial and error in practice. Researchers should publish their experiences and provide guidelines. Pharmaceutical companies, regulatory authorities, and consumer organizations should endeavor altogether for the children's right to get safe and efficacious drugs as adults do. Here, the definition as well as the current status of off-label and unlicensed drug prescriptions will be introduced. Critical issues regarding the off label drugs are discussed. In addition, I will describe the present condition as to the off-label and unlicensed drugs in child and adolescent psychiatry and the authorization process of off-label drug prescription in Korea. Lastly, direction we should like to take in this field will be mentioned.

• The Journal of Korean Medical History
• /
• v.14 no.2
• /
• pp.109-152
• /
• 2001

Throughout this paper, I adjusted the study of 'Qian Yi'(錢乙)'s Medical Thought, and the following is the summary. 1. 'Qian Yi' wrote 'Xiao Er Yao Zheng Zhi Jue'("小兒藥證直訣", edited by 誾季忠), and there were 'Shang Han Lun Zhi Wei'("傷寒論指微"), 'Ying Ru Lun', however those are loss of the record. 2. Qian Yi's 'Zhi Jue'("直訣") was influenced by 'Lu Xin Jing', yet if we compare the quality of 'Sheng Li, Byeng Li, Bang Jae'(生理, 病理, 方劑), 'Lu Xin Jing' cannot be the foundation of 'Zhi Jue'. He took over 'Nei Jing, Shang Han Lun, Jin Gui Yao Lue, Shen Long Ben Cao Jing, Tai Ping Sheng Hui Fang'("內經", "傷寒論", "金?要略", "神膿本草經", "太平聖惠方") and put them together to the direct clinical experiences of pediatrics. 3. There is no reference regarding the difficulties of pediatric diagnosis and diseases in 'Huang Di Nei Jing'("黃帝內經") Before 'Bei Song'(北宋), regardless of the lack of data related to pediatric diseases, 'Qian Yi' established the pediatric system in 'Xiao Er Yao Zheng Zhi Jue' for the first time. 4. In his diagnosis of the pediatric diseases, he 'Si Zhen He Can'(四診合參), also considered in the eye exam seriously. In addition, he closely combined 'Wu Zang Bian Zheng'(五臟辨證), and diagnosis the pediatric diseases. 5. 'Wu Zang Bian Zheng', what Qian established method was based on 'Zheng Ti Guan'(整體觀) in 'Huang Di Nei Jing'. It was based on clinical experiences and established the perspectives of 'Tian Ren Xiang Ying'(天人相應). First of all, he pinpointed 'Zhu Zheng'(主證) clearly. Secondly, he pinpointed the relationships to symptoms and then, he distinguished a generic character of 'Xu, Shi, Han, Re'(虛, 實, 寒, 熱). Finally, he made an induction from genealogical pediatric physiology. 6. 'Qian Yi' took a serious view of 'Ban Zhen'(斑疹), the inadequate field in those days. At that time, he criticized on the habituation of the misuse of medication. He treated separately which 'Ji Jing'(急驚) as 'Liang Xie'(凉瀉) and 'Man Jing'(慢驚) as 'Wen Bu'(溫補). He proposed 'Cong Gan Zhu Feng, Xin Zhu Jing'(從肝主風, 心主驚) theory and formulated 'Jing Feng'(驚風) theory as well. 7. As an opponent of a tendency to misusage of medicine, 'Qian Yi' made out a prescription with pliant medicine. He emphasized on 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 so lucid demonstration to 'Xu Shi Han Re'(虛實寒熱) of the five viscera in the field of 'Bang Yak'(方藥). 8. There were no pediatrics schools at that time, however, the pediatrics was being made up gradually by 'Jin Yuan Si Da Jia'(金元四大家) who was influenced by 'Qian Yi'. He raised an objection to medical treatment using pliant medicine. 'Qian Yi' applied 'Qu Xia'(驅下) treatment using 'Han Liang'(寒凉) medicine. 'Han Liang Pai'(寒凉派) is greatly influenced by Qian. 'Chen Wen Zhong'(陳文中) had a great impact on 'Han Liang Pai' who used a 'Zao Shu Wen Bu'(燥熟溫補) medicine for treatment. Since 'Song Jin'(宋金), he had a tremendous influence on pediatrics treating patients in both 'Han Wen'(寒溫) ways. 9. 'Qian Yi' had an influence on his medical thoughts on future generations, especially to 'Wan Quan'(萬全) of 'Ming Dai', 'Wu Tang'(吳塘) of 'Qing Dai'(淸代) and 'Yun Shu Jie'(?樹珏) of 'Min Guo'(民國). 'Wan Quan' is an advocate of 'You Yu, Bu Zu Zhi Shuo'(有餘, 不足之說)of 'Xiao Er Wu Zang'(小兒五臟) that he revealed Qian's 'Wu Zang Bian Zheng'(五臟辨證). 'Wu Tang' disclosed Qian's 'Xiao Er Ti Zhi Shuo'(小兒體質說) and 'Xiao Er Ke'(小兒科)'s 'Yong Yao Lun'(用藥論), therefore, he uncovered pediatric physiological characteristics through the advocate of Qian's 'Zang Fu Rou Ruo, Ji Gu Nen Qie, Yi Xu Yi Shi, Yi Han Yi Re' (臟腑柔弱, 肌骨嫩怯, 易虛易實, 易寒易熱). 'Yun Shu Jie' developed intrinsic relationships among time, symptom and 'Tian Ren Xiang Ying Guan'(天人相應觀), What 'Qian Yi' stated about them. And also, he developed Qian's 'Di Huang Wan'(地黃丸), 'Xie Qing Wan'(瀉靑丸), 'Yi Huang San'(益黃散) clinical usages as well. 10. Regarding Qian's 'Wu Zang Xu Shi'(五臟虛實), it has an influence on 'Zhang Yuan Su'(張元素)'s 'Zang Fu Bing Ji Bian Zheng'(臟腑病機辨證). 'Di Huang Wan', 'Xie Qing Wan', 'Xie Xin Tang'(瀉心湯), 'Yi Huang San', 'Xie Huang San'(瀉黃散) are the standard prescription of 'Wu Zang Bu Xie'(五臟補瀉). It is under the influence of Qian's treatment. Besides, 'Qian Yi' took a serious view of 'Xiao Er'(小兒)'s 'Pi Wei'(脾胃). 'Qian Yi' had an impact on 'Li Dong Yuan'(李東垣) one of the member of 'Bu Tu Pai'(補土派). 'Di Huang Wan', which placed great importance on 'Bu Yi Shen Yin'(補益腎陰), had a great impact on 'Da Bu Yin Wan'(大補陰丸) and 'Jin Yuan Si Da Jia' as well. 11. In a theory of Qian's 'Wu Zang Bian Zheng', though it had been stated clearly in 'Wu Zang Bian Zheng', but he neglected in 'Liu Fu Bian Zheng'(六腑辨證). In prescription field, The problem with the medicine is that it is either toxic or mineral, therefore, we are not able to use those medicine in a clinical testing at the present time.