• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.797-803
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• 2008

Lymphadenopathy is a common problem in children and adolescents. A wide variety of diseases and conditions may present as lymphadenopathy and an understanding of these conditions is essential to determine the most appropriate diagnostic work-up for each patient. A detailed history and physical examination with careful attention to the anatomical regions drained by the involved lymph node or mass often leads to the appropriate diagnosis. A majority of these children will prove to have a benign disorder; however, it is important for the pediatrician to have an appreciation for the malignant diseases or serious systemic illnesses that may initially present with lymphadenopathy, to ensure the timely diagnosis of a serious disease.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.718-725
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• 2007

Sleep disorders are very common among pediatric patients. Its prevalence is between 10% and 45% in preschool- and school-aged children. However parents commonly do not concern about their children's sleeping habits and for many pediatricians, there is not part of the routine office visit about a childs sleep. Sleep disorders were classified by International Classification of Sleep Disorder (ICSD) as dyssomnias, parasomnias, sleep disorders associated with mental, neurologic, or other medical disorders, and proposed sleep disorders. There are lots of differences in the causes, manifestations, and managements of sleep disorders between children and adult. The sleep disorders in childhood may manifest themselves as bedtime resistance, refusal to go to bed at a parentally described time, sleep-onset delay, inability to fall asleep within a reasonable time, prolonged nighttime awakening, and inability to return to sleep without assistance after waking during the night, and so have wide-ranging influences on children's behavior, mood, school performance, and family life. It's very important for pediatrician to concern about the sleep disturbances in childhood and so the problems of sleep in children should be early detected and managed.

• ETRI Journal
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• v.41 no.4
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• pp.515-527
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• 2019

This paper discusses the design, implementation, and potential use of an ontology-based mobile pediatric consultation and monitoring system, which is a smart healthcare expert system for pediatric patients. The proposed system provides remote consultation and monitoring of pediatric patients during their illness at places distant from medical service areas. The system not only shares instant medical data with a pediatrician but also examines the data as a smart medical assistant to detect any emergency situation. In addition, it uses an inference engine to infer instant suggestions for performing certain initial medical treatment steps when necessary. The applied methodologies and main technical contributions have three aspects: (a) pediatric consultation and monitoring ontology, (b) semantic Web rule knowledge base, and (c) inference engine. Two case studies with real pediatric patients are provided and discussed. The reported results of the applied case studies are promising, and they demonstrate the applicability, effectiveness, and efficiency of the proposed approach.

• Health Policy and Management
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• v.32 no.4
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• pp.345-346
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• 2022

2022 was a time when the global healthcare system was challenged and has grown in response to the coronavirus disease 2019 pandemic. In addition, various issues accumulated in the process of quantitative growth have emerged in the Korean healthcare system. For instance, problems of sustainability in health insurance finances and removing bubbles from excessive medical utilization should be urgently resolved as tasks that occurred in the process of expanding the coverage of the health insurance system. The deficit of applicants for the pediatrician residency program suggests that expanding health insurance coverage alone has limitations in providing essential medical services. There is a need to incentivize doctors who provide essential medical care services. In 2023, we hope that efforts to enhance and internally reinforce the healthcare system will be concentrated.

• Clinical and Experimental Pediatrics
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• v.65 no.1
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• pp.10-20
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• 2022

The prevalence of developmental disabilities is increasing worldwide over time. Developmental issues in infancy or early childhood may cause learning difficulties or behavioral problem in school age, further adversely affecting adolescent quality of life, which finally lead to low socioeconomic status in family, increase in medical expenses, and other relevant issues in various ways. Early childhood has brain plasticity, which means there is a high chance of recovering from developmental issues by early detection and timely intervention. Pediatricians are placed an ideal position to meet with young children till 6 years of age, of which age range is the time applicable to early intervention. Determining child's developmental status can be made by 2 pathways such as developmental surveillance and developmental screening tests. For better results, pediatricians should update their knowledge about developmental issues, risk factors, and screening techniques through varying educational program or other relevant educating materials. This paper will update reports on the prevalence of developmental disabilities and review the recent results of the Korean developmental screening test and discuss relevant issues. Finally, it will be addressed the pediatrician's role in early detecting developmental issues and timely intervention.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.28-35
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• 2007

Purpose: The aim of this study was to evaluate the clinical usefulness of ultrasound examination of children performed by a pediatrician. Methods: One thousand children who presented with symptoms of a gastrointestinal disorder and underwent abdominal ultrasound evaluation in the Department of Pediatrics, between January 2003 and June 2006, were included in this study. We analyzed the patient's medical records and ultrasound results retrospectively. Results: Among the 1,000 patients, 58.4% were male and 41.6% were female. The mean age of the patients was $4.7{\pm}4.0$ years. The main reasons for ultrasound were abdominal pain (43.9%), vomiting (17.3%), elevated liver enzymes (11.8%), and jaundice (9.8%). Abnormal ultrasound findings were present in 57.9% of cases. The major abnormal findings were mesenteric lymphadenitis (29.2%), fatty liver (12.1%), hepatitis (6.4%), hepatosplenomegaly (6.2%), and acute appendicitis (4.8%). The time interval between the initial medical evaluation and the ultrasound evaluation was within 24 hours in most cases (78.5%). The main findings in children with abdominal pain were mesenteric lymphadenitis (32.6%), fatty liver (5.9%), intussusception (2.7%), and acute appendicitis (2.7%). The main findings in children with vomiting were mesenteric lymphadenitis (12.7%), hypertrophic pyloric stenosis (10.4%), and acute appendicitis (3.5%). The major ultrasound findings in children with urinary tract diseases were hydronephrosis (45.4%), urolithiasis (21.5%) and cystic renal disease (18.1%). Conclusion: Ultrasound examination played an important role as a non-invasive and prompt screening examination for detection of abdominal diseases. Ultrasound was an important tool for pediatricians to determine timely information for patient management.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.75-98
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• 2018

Recently, the antitrust tribunal of Seoul High Court revoked the disposition of Korea Fair Trade Commission(hereafter 'KFTC'). While KFTC determined that the restriction of Korea Pediatrician Association violated article 26 of the Monopoly Regulation and Fair Trade Act(Korean antitrust law), Seoul High court viewed that KFTC failed to prove the compulsory measures and the restraint of competition required in article 26. The 'restriction' of article 26 should be interpreted as 'excessive restriction'. Since entrepeneurs' organization is allowed to limit its member's activities, KFTC could regulate entrepeneurs' organization on a very exceptional basis. In addition, though entrepeneurs' organization did not use compulsory measures to enforce its resolution, its 'excessive restriction' could fit into the notion of 'restriction' of article 26. Under the current medical care system, the price of medical care is decided by Korean government. Therefore the restriction of Korea Pediatrician Association is not likely to have effect on the price. However, the resolution of Korea Pediatrician Association was aimed to decrease the supply of medical care. Therefore the resolution is capable of having effect on the competition. In this sense, though KFTC failed to submit direct evidence to support the decrease of quantity, there could be possibility of restraint of competition. The Seoul High Court's decision has important implications. The leading case on restraint of competition(Supreme Court 2002Du8628, Posco case) was delivered in 2007. However the remaining issue such as the standard and scope of restraint of competition is not clear. Through reappeal case of this decision, Supreme Court has to decide the line between competition and its restraint.

• Journal of Nutrition and Health
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• v.37 no.7
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• pp.540-549
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• 2004

Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.105-119
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• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.11-18
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• 2008

We often have difficulties in the diagnosis of acute abdominal pain in children because they are unable to adequately express the characteristics of their pain. With a good understanding of the etiologies of abdominal pain associated with ages, we should create a diagnostic approach based on the location of the pain. First, we must differentiate the surgical abdomen from the non-surgical acute abdomen. Then, we have to identify whether the pain originating from intestinal obstruction, ulcerative diseases, or hepatobiliary dysfunction. It is important to interview and examine the patient serially until the patient completely improves. These attitudes will reduce the patient's pain caused by delayed diagnosis and unavoidable misdiagnosis. Finally, the new insight for the appropriate use of analgesics against acute abdominal pain in children is now needed by the pediatrician.