• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.367-374
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• 1986

To make better clinical diagnosis, authors reviewed 9 patients of nonchromosomal multiple malformation disorders with psychomotor retardation, who were evaluated at pediatric department of Yeungnam University hospital for recent 2 years. We could make clinical diagnosis in 5 patients out of 9 as Aarskog syndrome, Beckwith-Wiedemann syndrome, Hallermann-Streiff syndrome, Rubinstein Taybi syndrome and Weaver syndrome. But even in diagnosed cases, there were many discrepant findings in comparison with typical cases of reference literatures and family history was positive in only one case. Moreover we could not make diagnosis in 4 patients. Therefore we think it is necessary to make a survey of unique pattern, incidence, distribution and etiologic factors of malformation disorders in our country by geneticist and pediatrician as well as to improve the laboratory aids for better diagnosis and genetic counceling.

• Clinical and Experimental Pediatrics
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• v.54 no.7
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• pp.287-291
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• 2011

Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies and the lack of community interest. And the nutrition guidelines that is suitable for Korean adolescent leaves something to be desired, and the pediatrician's concern is lacking yet. In the Korean dietary reference intakes 2010 that was revised according to the 2007 Korean National Growth Chart and 2007 Korean National Health and Nutrition Examination Survey, the range for adolescents is changed to the age 12-18 and dietary reference intakes of some nutrients mainly with vitamin D is changed. Recently several researches, about how school nutrition policies and media effect on eating habits and the weight concerns, and influences of public nutrition policies and fast food commercials have been actively studied to improve adolescent nutritive conditions. In this review, I summarize the dietary reference intakes for Korean adolescents that were revised in 2010, and current studies about the adolescent nutrition.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1460-1467
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• 2004

Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.911-921
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• 2008

Learning disabilities (LD) are heterogeneous group of disorders with evidences of genetic or familial trait, intrinsic to the individual and presume to be due to central nervous dysfunction. Learning disabilities and attention deficit hyperactivity disorder (ADHD) are the two of the most common disorders in the population of school-age children. Typically academic achievements in children with learning disabilities are significantly lower than expected by their normal or above normal range of IQ. Although academic and cognitive deficits are hallmarks of children with LD, those children are also at risk for a broad range of behavioral and emotional problems. Almost all cases meet criteria for at least one additional diagnosis such as ADHD, developmental coordination disorder, depression, anxiety, obsessive compulsive disorder, tic disorder, among which ADHD is particularly predominant. Because of the response to the therapeutic intervention program is promising and positive when applied early, it is critical to recognize patients as early as possible. Pediatricians often are the first to hear from parents worried about a childs academic progress. It is not the responsibility of pediatrician to make a diagnosis, referring children for a diagnostic evaluation of LD is a reasonable first step. Pediatricians can make early referral of suspicious children by asking some serial short questions about basic and processing skills. With a basic knowledge about the clinical characteristics, diagnostic and therapeutic procedures of LD, pediatricians also can provide primary counseling and education for parents at their outpatient clinical settings.

• Journal of mucopolysaccharidosis and rare diseases
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• v.2 no.1
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• pp.23-26
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• 2016

Mucopolysaccharidosis (MPS) I is a rare, progressive and multisystemic disease with insidious initial signs and symptoms, and making an early diagnosis can be a challenge for the first-line general medical practitioner. We report a 6-month-old girl who was brought to our well baby clinic for regular immunization with the manifestations of lumbar gibbus, hirsutism, large Mongolian spots over back and buttock, and mild bilateral legs spasticity noticed by the general pediatrician, and then newly diagnosed with MPS I after referral to the geneticist in time. Her surgical history included inguinal hernia repair at 1 month old, $CO_2$ laser supraglottoplasty for laryngomalacia and tracheostomy due to chronic respiratory failure with ventilator dependence at 2 months old. Understanding and identification of the early signs and symptoms of this disease have the potential to early diagnosis and timely appropriate treatment, which could contribute to a better clinical outcome.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.1
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• pp.10-18
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• 2014

Recent advances in the diagnosis and treatment of inborn errors of metabolism have improved substantially the prognosis of many of these diseases, if diagnosed early enough before irreversible damage occurs. This makes it essential that the practicing pediatrician, especially neonatologists be familliar with the clinical presentations and systematic approaches of these disorders. Characteristic clinical presentations, methods of systematic approach and typing of various disorders is discussed in this review. The signs of neurological dysfunctions of many IEMs manifesting in the neonatal period is very nonspecific, such as poor feeding, poor sucking, apnea or tachypnea, vomiting, hypertonia, hypotonia, seizure, letharginess, consciousness change and coma. Many other non-metabolic severe disorders of neonatal period such as neonatal sepsis and intracerebral hemorrhage share these nonspecific symptoms. Hyperammonemia, metabolic acidosis, ketosis and hyperlatic acidemia are observed in many of these conditions but there are exceptions in which conditions all basal laboratory tests are normal, such as NKH, sulfite oxidase deficiency and peroxisomal disorders. According to the results of basal laboratory tests, IEMs in the neonatal period can be categorized in to 6 types. Grouping of IEMs into 6 types will make confirmatory tests and early emergency treatment more efficient.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.286-293
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• 2010

Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA) is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD) of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD) Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.

• Korean Journal of Hospice Care
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• v.5 no.2
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• pp.54-63
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• 2005

The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.4
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• pp.232-236
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• 2022

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

• Women's Health Nursing
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• v.6 no.3
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• pp.348-357
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• 2000

The purpose of this study was to investigate encouragement experience on breastfeeding of health professionals, and the support in their hospitals on breastfeeding. A questionnaire on breastfeeding was administered to the 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). Data was statistically analyzed according to descriptive statistics, Chi-square test and multivariant analysis. The results were as follows : 1. Most of the respondents (93.6%) had a knowledge regarding breastfeeding which had more advantage than formula-feeding. But their experience to educate the mother about breastfeeding was very limited (34.8%). The major problems were insufficient concern of healthcare professionals, no trained personnel's and lack of education programs on breastfeeding. 2. Most of the respondents (82%) had learned breastfeeding management in class at the university. But 2/3 of them had not been educated on breastfeeding management after graduation. 3. More than half of the hospitals had no breastfeeding education programs. And they recommended the formula-feeding to the mothers. 4. Seventy percent of the respondents recognized that breastfeeding information offered to the mothers in their hospitals might help to increase the rate of breastfeeding. But only 40% of hospital had offered breastfeeding information using pamphlets or brochures. In our study, a majority of respondents had not been educated on breastfeeding after graduation. A personal experience in breastfeeding is known predictor of confidence in breastfeeding. Educational programs may have an effect to change the health professionals behavior. Therefore, it is necessary to assist health professionals in obtaining more knowledge about breastfeeding. Continuing education programs to health professionals should be offered by nation and regional organization.