General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.
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.
Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.
Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.
Atopic sensitization is a complex phenomenon that changes dynamically with age throughout childhood; its prevalence increases with age in young children. Additionally, with increasing age, the prevalence of sensitization to inhalant allergens and the prevalence of polysensitization to allergens increase. It is also well established that the development of atopic sensitization is the result of a complex interplay of genetic and environmental factors. However, there is considerable heterogeneity in the literature in terms of the effect of different environmental exposures in young children on the subsequent risk of atopic sensitization and allergic diseases. Previous studies on the relationship, in early life, between pet ownership, sex, exposure to secondhand smoke, exposure to traffic-related air pollution components, and atopic sensitization have yielded different results. Recent studies have highlighted the importance of gene-environment interactions, especially during early childhood, on the risk of subsequent atopic sensitization and allergic diseases. Therefore, pediatricians should consider the genetic and environmental determinants of atopic sensitization in infants and young children when diagnosing and treating patients with allergic diseases. Determining ways in which early exposure to these risk factors in young children may be reduced could be beneficial in preventing the likelihood of developing atopic sensitization.
Epiploic appendagitis is an inflammation of the epiploic appendage in which the small sacs projecting from the serosal layer of the colon are positioned longitudinally from the caecum to the rectosigmoid area. Epiploic appendagitis is rare and self-limiting; however, it can cause sudden abdominal pain in children. Epiploic appendagitis does not typically accompany other gastrointestinal diseases. Here, we report on a healthy eight-year-old girl who presented with abdominal pain, fever, vomiting, and diarrhea. Based on these symptoms, she was diagnosed with acute gastroenteritis, but epiploic appendagitis in the ascending colon was revealed in contrast computed tomography (CT). The patient was treated successfully with conservative management. CT is beneficial in diagnosis and further assessment of epiploic appendagitis. Pediatricians need to be aware of this self-limiting disease and consider it as a possible alternate diagnosis in cases of acute abdominal pain.
A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.
School bullying has become a major social problem in Korea after the emergence of media reports on children who committed suicide after being victimized by bullies. In this article, we review the characteristics of bullying, and investigate the role of the pediatrician in the prevention of and intervention against bullying and school violence. Bullying can take on many forms such as physical threat, verbal humiliation, malicious rumors, and social ostracism. The prevalence of bullying in various countries is approximately 10% to 20%. In Korea, the prevalence of school violence is similar but seems to be more intense because of the highly competitive environment. From our review of literature, we found that children who were bullied had a significantly higher risk of developing psychosomatic and psychosocial problems such as headache, abdominal pain, anxiety, and depression than those who were not bullied. Hence, it is important for health practitioners to detect these signs in a child who was bullied by questioning and examining the child, and to determine whether bullying plays a contributing role when a child exhibits such signs. Pediatricians can play an important role in the prevention of or intervention against school violence along with school authorities, parents, and community leaders. Moreover, guidelines to prevent school violence, such as the Olweus Bullying Prevention Program, KiVa of the Finish Ministry of Education, and Connected Kids: Safe, Strong, Secure of the American Academy Pediatrics, should be implemented.
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.
Congenital anomalies of the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characteristic of these lesions in order to diagnose and treat them properly. Three hundred and nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four (25.1 %) of 335 lesions were preauricular sinus and skin tag, 81 (24.2 %) were thyroglossal duct cyst, 81 (24.2 %) branchial anomaly, 58 (17.3 %) cystic hygroma and 31 were (9.2 %) dermoid cyst. The male-to-female ratio was 1.4:1. Thyroglossal duct cyst most commonly present at 3-5years, however branchial anomalies commonly are diagnosed in children younger than 1 year. Preauricular sinus showed familial tendency in three patients and was bilateral is 33.8 %. Most head and neck anomalies in children have specific clinical and anatomical characterics. A careful history and physical examination is very useful for diagnosis and proper management. Experienced pediatric surgeons should do the initial surgery since the recurrence rate after incomplete surgical excision can be high.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.