• Title/Summary/Keyword: Korean pediatrician

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A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

  • Watanabe, Takuma;Yokoyama, Atsushi;Shimizu, Satoshi;Bessho, Kazuhisa
    • 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.

Acute Abdominal Pain in Children (급성 복통)

  • Kang, Ki Soo
    • 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.

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Pediatric approach to early detection of learning disabilities (학습장애의 조기 발견을 위한 소아과적 접근)

  • Sung, In Kyung
    • 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.

Systematic Approach for the Diagnosis of IEM in the Neonatal Period (신생아기의 유전성대사이상질환의 체계적 접근방법)

  • Lee, Hong Jin
    • 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.

소아암 환아의 영적 케어

  • Sin, Min-Seon
    • 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.

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A Survey Examining Satisfaction with Korean Medical Treatment in Pediatric Patients Recovering from Traffic-Accident Injuries (소아 교통사고 환자의 한방치료 만족도 조사)

  • Shim, Soo Bo;Lee, Hyun Hee;Lee, Hye Lim
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.145-156
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    • 2021
  • Objectives This study aims at using information about treatment satisfaction obtained from surveying pediatric traffic-accident patients to guide future improvement in the quality of traditional Korean medical services. Methods The survey included 95 pediatric patients treated for traffic-accident injuries at a traditional Korean medical institution. The questionnaire was developed from a similar satisfaction survey for adult traffic-accident patients and approved by a traditional Korean pediatrician. The year-long survey ran from April 2020 to April 2021. The collected data were analysed using t-tests, one-way analysis of variance, and cross-tabulation. Results Of the pediatric traffic-accident patients surveyed, the highest percentage of children were aged between 1 and 7 years (70.5%). Just over half the patients (55.8%) complained of sleeping difficulties, and 54.7% exhibited symptoms of anxiety and fear. Almost all the patients surveyed (97.9%) reported an improvement in their symptoms after undergoing traditional Korean medical treatment. The degree of satisfaction with the treatment correlated with the alleviation of symptoms. Approximately 83.2% of respondents reported 'difficult-to-administer treatment for children' and rated their satisfaction degree comparatively lower than those patients with no reported treatment difficulties. The most struggling treatment was herbal medicine (42.1%), highlighting the need for improvement in the adaptability of herbal medicine to the treatment of pediatric patients. Conclusions Treatment acceptance by pediatric traffic-accident patients affects reported treatment satisfaction. It is important to improve treatment experience and adaptability to pediatric patients to improve the perceived quality of traditional Korean medical services.

Study on Weak Children Information Collection Using Personal Health Record (PHR) (개인건강기록 (PHR)을 이용한 허약아 정보 수집 연구)

  • Lee, Seungho;Kim, Anna;Jang, Hyunchul;Jeong, Minjeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.3
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    • pp.46-63
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    • 2017
  • Objectives The Korean Medicine (KM) PHR platform is a personalized healthcare service which allows individuals to keep and manage their own health records. When parents are reporting for their children from their memories, there is high possibility of recall errors. In these cases, it could be useful for doctors to collect the patient's symptoms through PHR platform. In this study, we aimed to investigate the clinical significance of the PHR by using the KM PHR platform in the pediatric clinic. Methods The PHR platform was used to collect child health information from parents and child care teachers. The collected data were analyzed in comparison with the results of screening by pediatrician. Results A total of 58 children were recruited, 44 of which health information were collected from their parents and their child care teachers. The remaining 14 children's health information were collected from their parents only. As a result the parents tended to perceive their children weaker than the child care teacher. Compared to other organs, there was a only significant difference in the heart weakness score and spleen weakness score in the comparison of the weak and healthy children. Conclusions Although the study was conducted on a small group of subjects, and used PHR platform developed specifically for adults to indirectly input child's symptoms, and analyzed their health information, there was a difference in health records between information providers. Development of PHR platform for children is needed to collect more reliable information.

A Study on the Medical Records and Qian Yi(錢乙)'s Medical Thought in $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ (소아약증직결(小兒藥證直訣)의 의안(醫案)에 나타난 전을(錢乙)의 의학사상에 관한 연구)

  • Hwang, Young Jun;Min, Sang Yeon;Kim, Jang Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.1
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    • pp.104-116
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    • 2010
  • Objectives The Medical record consist of symptoms, the cause of a disease, diagnostic studies, medical treatment, prescription, and so on. Doctors can use medical records as data for diagnosis, treatment, and education. Therefore, medical records are beneficial. Methods Translating $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ into modern Korean, and studying the medical records of Qian Yi(錢乙)'s Medical concept in $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ were examined. Results Regarding the diagnosis of the pediatric diseases, Si Zhen He Can(四該合參), consider in the eye exam closely. In addition, he closely combined the concept of Wu Zang Bian Zheng(五藏辨證), and diagnosis the pediatric diseases. Wu Zang Bian Zheng(五藏辨證). what Qian-Yi(錢乙) established method was based on Zheng Ti Guan(整體觀) in Huang Di Nei Jing(黃帝內經). Qian-Yi(錢乙) took a close look on Chuang Zhen(瘡疹) which had been an inadequate field in those days. He criticized on the habitual misuse of medications. He treated Ji Jing(急驚) and Man Jing(慢驚) separately; Ji Jing(急驚) as Liang Xie(凉瀉) and Man Jing(慢驚) as Wen Bu(溫補). He proposed Zong Gan Zhu Feng and Xin Zhu Jing(縱肝主風, 心主驚) theory and formulated Jing Feng(驚風) theory as well. He emphasized 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 a clear demonstration to Han Re Xu Shi(寒熱虛實) of the five viscera in the field of Fang yao(方藥). Conclusions Understanding $\ll$Xiao Er Yao Zheng Zhi Jue$\gg$ and its medical records of Qian Yi(錢乙)'s medical concept had quintessential meaning to both modern pediatrician and oriental medical doctors of all medical fields in treating children.

Breastfeeding Encouragement and Support of Health Professionals in the Hospitals (의료인의 모유수유에 대한 권장경험과 병원지원 실태조사)

  • Kang, Nam-Mi;Lee, Young-Hyuk;Hyun, Tai-Sun;Kim, Ki-Nam
    • 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.

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MULTIDISCIPLINARY CARE OF FREEMAN SHELDON SYNDROME (Freeman-Sheldon Syndrome의 치료에 대한 고찰)

  • Kim, Ji-Hun;Lee, Jeong-Sub;Chang, Cherry
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.545-550
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    • 2010
  • Freeman-Sheldon Syndrome (FSS, also known as "Whistling Face Syndrome") is a rare genetic condition which characteristically includes a small "whistling" mouth, a flat mask-like face, club feet, joint contractures usually involving the fingers and hands, and under-development of the cartilage of the nose. Intelligence is usually normal. Most of the features of this syndrome are due to muscle weakness. The patient, 11 years old boy was consulted from pediatrics to pediatric dentistry due to dental management. After clinical & radiographic examinations, severe multiple problems were found. Dental problems were microsomia(whistling mouth) & micrognathia, perioral muscle contracture, restricted mouth opening, poor oral hygiene & care, generalized dental caries, high palatal vault, severe malocclusion & crowding. And Orthopedic problems, ophthalmic & respiratory, anesthetic problems were found. Then He also had psychiatric problem, hospital(dental) phobia due to previous medical history(frequent hospitalization). And he had genital problem, cryptochidism, too. Due to these intricate problems, he suffered with feeding, swallowing difficulties and showed growth retardation. For enhancing patient's oral health, pediatric dentist, orthodontist, oral surgeon, pediatrician, psychiatrist, orthopedist, they all agree with early, cautious intervention and treatment. So, he has been treated by multidisciplinary care, now he is recovering general health maintenance.