• 제목/요약/키워드: Various Disease of Children

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영유아의 영양평가 (Nutritional evaluation of infants and young children - About Definition, Method, necessity, Importance and Korean Medical Approach -)

  • 정다희
    • 대한융합한의학회지
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    • 제3권1호
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    • pp.15-27
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    • 2022
  • Objectives: This study was conducted to review the overall concept of nutritional evaluation of infants and young children. Methods: Literature search was done to study definition, method and importance of nutritional evaluation of infants and young children. Pubmed and Google scholarship were used in the research. Search words were 'Nutritional evaluation', 'infants' and 'young children'. Results: Nutrition evaluation is mainly used by physical measurement, clinical evaluation, dietary intake survey, and biochemical test depending on the age and disease. The treatment method for 治未病, which is a concept of korean medicine, and 健兒法 for treating the concept of weak children are considered to have very high applicability in solving various problems found through nutrition evaluation in korean medical approach. Conclusion: Infants and children are the fastest growing period of their lives, showing rapid growth in physical, and emotional development along with rapid brain growth. Therefore, inadequate nutrition during this period affects mental and physical growth and development not only during that period but also throughout life. Nutrition evaluation is divided into regular evaluation that includes children in all growing seasons and screening evaluation for problem solving, and follow-up nutritional evaluation that evaluates nutritional status in the long run. For each nutritional evaluation, evaluation is conducted by physical measurement, clinical evaluation, dietary intake survey, and biochemical test. By comprehensively interpreting them, nutritional status is determined. This study provides basic data on the proper nutrition evaluation method to identify and correct nutritional problems such as growth level, nutritional deficiency, and nutritional excess early.

A Long Way from Transfer to Transition: Challenges for Pediatric and Adult Nephrologists

  • Lemke, Johanna;Pape, Lars;Oh, Jun
    • Childhood Kidney Diseases
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    • 제22권1호
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    • pp.7-11
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    • 2018
  • Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.

초고층 아파트 거주 아동의 건강성 조사연구 (A Study of the Children's Health in Super-Highrise Apartments)

  • 백혜선;강인호
    • 한국주거학회논문집
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    • 제17권6호
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    • pp.1-8
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    • 2006
  • Though super-highrise apartment buildings have become increasingly widespread, their negative effects on the residents have not been investigated sufficiently and practically in domestic situations. In particular, the foreign discussion on residential environment and the residents' health can not be applied domestically due to physical or cultural differences including physical residential space structure and life-style. Therefore, this research aims to investigate the inter-relationship between residence in super-highrise apartments and their residents' health, to reveal the problems which exist. for this purpose, a parental-response health evaluation - questionnaire on children's physical, emotional and behavioral characteristics was given to a total of 336 persons. The health of the children living in super-highrise apartments is evaluated to be good, and is related to what floor of the apartment building people live on. It is represented that the higher the story, the better the children's health. However, there is no meaningful difference according to various evaluation items including the frequency and type of disease, emotional health, behavioral characteristics, etc. Therefore, it cannot be said that children's health shows no meaningful differences depending on what floor they live on. The parents dwelling on higher floors of the building display a more careful educational attitude. This is because they feel anxious about the children's safety as shown by the fact they live on higher stories.

Acalculous Diffuse Gallbladder Wall Thickening in Children

  • Lee, Ji Haeng;No, Young Eun;Lee, Yeoun Joo;Hwang, Jae Yeon;Lee, Joon Woo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권2호
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    • pp.98-103
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    • 2014
  • Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

다양한 신질환을 가진 소아에서 Cystatin C 검사의 임상적 유용성 (The Clinical Usefulness of Cystatin C in Evaluating Renal Function in Children with Various Renal Diseases)

  • 김기주;김정아;신재일;황유식;정일천;임종백;이재승
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.161-167
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    • 2007
  • 목 적 :사구체 여과율은 신손상 정도와 진행을 예측하는데 중요한 척도이다. 현재까지는 혈청 creatinine을 광범위하게 사용하고 있으나 creatinine의 많은 단점으로 인해 새로운 내부표지자의 필요성이 대두되었고 cystatin C가 새로운 신기능 지표로 주목을 받고 있다. 이에 본 연구는 cystatin C의 유용성을 확인하고자 creatinine과 비교하여 연구를 진행하였다. 방 법 : 2004년 8월부터 2006년 12월까지 연세대학교 세브란스 병원 소아과를 내원한 환자들로서 다양한 신질환을 가지고 있는 43명(총 검사 횟수는 60회)을 대상으로 하였으며 creatinine, cystain C, creatinine 청소율을 측정하였고 creatinine 청소율이 감소된 환자를 그 정도에 따라 3군(Group 1 CrCl < 40mL/min/$1.73m^2$, Group 2 :CrCl 40-60 mL/min/$1.73m^2$, Group 3 : CrCl >60 mL/min/$1.73m^2$)으로 나누어 비교하였다. 결과 : Creatinine 청소율과 1/cystatin C 및 1/creatinine의 상관성을 분석하였고 각각의 상관계수는 0.685(P<0.01)와 0.640(P<0.01)이였다. Creatinine 청소율이 80 mL/min/$1.73m^2$ 이하로 감소함을 검출할 진단적 정확도는 ROC curve로 분석한 결과 AUC가 cystatin C와 creatinine에서 각각 0.829, 0.826로 큰 차이를 보이지 않았다(P=0.848). Creatinine clearance가 40 mL/min/$1.73m^2$ 이상에서는 cystatin C가 creatinine보다 높은 민감도를 보이고 있었다(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%). 결론 : Cystatin C는 사구체 여과율을 측정하기 위한 유용한 내부 표지자이며 신기능 손상을 creatinine 보다 일찍 발견할 수 있다는 점에서 향후 신손상 검출을 위한 선별 검사로서 유용성이 높을 것으로 생각된다.

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Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder

  • Nam, Seok-Hyun;Lim, Myung Ho;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권2호
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    • pp.27-34
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    • 2022
  • Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

Nuclear Medicine in Pediatric Urology

  • Jang, Su Jin
    • Childhood Kidney Diseases
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    • 제19권1호
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    • pp.14-22
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    • 2015
  • Renal scintigraphic methods, which are physiologic and minimally invasive, have played important role in the management of various renal diseases in children, providing sensitive tool for early detection of disease even before structural changes become prominent and giving valuable functional and anatomical information to aid medical decision makings in the treatment and follow-up of patients. This review article focuses on the concept and advantages of renal scintigraphy in pediatric patients with various urologic diseases.

장애아를 가진 일부 모성의 임신기왕력에 대한 연구 (A Study on a past pregnancy experiences of maternity with handicaped children)

  • 김초강
    • 보건교육건강증진학회지
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    • 제3권1호
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    • pp.63-73
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    • 1985
  • Ratio of physically and mentally handicapped people among the total population is about 3∼4%. Regardless of the extent of seriousness of handicaps, they have to sustain various difficulties in their life time and pose challenging problems to their homes, community and nation. In the spectrum of their problems, measures such as treatment, rehabilitation and welfare work all occupied important part but most significant measure is the prevention. Such handicaps items from health care of maternal and child, mostly causes throughout the process of pregnancy, delivery and upbringing. And then this study is focused on the pregnant history of the mothers with handicapped children. The objective of this study is to identify the basic factors which can create a handicapped child during pregnancy and is to prevent the birth of such a child. For this study, 301 mothers who have handicapped children were selected, now receiving various training at 5 rehabilitation and educational facilities. And questionnaires distributed to them during the period of Oct, 1983 to Dec, 14. The collected responses have been analized in terms of significant numbers, percentage and metic average. Their related results are as follows: 1. The sexual ratio between the male and female was 58.5% compare 41.5%. The average age of the handicapped children was 10.1 years old and that of mothers at the time of the children's birth was 28.9 old years. They were born as 2.14th in their family, the ratio of antenatal care for pregnant mothers was 36.2% and 22.9% were abnormally delivered. 37.9% out of the total were born from mothers with ages above 35 years and as their first baby. 2. The time of confirming the handicapped nature of children was during babyhood by 97.1% and discovery of these misfortunes were made by chance. As for causes of those-handicapped status 20.9% disease from complication, 15.3% from difficulties experience at the time of delivery, 11.3% from heredity and 10% were results of drug abuse during pregnancy, and 49.8% of the handicapped children were mentally retarded.

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성인기에 진단된 당원병 제 Ia형의 다양한 임상 양상 (Heterogenous Clinical Manifestations in Adult Patients with Late Diagnosis of Glycogen Storage Disease type Ia)

  • 김유미;전종근;김구환;유한욱
    • 대한유전성대사질환학회지
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    • 제15권1호
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    • pp.9-17
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    • 2015
  • 당원병 Ia형은 glucose-6-phosphatase 효소의 결핍으로 인해 발생되는 상염색체열성 질환으로 특징적인 임상양상으로 대부분 영아기에 진단되나 증상의 경중에 따라 진단 연령이 늦어지기도 한다. 또한 환자 진단 시 유전 양식을 고려한 올바른 유전 상담과 더불어 형제, 자매에 대한 스크리닝이 중요하겠다. 본 연구는 성인기에 진단된 GSD Ia 자매에서의 임상양상의 차이를 기술하고 성인기 합병증에 대한 문헌을 고찰하여, 특히 간질환, 신부전 또는 대사성 질환으로 진료 받는 성인 환자들에서 당원병에 대한 감별과 당원병 진단 시 합병증에 대한 검사와 관리에 대해 필요성을 보고하는 바이다. 저혈당, 고지혈증, 고요산증, 젖산혈증, 대사성 산증, 기관 내 당원 축척에 대한 적절한 검사 및 약물 요법을 통해 급성 및 만성 합병증 예방과 적절한 치료를 위해 의료진의 체계적인 접근 및 노력이 필요하겠다.

Most Reliable Time in Predicting Residual Kyphosis and Stability: Pediatric Spinal Tuberculosis

  • Moon, Myung-Sang;Kim, Sang-Jae;Kim, Min-Su;Kim, Dong-Suk
    • Asian Spine Journal
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    • 제12권6호
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    • pp.1069-1077
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    • 2018
  • Study Design: A case study. Purpose: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change, and to define the accurate prediction time in assessing residual kyphosis. Overview of Literature: None of the previous papers up to now dealt with the residual kyphosis, stability and remodeling processes of the affected segments. Methods: One hundred and one spinal tuberculosis children with various stages of disease processes, age 2 to 15 years, were the subject materials, between 1971 to 2010. They were treated with two different chemotherapy formula: before 1975, 18 months of triple chemotherapy (isoniazid [INH], para-aminosalicylic acid, streptomycin); and since 1976, 12 months triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). The first assessment at post-chemotherapy one year and at the final discharge time from the follow-up (36 months at minimum and 20 years at maximum) were analyzed by utilizing the images effect of the remaining growth plate cartilage on chronological changes of kyphosis after initiation of chemotherapy. Results: Complete disc destruction at the initial examination were observed in two (5.0%) out of 40 cervical spine, eight (26.7%) out of 30 dorsal spine, and six (19.4%) out of 31 lumbosacral spine. In all those cases residual kyphosis developed inevitably. In the remainders the discs were partially preserved or remained intact. Among 101 children kyphosis was maintained without change in 20 (19.8%), while kyphosis decreased in 14 children (13.7%), and increased in 67 children (66.3%) with non-recoverably damaged growth plate, respectively. Conclusions: It could tentatively be possible to predict the deformity progress or non-progress and spontaneous correction at the time of initial treatment, but it predictive accuracy was low. Therefore, assessment of the trend of kyphotic change is recommended at the end of chemotherapy. In children with progressive curve change, the deformity assessment should be continued till the maturity.