• Title/Summary/Keyword: child under 10 years

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Clinical Features of Subacute Necrotizing Lymphadenitis in Children (소아 아급성 괴사성 림프절염의 임상적 특징)

  • Hong, Ji Young;Bae, Sun Hwan;Kim, Wan Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.994-999
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    • 2002
  • Purpose : There is a predilection for subacute necrotizing lymphadenitis(SNL) in young Asian women. Few pediatric cases have been reported. This study was performed to evaluate clinical features of children with SNL. Methods : We retrospectively analyzed clinical features of 23 cases of SNL under 15 years of age identified in Nowon Eulji Hospital from February 1995 to January 2002. Two cases were diagnosed by excisional biopsy and 21 cases by fine needle aspiration. Results : The ages ranged from 14 months to 14 years(mean $8.1{\pm}3.8$ years). The male to female ratio was 1 : 1.6. Ten cases(10/23) were diagnosed in 2000. The onset was more frequent in spring. The common presenting symptoms were neck mass(22/23), pain(12/20) and fever(8/18). Fever subsided within two weeks in seven out of eight and lymphadenopathy resolved within five months in 14 out of 15. The mean WBC count was $7,664{\pm}3,454/mm^3$. Elevated levels of ESR(10/ 12) and lactate dehydrogenase(5/6) and positive reaction for CRP(3/4) were frequent. Radiologically measured greatest diameter of the enlarged lymph nodes was less than 2 cm in 14 out of 15. One case occurred in a child with alopecia areata and one case with type 1 diabetes. Clinical outcomes were good in 23 cases. Conclusion : SNL should be considered in children with cervical lymphadenopathy regardless of fever or pain. SNL seems not rare in pediatric groups in Korea.

Value of the International Classification of Diseases code for identifying children with biliary atresia

  • Tanpowpong, Pornthep;Lertudomphonwanit, Chatmanee;Phuapradit, Pornpimon;Treepongkaruna, Suporn
    • Clinical and Experimental Pediatrics
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    • v.64 no.2
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    • pp.80-85
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    • 2021
  • Background: Although identifying cases in large administrative databases may aid future research studies, previous reports demonstrated that the use of the International Classification of Diseases, Tenth Revision (ICD-10) code alone for diagnosis leads to disease misclassification. Purpose: We aimed to assess the value of the ICD-10 diagnostic code for identifying potential children with biliary atresia. Methods: Patients aged <18 years assigned the ICD-10 code of biliary atresia (Q44.2) between January 1996 and December 2016 at a quaternary care teaching hospital were identified. We also reviewed patients with other diagnoses of code-defined cirrhosis to identify more potential cases of biliary atresia. A proposed diagnostic algorithm was used to define ICD-10 code accuracy, sensitivity, and specificity. Results: We reviewed the medical records of 155 patients with ICD-10 code Q44.2 and 69 patients with other codes for biliary cirrhosis (K74.4, K74.5, K74.6). The accuracy for identifying definite/probable/possible biliary atresia cases was 80%, while the sensitivity was 88% (95% confidence interval [CI], 82%-93%). Three independent predictors were associated with algorithm-defined definite/probable/possible cases of biliary atresia: ICD-10 code Q44.2 (odds ratio [OR], 2.90; 95% CI, 1.09-7.71), history of pale stool (OR, 2.78; 95% CI, 1.18-6.60), and a presumed diagnosis of biliary atresia prior to referral to our hospital (OR, 17.49; 95% CI, 7.01-43.64). A significant interaction was noted between ICD-10 code Q44.2 and a history of pale stool (P<0.05). The area under the curve was 0.87 (95% CI, 0.84-0.89). Conclusion: ICD-10 code Q44.2 has an acceptable value for diagnosing biliary atresia. Incorporating clinical data improves the case identification. The use of this proposed diagnostic algorithm to examine data from administrative databases may facilitate appropriate health care allocation and aid future research investigations.

Denver II Developmental Screening Test: A Cross Cultural Comparison (Denver II 발달검사를 이용한 한국과 미국의 아동 발달 비교 연구)

  • Shin, Hee-Sun;Han, Kyung-Ja;Oh, Ka-Sil;Oh, Jin-Joo;Ha, Mi-Na
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.89-97
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    • 2002
  • Purpose: The purpose of this study is to explore the validity of the application of the Denver II developmental screening test to Korean children. This screening test. which was developed and standardized in United States. was designed to screen for developmental delay in Korea. and to compare the levels of development of Korean children with the development of children from the U.S. Method: Quota sampling. NP To facilitate field sampling. the age range used from 0 to 6 years old. was split into 10 different age groups. Sample size was estimated according to residence. 1.054 children were recruited from Seoul's metropolitan. urban and rural areas. NP To fill the quota established. the Recruitment and testing of children was done at public health centers, pediatric outpatient clinics of general hospitals and a child care center. The 25, 50, 75 and 90 percentiles were identified by using logistic regression analysis and were calculated as norms. The items in which the ages of both 50 and 90 percent passing differed more than 20 percent by the calculation was identified for comparison. NP Result: There were significant differences found in 45 items between Korean children and the children from the City of Denver as it relates to age differences. 90% of the sample passed items among 125 items from 4 sectors, e.g., personal- social. fine motor adaptive, language, and gross motor sectors. Korean children were found to be advanced in 9 items, whereas there were significant differences found in 38 items in our comparison of the two countries for age differences when 50% of sample pass items. Korean children were found to be advanced in 16 items. NP Conclusion: The result showed that there was a discrepancy in the developmental norms. It could be explained by the differences in the developmental environment. including child rearing patterns and ethnicity. Therefore, a restandardization of the Denver Screening Test is necessary as it relates to its application on Korean children. This restandardization is necessary in order to avoid both under and over-referrals of children with developmental abnormality. The modification of items in the language sector is especially suggested.

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The Anxiety, Diabetes-Related Distress and Posttraumatic Growth of Parents Who Have Child with Type 1 Diabetes (1형 당뇨병 자녀를 둔 부모의 불안, 당뇨관련 스트레스 및 외상 후 성장)

  • Kim, Mi Young;Kang, Hyun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.257-268
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    • 2017
  • The purpose of this study was to examine the anxiety, levels of diabetes-related distress, and post-traumatic growth of parents who have children with type 1 diabetes and determine the correlation between the differences and variables based on the general characteristics and disease-related characteristics. This is a descriptive survey research and data collection was conducted from January 4th-29th of 2016 with an online survey in an internet community for type 1 diabetes. Seventy seven individuals were included in the final analysis. Statistical analysis was carried out with a t-test, Mann-Whitney U test, Kruskal-Wallis test, and Pearson correlation coefficient. The study results showed that posttraumatic growth was significantly high (p<.05) under parents with a religion, and that parental anxiety and stress were high with children under 6 years of age (p<.05), with cases of hypoglycemia (p<.05), and with high levels of glycated hemoglobin (p<.05). Anxiety and stress had a positive correlation (r=.684, p<.001), and anxiety and stress exhibited a negative correlation with posttraumatic growth (r=-.401, p<.001; r=-.327, p<.05). This suggests that posttraumatic growth can reduce the negative emotions sufficiently, and that a mediating mechanism is needed that promotes posttraumatic growth while decreasing the level of anxiety and stress.

The relationship between the burden and the social support of grandmothers caring their grandchildren (손자녀를 돌보는 조부모의 부담감과 사회적 지지)

  • Kwon In Soo
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.212-223
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    • 2000
  • The purposes of this research were to add to the developing knowledge base about the burden and social support of grandmothers involved with caring grandchildren, and to examine whether a significant relationship exists between their burden and social support perceived by the grandmothers. A convenience sample of 102 grandmothers was recruited from five collective apartment areas at a small city in Korea. The criteria of selection of sample were that the grandmothers were raising their grandchildren under the age of 36 months for 3 months or longer at own or gandchildren's home. The instruments used were a 15-item multidemensional burden scale and a 8-item social support scale. Both scales were self report, five point Likert type scales. The higher the score, the higher the degree of burden and social support. Data was collected by two prepared research assistants visiting subjects' home from December 10, 1998 to March 20, 1999. The collected data were analysed using mean, t-test, one-way ANOVA, and Pearson's correlation coefficient computed by SPSS software. The results were as follows. 1. In the age distribution of grandmothers, the over half of subjects(58.8%) were under 60 years old. The majority(69.6%) of subjects were married at time of data collection. 79(77.5%) of the sample reported that their perceived health status was good or over. 2. The burden of the grandmothers was not scored high, and the item means on burden scale were ranged from 2.26 to 4.19 out of 5. 'Short of private time'(4.19) had the highest score, followed by 'fatigue'(3.92), 'short of rest'(3.75), and 'short of contact with friends and neighbors'(3.62). The lowest item was 'family doesn't help me'(2.26), and followed by 'family doesn't understand me'(2.33), 'angry with family' (2.43), and 'angry while caring for grandchild'(2.60). 3. There were significant relationships between the burden and present health status(p<.01), childcaring confidence(p<.01), and motive of caring(p<.01). 4. The score of social support, was ranging from 3.61 to 4.01 out of 5. 5. The relationship between burden and social support was found to be correlated negatively. The relationship was statistically significant(γ= - .2833, p<.001). In conclusion, it was found that the burden was not high and burden of grandmothers caring grandchildren was correlated negatively to social support. Therefore, these results provide a basis for developing a nursing intervention to reduce the burden of grandmothers.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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Clinical manifestations patterns of allergic disease in Korean children under the age of 6 : multi-center study (다 기관 설문 조사를 통한 알레르기 질환의 연령별 임상 양상)

  • Kim, Dong Il;Yang, Hyeon Jong;Park, Young Mean;Rha, Yeong Ho;Choung, Ji Tai;Pyun, Bok Yang
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.640-645
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    • 2008
  • Purpose : It is widely known that allergic diseases progress through an allergic march. However, there have not been any recent reports in Korea on how the diseases progress. Methods : Parents who visited one of the Pediatric Allergy Clinics of four university hospitals in Seoul with a child under the age of 6 years during the period from May 1-30, 2006 were asked to complete a questionnaire. Results : A total of 229 parents answered the questionnaire about their children, of which 122 were male and 107 were female. The most common allergic disease before 2 years of age was atopic dermatitis (79%). Meanwhile, in 2- to 4-year age group, allergic rhinitis (38%) and asthma (37%) were predominant. The most common allergic disease in the 4- to 6-year age group was asthma (72%), followed by allergic rhinitis (64%). Seventy-three percent of the children had a family history of allergic disease, most often in the fathers (39%). Among patients with allergic rhinitis, 50% had experienced asthma in their earlier days and 30% had experienced atopic dermatitis. In addition, 57% of the children with asthma had suffered from atopic dermatitis. Parents believed that asthma was the most serious allergic disease. Conclusion : In the present study, allergic disease showed a tendency to march from atopic dermatitis to asthma and then to allergic rhinitis. Early diagnosis and treatment of atopic dermatitis is, therefore, considered important for prevention of the allergic march.

A Study on the Distribution of Mycoplasma pneumoniae Infectious Disease in Children from 2016 to 2018 According to Age (2016년에서 2018년의 소아 마이코플라즈마폐렴균 감염질환의 연령별 발생분포에 대한 연구)

  • Junhyung Choi;Ki Hwan Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.121-128
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    • 2023
  • Purpose: This study aimed to investigate the recent age distribution of Mycoplasma pneumoniae in patients with respiratory infections and the differences in diagnostic usefulness according to the methods used in these patients. Methods: We retrospectively reviewed the medical records of patients aged ≤18 years with respiratory infectious diseases who underwent polymerase chain reaction (PCR) or a specific immunoglobulin M (IgM) test between July 2016 and February 2019. The diagnosis of M. pneumoniae infection was confirmed by a positive result in the PCR or IgM test. Results: Of the 2,721 patients tested for M. pneumoniae, 2,197 underwent IgM, and 1,144 underwent PCR, with positivity rates of 17% and 20%, respectively. Among the 620 patients tested for both IgM and PCR tests simultaneously, 35% had M. pneumoniae infection, with 14% under 1 year old and 13% under 1-2 years old. The positive rate increased with age in both tests. Higher positive rates were observed in the IgM test before 3 years of age and in the PCR test after 3 years of age. The agreement rate between the two tests was 77.9% (Cohen's kappa 0.402). Conclusions: As age increased, the rates of M. pneumoniae infection also increased. In patients under 2 years of age, 4¬-14% of infections were confirmed depending on the method used. The moderate agreement between the PCR and IgM tests suggests that the simultaneous use of PCR and the IgM test for the early diagnosis should be approached with caution.

Dental Health Insurance Awareness and Satisfaction of Parents with Children 12 and Under (12세 이하 자녀를 둔 학부모의 치과건강보험 인식 및 만족도)

  • Lee, Yu-Hee;Lee, Jung-Hwa;Jang, Kyeung-Ae;Yun, Jung-Won
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.163-169
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    • 2020
  • The purpose of this study was to identify the degree of awareness and need for dental health insurance of parents with children under 12 years of age, and provide it as basic data for the development of the dental health insurance system in the future. It was conducted with 158 parents who are raising children under the age of 12 in Busan and Gyeongnam areas. In the case of mothers(p=.001), the higher the age (p=.005), the higher the experience of sealant. In the case of mothers, the knowledge of sealant (p=.012) was high. When the gender was female (p=.026), the parenting relationship was mother (p=.006), and regularly engaged in vocational activities (p=.003), the awareness of resin filling was high, and the experience was the child's age (p=. 004) was higher, the higher the knowledge was when the parenting relationship was mother (p=.024). The factors influencing the satisfaction of sealant were found to be the parents education level (p=.004), the awareness of the sealant (p=.003), and the experience (p=.011). From the above research results, more active publicity is needed to increase the awareness and experience of parents' health insurance.

Diagnostic value of the Vesikari Scoring Sys­tem for predicting the viral or bacterial patho­gens in pediatric gastroenteritis

  • Shim, Dong Ho;Kim, Dong Yeon;Cho, Ky Young
    • Clinical and Experimental Pediatrics
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    • v.59 no.3
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    • pp.126-131
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    • 2016
  • Purpose: To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG). Methods: In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test. Results: Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG. Conclusion: VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available.