• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.225-232
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• 2008

The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child's age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.

• 의료법학
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• 제8권2호
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• pp.9-35
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• 2007

The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.

• Clinical and Experimental Pediatrics
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• 제55권7호
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• pp.224-231
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• 2012

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. The main clinical features include neonatal hypotonia, distinctive facial features, overall developmental delay, and poor growth in infancy, followed by overeating with severe obesity, short stature, and hypogonadism later in development. This paper reviews recent updates regarding the genetic aspects of this disorder. Three mechanisms (paternal deletion, maternal disomy, and deficient imprinting) are recognized. Maternal disomy can arise because of 4 possible mechanisms: trisomy rescue (TR), gamete complementation (GC), monosomy rescue (MR), and postfertilization mitotic nondisjunction (Mit). Recently, TR/GC caused by nondisjunction at maternal meiosis 1 has been identified increasingly, as a result of advanced maternal childbearing age in Korea. We verified that the d3 allele increases the responsiveness of the growth hormone (GH) receptor to endogenous GH. This paper also provides an overview of endocrine dysfunctions in children with PWS, including GH deficiency, obesity, sexual development, hypothyroidism, and adrenal insufficiency, as well as the effects of GH treatment. GH treatment coupled with a strictly controlled diet during early childhood may help to reduce obesity, improve neurodevelopment, and increase muscle mass. A more active approach to correct these hormone deficiencies would benefit patients with PWS.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.81-90
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• 2024

Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

• 한국병원경영학회지
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• 제7권2호
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• pp.24-36
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• 2002

The purpose of this paper is to find the factors affecting the number of patients per physician for a day at hospital and compare them with the results of previous studies. We used data of Korean national patients survey that had been carried out by central government and local health centers from October 27th to November 11th in 1999. Descriptive analyses were performed to overview the general characteristics of our study subject. Also, we tried to find the factors affecting the number of patients per physician for a day at hospital through t test and correlation analysis. Factors affecting the number of outpatients per physician for a day at hospital are location, training type, ownership, No. of physicians, No. of beds per physician, No. of physicists per physician, No. of nursing aids per physician and No. of medical technicians per physician. While factors affecting the number of inpatients per physician for a day at hospital are location, ownership, No. of physicians, No. of beds per physician, No. of pharmacists per physician, No. of nurses per physician, No. of nursing aids per physician and No. of administrative auxiliary personnels per physician. The most correlated variable with outpatients per physician for a day at hospital is No. of medical technicians per physician while the most correlated variable with inpatients per physician for a day at hospital is No. of beds per physician. A more detailed investigation is needed for verifying factors affecting the number of patients per physician for a day at hospital and other medical institutions.

• The Korean Journal of Pain
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• 제36권4호
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• pp.408-424
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• 2023

Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.

• 대한통합의학회지
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• 제12권2호
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• pp.101-110
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• 2024

Purpose : The purpose of this study provided an overview of the general status and recent intervention approaches in overseas research related to feeding problems in children with autism spectrum disorder (ASD). This review aims to explore interventions for feeding problems in order to provide higher quality follow-up research directions and implications, particularly focusing on providing recommendations for future research in the context of domestic studies. Methods : Analyzing studies published in international journals from 2017 to 2023. This review involved six selected articles, through Embase, Pubmed, RISS, KISS database search engine. A literature analysis that includes inclusion and exclusion criteria, six selected articles were examined. The literature analysis categorized the general status of the research and intervention approaches and treatment components into intervention, treatment settings and therapists, and dependent variables, respectively. Results : Among feeding intervention approaches, parent education interventions based on behavioral therapy had the highest proportion, followed by multidisciplinary interventions. To maintain the effectiveness of interventions over the long term and to generalize them to the home environment, parent education that utilizes parents as mediators is considered a crucial factor. The most commonly observed effects as dependent variables were changes in the consumption of disliked foods, health foods and alterations in feeding behavior. Conclusion : This study introduces various intervention approaches for addressing feeding problems in children with autism spectrum disorder (ASD), focusing on the positive effects demonstrated by active intervention research in abroad. Furthermore, it underscores the need for additional research in Korea to validate the efficacy of these feeding intervention methods. Lastly, the study outlines future research directions aimed at developing feeding programs to support children with ASD and their families coping with feeding issues.

• Asian Spine Journal
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• 제12권6호
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• pp.973-980
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• 2018

Study Design: Retrospective review. Purpose: To identify the trends in stimulator use, pair those trends with various grafting materials, and determine the influence of stimulators on the risk of revision surgery. Overview of Literature: A large number of studies has reported beneficial effects of electromagnetic energy in healing long bone fractures. However, there are few clinical studies regarding the use of electrical stimulators in spinal fusion. Methods: We used insurance billing codes to identify patients with lumbar disc degeneration who underwent anterior lumbar interbody fusion (ALIF). Comparisons between patients who did and did not receive electrical stimulators following surgery were performed using logistic regression analysis, chi-square test, and odds ratio (OR) analysis. Results: Approximately 19% of the patients (495/2,613) received external stimulators following ALIF surgery. There was a slight increase in stimulator use from 2008 to 2014 (multi-level $R^2=0.08$, single-level $R^2=0.05$). Patients who underwent multi-level procedures were more likely to receive stimulators than patients who underwent single-level procedures (p<0.05; OR, 3.72; 95% confidence interval, 3.02-4.57). Grafting options associated with most frequent stimulator use were bone marrow aspirates (BMA) plus autograft or allograft for single-level and allograft alone for multi-level procedures. In both cohorts, patients treated with bone morphogenetic proteins were least likely to receive electrical stimulators (p<0.05). Patients who received stimulation generally had higher reimbursements. Concurrent posterior lumbar fusion (PLF) (ALIF+PLF) increased the likelihood of receiving stimulators (p<0.05). Patients who received electrical stimulators had similar revision rates as those who did not receive stimulation (p>0.05), except those in the multilevel ALIF+PLF cohort, wherein the patients who underwent stimulation had higher rates of revision surgery. Conclusions: Concurrent PLF or multi-level procedures increased patients' likelihood of receiving stimulators, however, the presence of comorbidities did not. Patients who received BMA plus autograft or allograft were more likely to receive stimulation. Patients with and without bone stimulators had similar rates of revision surgery.

• 한국수정란이식학회지
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• 제23권4호
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• pp.229-237
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• 2008

Recently, parabens have been believed to act as xenoestrogens, an identified class of endocrine disruptors (EDs). These environmental compounds are the most well-known as preservatives in many commercial products, including food, cosmetics and pharmaceutical industries. It has been demonstrated that the human health risks of parabens result from a long-term exposure to skin in which this chemical group is rapidly absorbed through the skin. On the other hand, parabens are also completely absorbed from gastrointestinal tract. It has reported that these substances possess several biological effects in which inhibitory property involved in membrane transports and mitochondrial functions is considered to be important for their action. Testing of parabens has revealed that estrogen-like activities of these chemicals are much less potent than natural estrogen, $17{\beta}$ estradiol (E2). Additionally, the estrogenicity of individual paraben- compounds is distinct depending upon their biochemical structure. Recent findings of paraben-estrogenic activities have shown that these compounds may affect breast cancer incidence in women, suggesting adverse ecological outcomes of this environmental group on human and animal health. Although the biological and toxicological effects of parabens have been demonstrated in many previous studies, possible mechanism(s) of their action are required to be explored in order to bring the better understanding in the detrimental impacts of parabens in human and wildlife. There have several different types of parabens which are the most widely used as preservatives. These include methyl-paraben, ethylparaben, propylparaben, butylparaben and p-hydroxybenzoic acid, a major metabolite of parabens. In this review, we summarize current database based on in vitro and in vivo assays for estrogenic activities and health risk assessment of paraben- EDs which have been published previously.

• Asian Spine Journal
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• 제12권6호
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• pp.998-1009
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• 2018

Study Design: Olfactory ensheathing cells (OECs) from rat olfactory mucosa were cultured, characterized, and transplanted into a rat model of spinal cord injury (SCI). Purpose: To evaluate different doses of OECs in a rat model of SCI. Overview of Literature: SCI causes permanent functional deficit because the central nervous system lacks the ability to perform spontaneous repair. Cell therapy strategies are being explored globally. The clinical use of human embryonic stem cell is hampered by ethical controversies. Alternatively, OECs are a promising cell source for neurotransplantation. This study aimed to evaluate the efficacy of different doses of allogenic OEC transplantation in a rat model of SCI. Methods: OECs were cultured from the olfactory mucosa of Albino Wistar rats; these cells were characterized using immunohistochemistry and flow cytometry. Rats were divided into five groups (n=6 rats each). In each group, different dosage ($2{\times}10^5$, $5{\times}10^5$, $10{\times}10^5$, and >$10{\times}10^5$) of cultured cells were transplanted into experimentally injured spinal cords of rat models. However, in the SCI group, only DMEM (Dulbecco's modified Eagle's medium) was injected. Rats were followed up upto 8 weeks post-transplantation. The outcome of transplantation was assessed using the Basso, Beattie, Bresnahan (BBB) scale; motor-evoked potential studies; and histological examination. Results: Cultured cells expressed 41% of p75NTR, a marker for OEC, and 35% of anti-fibronectin, a marker for olfactory nerve fibroblast. These cells also expressed $S100{\beta}$ and glial fibrillary acid protein of approximately 75% and 83%, respectively. All the transplanted groups showed promising BBB scores for hind-limb motor recovery compared with the SCI group (p<0.05). A motor-evoked potential study showed increased amplitude in all the treated groups compared with the SCI. Green fluorescent protein-labeled cells survived in the injured cord, suggesting their role in the transplantation-mediated repair. Transplantation of $5{\times}10^5$ cells showed the best motor outcomes among all the doses. Conclusions: OECs demonstrated a therapeutic effect in rat models with the potential for future clinical applications.