• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.2
• /
• pp.213-221
• /
• 2005

Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.

• Pediatric Infection and Vaccine
• /
• v.6 no.1
• /
• pp.107-115
• /
• 1999

Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.

• Journal of agricultural medicine and community health
• /
• v.28 no.2
• /
• pp.155-169
• /
• 2003

Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.43 no.6
• /
• pp.926-933
• /
• 2014

The purpose of this study was to evaluate vegetable intakes according to body mass index (BMI) of adolescents. For this, 400 middle and high school adolescents living in Buyeogun, Chungnam were classified into underweight group, healthy weight group, and overweight group according to BMI, after which eating habits, daily intake levels of vegetables, perception of vegetables, and vegetable-related eating habits were compared and analyzed. As the reason for skipping breakfast, 'Lack of time (44.3%)' was the most frequently cited. In the case of unbalanced food intakes, the underweight group and overweight group showed the highest response for 'grain' while the healthy weight group showed the highest response for 'vegetables' with significant differences (P<0.001). Daily intakes of one serving size of vegetables was 3.3 in the underweight group, 3.8 servings in the healthy weight group, and 3.8 servings in the overweight group, but there was no significant difference. However, frequency of vegetable intake at lunch was once in the underweight group, which was significantly lower than 1.3 servings in the healthy weight group and 1.4 servings in the overweight group (P<0.05). Regarding perception of vegetables, perception of 'Vegetable consumption helps to get beautiful skin' (P<0.01) and 'I eat vegetables or don't eat depending on a cooking method' (P<0.05) were significantly higher in the underweight group. In the evaluation of vegetables-related eating habits, preference for vegetables in the underweight group was lower than that in the healthy weight and overweight groups (P<0.05). Summarizing the above results, vegetable intake by adolescents was generally low, and the frequency of vegetable intake at lunch as well as preference for vegetables were significantly lower in the underweight group. Studies to identify the relationships between adolescent body types and vegetable intakes are required.

• Clinical and Experimental Pediatrics
• /
• v.52 no.5
• /
• pp.538-543
• /
• 2009

Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.

• Clinical and Experimental Pediatrics
• /
• v.51 no.8
• /
• pp.804-811
• /
• 2008

Purpose : Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods : A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results : There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion : Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

• Journal of Nutrition and Health
• /
• v.9 no.1
• /
• pp.25-42
• /
• 1976

In order to determine nutrition education needs and related problems, a study was conducted of children's dietary habits, focusing on parental influence and degree of agreement between parent and child on foods liked, accepted, or disliked, in addition to a general survey of food atiitudes. This study was conducted throughout a two-month period, June to July of 1974. One thousand children of both sexes, from the fifth grade, junior and senior high schools of Seoul city, and their 2,000 matched parents, were surveyed, Teachers distributed questionnaires in the classroom and assisted the children in answering. Questionnaires also were distributed to the parents through their children, after the teachers explained the procedure of study. As to the influence of parents' food preferences, the following conclusiolns can be reached, in light of the results of chi-square tests conducted: 1. Agreement between mother and child on food preference was much higher than that between father and child, regardless of sex or birth order of the child. This observed difference in degree of agreement was greatest for children in the middle birth order, and greater for girls than for boys. 2. Various food attitudes: a. Food preferences: Beef, milk, and mandoo (boiled or steamed, filled dumplings) were extremely well liked by all subjects, regardless of age or sex. Cucumber, lettuce, and spinach also were lied. Most disliked foods were fatty layers of pork and liver. Cooked rice in the too wet or too dry state and pork were low preference items. b. Socioeconomic background and dietary practice: Higher educational background of the wife and higher income level of the family were associated with greater knowledge of nutrition, and interest in family nutrition and in introducing new foods to the family. But use of food as prize or punishment was found, regardless of the mother's educational and economic status. c. Change of food habit: Over 70 percent of subject had changed ad improved their dietary habits, mostly by reason of husbands' and wives' mutual influence after marriage. This study emphasized the great importance of nutrition eudation for mothers, and their prominent role and responsility in guiding the family to better nutrition, whatever the mother's educational background.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.35 no.4
• /
• pp.422-429
• /
• 2006

The study aims to examine that regular leisure activity of the elderly has a beneficial effect to enhance their health condition. The elderly subjects of 164 (82 of elderly who do leisure and 82 of elderly who do not leisure) aged over 60 years in Suwon area were employed. Survey questionnaires were administered to investigate general characteristics, life style, mental status, dietary life and nutritional status. From the findings, the elderly who do leisure were highly educated, better in living status and higher employment rate. The mental status of the elderly without leisure activity was very much inferior to that of the elderly with leisure activity, representing higher prevalence rate of depression. Furthermore, the elderly who do not leisure showed higher drinking and smoking rates, irregular eating habits, poor teeth condition and chewing style as well as having eating obstacles. Mean caloric intake of both the elderly was also lower than that of RDA. The elderly who do not leisure have shown lower intakes in most of essential nutrients in contrast to the elderly who do leisure. In conclusion, the elderly with regular leisure activity seemed to have better life style and mental status, dietary life and nutritional status. Therefore, it is critically important to establish the health program combined with various leisure activity for the seniors to promote and energize the later years of life.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.37 no.11
• /
• pp.1427-1434
• /
• 2008

This study was aimed to compare nutrition knowledge, dietary attitude and habit of elementary school children with and without education. Eighty-four subjects with unbalanced eating behavior were selected and assigned to either control or education group. The subjects in education group participated in a nutrition education program once a week for 8 weeks. The contents of nutrition education were on food tower, balanced nutrition, nutrient function, food group, importance of breakfast, and nutrition label, etc and the program was performed by a school dietitian. The effects of education was assessed by self-administered questionnaire prior to and after nutritional education. Nutrition knowledge except on snack, dietary self-efficacy except on low fat/ low calorie, attitude except on functional food and favorite, and general dietary habits of children in education group were significantly improved while those in control group showed no changes. Also, factors for unbalanced eating was improved by nutrition education indicating the need for correction on unbalanced eating was diminished. However, children's adherence to snack, instant and fast food remained to be corrected. The dietary habit of balanced eating was improved by education reducing the percentage of unbalanced eating on grain and meat.fish.milk groups. The nutrition education appears to be effective to provide nutrition knowledge thereby to improve dietary attitude, dietary self-efficacy, and partly to reduce children's unbalanced eating factor.

• Clinical and Experimental Pediatrics
• /
• v.48 no.2
• /
• pp.178-185
• /
• 2005

Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.