• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.150-159
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• 2008

Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.116-121
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• 2008

Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.356-363
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• 2009

Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.

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

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1491-1496
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• 2002

Purpose : This study was performed to investigate the level of obesity awareness and to help to prevent and to treat obesity by examining the relationship between knowledge of obesity and life style. Methods : Of the students who were surveyed, 1514 answered seriously and were accepted as subjects for the study. The questionaire was anonymous and was filled in by the students themselves. Body mass index was used to compare and analyze the subjects according to gender and age, with 85 percentiles or lower as group one, 86-94 percentiles as group two, and 95 percentiles or higher as group three. Results : Among the boys, level of obesity-awareness was significantly higher(P<0.01) in the obese group than in the normal-weight group. Among the girls, there was no difference in the level of obesity-awareness among the groups(P=0.332). The knowledge of obesity between the groups was not significantly different in either boys or girls. As for the relationship between healthy eating habits and knowledge of obesity, there were no significant differences in either boys or girls. There was no significant difference between the habit of regular exercise and the knowledge level of obesity in either boys or girls. Conclusion : Although this was a localized study and the students were aware of the seriousness of obesity to a certain extent, there was no difference in knowledge of obesity between normal-weight students and obese students. Also, there was no relationship between knowledge of obesity and healthy eating habits or the presence/absence of regular exercises.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.130-136
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• 2006

Purpose : The purpose of this study is to confirm the epidemiologic change of the causative organisms of neonatal and pediatric bacterial meningitis in Korea. And we tried to evaluate the risk factors correlated with prognosis which was available on the day of admission. Methods : Retrospectively, we reviewed the medical records of 57 patients admitted for bacterial meningitis at six hospitals affiliated with Catholic Medical Center for 6 years(Jan. 2000~Dec. 2005). Results : 22 cases(38.6%) of them were neonates under 28 days and 35 cases were infants and children ; 16 cases(28.1%), under 1 year ; 6 cases(10.5%), under 5 years ; 13 cases (22.8%), under 15 years. In neonates, 16 cases(72.7%) were caused by group B streptococcus (GBS). In infants and children, S. pneumoniae(25.7%), H. influenzae type b(Hib)(22.8%) and N. meningitidis(22.8%) were common cause of bacterial meningitis in order. In the informations available on the day of admission, weight deficit for age under 3 percentile, increased CRP level and decreased glucose level of CSF were related to poor prognosis(P<0.05). Conclusion : GBS became a leading cause of neonatal bacterial meningitis. Though, pneumoccocal, Hib and meningococcal meningitis were confirmed as major causes of bacterial meningitis. The routine immunization of pneumococcal and Hib vaccines will be considered, and it is necessary to introduce meningococcal vaccines to our country in the future.

• Journal of Korean Home Economics Education Association
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• v.33 no.2
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• pp.95-113
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• 2021

This study examined the food group and dietary nutrient intakes by sugar-sweetened beverage(SSB) intake level in high school students aged 15~18 years(n=2,377) using the 2007~2015 Korea National Health and Nutrition Examination Survey. Subjects were classified into three groups by SSB(included carbonated drinks, sports drinks, and caffeinated drinks that contained added sugars) intake level obtained from 24-hour recall method: SSB 1(SSB intake 0 g/d), SSB 2(0 g/d < SSB intake < 50th percentile) and SSB 3(SSB intake ≥ 50th percentile). Result of daily intakes of SSB were 160.6±10.5 g/d for boys and 98.6±7.1 g/d for girls and it increased for boys(p<0.0001) and girls(p=0.0280) by year. The highest intakes were carbonated drinks followed by fruit juices for boys and girls. Intakes of carbonated drinks increased as 2.7 times for boys(p<0.0001) and 1.6 times for girls between 2007 and 2015 year. Daily intakes of vegetables were the lowest in SSB 3 of three groups for boys and girls(p<0.0001), and those of fruits were lower in SSB 2 and SSB 3 than SSB 1 for boys(p=0.0013). Daily intakes of milk & milk products decreased toward SSB 3 group for boys(p<0.0001) while those were the lowest in SSB 3 of three groups for girls. Daily intakes of dietary fiber(21.3~25.3%) and calcium(49.6~59.8%) were very low compared to the dietary reference intakes. Percentage of daily intakes compared to the dietary reference intakes increased for energy for boys and girls(p<0.0001) while decreased for vitamin C toward SSB 3 group for boys(p<0.0001) and girls(p=0.0382). Those of calcium were the lowest in SSB 3 of three groups for boys(p<0.0001) and girls(p=0.0008). Ratio of excess intakes of energy/fat increased toward SSB 3 group for boys and girls(p=0.0002). Ratio of calcium deficiency was not different among groups but that was very high(85.9~92.5%). Therefore, it should be emphasized to reduce SSB intakes in order to improve diversity in food group and dietary nutrient intakes among high school students through dietary education and government support.

• Journal of Korean Home Economics Education Association
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• v.33 no.1
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• pp.63-79
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• 2021

This study examined yearly trend of sugar-sweetened beverage(SSB) intake and compared nutritional status by SSB intake level in middle school students aged 12~14 years(n=2,543) using the data from 2007~2015 Korea National Health and Nutrition Examination Survey. SSB included carbonated drinks, sports drinks, and caffeinated drinks contained added sugar. Subjects were classified into three groups by SSB intake level obtained from 24-hour recall method: SSB 1(SSB intake 0 g/d), SSB 2(0 g/d < SSB intake < 50th percentile) and SSB 3(SSB intake ≥ 50th percentile). Result of daily intake of SSB was 76.1±6.2 g/d for boys and 59.5±4.7 g/d for girls and it was increased significantly for boys(p-trend 0.0004) and girls(p-trend 0.0038) by year. The most intakes were carbonated drinks followed by fruit juices and sports drinks for boys and girls. Percentage of daily intake compared to the dietary reference was increased for energy and iron while was decreased for calcium and vitamin C toward SSB 3 group. Ratio of excess intake of energy/fat was increased significantly for boys(p=0.0091) and girls(p<0.0001) toward SSB 3 group. Ratio of calcium deficiency was 86.8~94.9% for boys and girls and it was very high. Therefore, it should be emphasized to reduce SSB intake and drink plain water without added sugar, etc. and milk as a source of calcium for improving nutritional status of middle school students through dietary education and social support.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.174-182
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• 2002

Purpose : The purpose of this study was to investigate the prevalence of obese and underweight adolescents in Incheon area and to examine the relationship between serum cholesterol level and obesity, then to assess the nutritional condition of adolescents. Methods : With a questionnaire regarding their demographic characteristics, blood samples were obtained from apparently healthy students aged 12 to 24 years by venipuncture at April and May, 2000. We measured the obesity index using standard body weight and the body mass index(BMI) according to the criteria established by the Korean Pediatric Society in 1998. Obesity was defined as BMI more than 95 percentile, and underweight less than 15 percentile by age and sex. Results : A total of 1,456 students(M : F=685 : 771) aged 12 to 24 years were included in this study. The prevalence of obesity by standard body weight in adolescents in Incheon were 11.7% : mild obesity 6.5%, moderate 4.6%, and severe 0.5%. By BMI, the prevalence of obesity was 6.4% in males and 6.2% in females. In males, the prevalence of obesity in rural areas was 8.5%, lower than in urban areas(14.3%). The prevalence of underweight by obesity index was 34.1% in rural areas and 22.9% in urban areas. In females, the prevalence of obesity was 12.5% in rural areas and 19.6% in urban areas. There were no significant differences between the two regions(P=0.529). The prevalence of obesity increased with age till 16.3% of peak prevalence in 16 years of age, and then decreased. In males, the prevalence of obesity in academic and vocational school were 13.7% and 9.7%, respectively(P=0.116). In females of the academic and vocational school, the prevalence of obesity was 6.8% and 18.0%, respectively(P=0.001). In obese adolescents, serum total cholesterol was over 200 mg/dL in 6.2%. Conclusion : This study revealed that the prevalence of obesity in adolescents was about 12% and that the prevalence of underweight adolescents was considerably high. We think nutritional assessment and intervention are warranted for adolescent students.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.40-47
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• 2004

Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.