• 대한장애인치과학회지
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• 제15권1호
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• pp.29-34
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• 2019

프래더윌리 증후군과 심장수술 병력을 가진 4세 환아가 외상으로 본과에 내원하였으며 임상검사결과 다발성 우식증과 상악 좌측 유전치의 측방탈구기 관찰되었다. 내원 당일 예방적 항생제 복용 하에서 측방탈구치아를 발치하였고, 구강내의 우식증은 약 4개월에 걸쳐 외래 하에서 보호안정장치 하에서 안정적으로 치료하였다.

• 한국지역사회생활과학회지
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• 제27권4호
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• pp.875-889
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• 2016

The aim of this study was to assess a dietary status and to examine the factors related to the prevalence of metabolic syndrome in Korean children and adolescents. For this study, 5,576 subjects aged 10~18 years, who participated in the health and dietary intake survey (24h recall method) of the 2007~2013 Korea National Health and Nutrition Examination Survey (KNHANES), were sampled. The five components for the diagnosis of metabolic syndrome in the subjects were taken from the modified NCEP-ATP III. The total prevalence of metabolic syndrome among the subjects was 4.6%. The total prevalences of the metabolic syndrome components among the subjects were central obesity 8.4%, hypertriglyceridemia 18.8%, low HDL-cholesterol 13.4%, hypertension 22.4%, and hyperglycemia 5.2%. The gender, age, weight status, frequency of daily meals and eating-out frequency of subjects affected the prevalence of metabolic syndrome. Based on these results, There should be to improve the dietary guidelines and nutrition education to decrease the prevalence of metabolic syndrome for Korean children and adolescents.

• 보건교육건강증진학회지
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• 제24권4호
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• pp.65-85
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• 2007

Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

• 대한지역사회영양학회지
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• 제10권6호
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• pp.930-942
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• 2005

This study was performed to investigate body image perceptions of women about themselves and their preschool children and also to investigate the relationship between these perceptions. Subjects were 545 women and their children (279 boys and 268 girls) residing in Daejeon city. $67.7\%$ of women were classified as normal group, $18.6\%$ as overweight group, and $13.8\%$ as underweight group by BMI. $68.5\%\;and\;78.7\%$ of their boys and girls, respectively, were classified as normal group, $22.4\%\;and\;16.4\%$ as overweight group, $9.1\%\;and\;4.9\%$ as underweight group by WLI. Women made relatively accurate judgments on their current body sizes and selected their body images as the most desirable one. But they preferred plumper figures for their children and failed to perceive their overweight children as overweight. While $74.7\%$ of women wished to be thinner, $81.1\%$ of them wished their children to be fatter. Women spending less then 100 thousand won and more than 500 thousand won as monthly food expenses and having only one child perceived their children's current body sizes the lowest and the highest, respectively. Women wished boys to be fatter than girls. Their current body sizes were correlated positively with the children's current body size (p < .01), and their healthiest, attractive, and 'wish' figures were correlated positively with children's current, healthiest, attractive, and 'wish' figures (p < .05- p < .01). Body size dissatisfaction (wish to be thinner) and BMI of women were correlated negatively with children's healthiest and attractive figures (p < .01). These findings suggest that in order to correct the women's body image misperceptions and to prevent childhood obesity, mother's perception about healthy body images for themselves and their children need to be included in nutrition education. Also, it is necessary to assist mothers to understand the relationship of body size and weight status with the risk of chronic disease which might appear later in their children's life. (Korean J Community Nutrition 10(6) : $930\∼942$, 2005)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권4호
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• pp.248-256
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• 2014

Purpose: Non-alcoholic fatty liver disease (NAFLD) in children has become an important public health issue because of its high prevalence and severity. Several noninvasive methods for estimating NAFLD are under investigation. We aimed to evaluate the usefulness of serum ferritin as a biomarker of severity of pediatric NAFLD patients. Methods: A total of 64 NAFLD patient were enrolled from Severance Children's Hospital from March 2010 to February 2013. Serum ferritin levels, liver related laboratory tests, liver magnetic resonance imaging (MRI) (2-dimensional [2D] proton density-fat fraction) and NAFLD severity markers were compared between obese group and overweight group. Correlation analyses were performed between serum ferritin and laboratory values including NAFLD severity markers. Results: In obese group, serum ferritin, alanine aminotransferase (ALT), total bilirubin, international normalized ratio (INR), MRI 2D proton density-fat fraction, aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis- 4 (FIB-4) (an index score calculated from platelet count, ALT, AST and age) were significantly higher than those of overweight group. NAFLD severity markers, APRI and FIB-4, and liver specific important laboratory values, AST, ALT, INR, cholesterol, triglyceride and low density lipoprotein show significant correlation with serum ferritin in NAFLD patients. Conclusion: Serum ferritin concentrations could be a candidate of useful severity marker in the pediatric NAFLD patients.

• 한국학교보건학회지
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• 제15권1호
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• pp.107-121
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• 2002

In this study we analysed time allotment and the contents of a health textbook and its teacher's guide book of the 7th elementary curriculum. We intended to offer the basic data needed to establish the single health education. So the analysed results are as follows according to the health education model developed by the korean nursing association and health teachers' meeting and the teaching time allotment presented by the teacher's guide book. It's goal is practice in regular class time of the subjects for the time and contents of health education in the 7th elementary curriculum. The total class periods of health education of the 7th elementary curriculum are 229 hours and annual periods of health education per year are an average of 38 hours. The health education of the 7th elementary curriculum is separated into the 9 following subjects: Wise life, Pleasant life, Righteous life, We are 1st grade, Physical education, Science, Social studies, moral education and Practical course. The health education of the 6th elementary curriculum was combined with the units of physical education, but in the 7th curriculum it must be separated by a single, required health subject. The contents of health education of the 7th elementary curriculum is mostly dominated by units of community and environmental health with a total of 55 hours (24%). Therefore, the units of home health and social health, development of physical strength are fairly insignificant. The newly added contents in the 7th curriculum are "pregnancy and child birth, the protection and counterplan from rape, the reasons and prevention of stress, the reasons and the treatment of obesity, the damage of smoking and drinking, etc. According to the result above, we must establish the criteria for each year's health education in the 8th elementary curriculum. The contents of mental health, home health and social health should be revised and added new items. The health education that is separated in some subjects now must be established as a systematically integrated health education.

• Clinical and Experimental Pediatrics
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• 제56권1호
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• pp.19-25
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• 2013

Purpose: Childhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan. Methods: This study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy. Results: Factors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%. Conclusion: APRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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• pp.59-67
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• 2018

Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.430-438
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• 2020

Purpose: We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. Methods: We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. Results: This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. Conclusion: Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.

• 한국식품위생안전성학회지
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• 제23권3호
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• pp.276-283
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• 2008

국내 외 선행연구결과에 의한 어린이 출생 전 후 건강에 영향을 미칠 수 있는 주요 유해물질은 inorganic arsenic, BPA, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalate, PFOA/PFOS, vinyl chloride 등으로서 국내에서도 이들을 포함한 확인 연구가 수행되어져야 할 것이다. 또한 어린이들의 행동발달과 연관된 생활환경에서의 다양한 인체노출이 확인됨에 따라 탁아소, 유치원과 같은 경우 어린이 활동공간을 대상으로 환경모니터링 및 위해관리활동도 병행되어야 할 것이다. 또한 어린이 건강에 영향을 미치는 유해물질을 중심으로 독성평가, 인체영향연구, 환경 및 인체모니터링과 위해평가를 수행하므로 유해물질의 원인-상관관계를 확인하고 사실자료에 근거한 관리정책을 반영하는 것이 바람직하다.