• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.259-265
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• 2020

Purpose: Perforation of choledochal cyst (CC) is a relatively rare clinical presentation in pediatric populations and difficult to predict preoperatively. We assess the clinical implications by comparing clinical parameters based on a single-center experience between perforated and nonperforated CC to facilitate the appropriate management for future interventions. Methods: A total of 92 cases of CC in pediatric patients (aged <18 years) who received surgical management between January 2003 and December 2018 at a Pusan National University Children's Hospital were reviewed. After screening the clinical features of perforated cases, we compared the demographic findings, clinical characteristics, and some laboratory results between the perforated and nonperforated groups. Results: Perforated CC was identified in 8 patients (8.7%), and nonperforated CC in 84 patients (91.3%). Perforation can be classified into three categories: free perforation of cyst (3 cases), pinpoint perforation of cyst (2 cases), and necrotic change of cyst (3 cases). CC perforation occurred significantly more commonly in patients aged <24 months. Clinically, the perforated group showed significantly higher frequency of fever and higher C-reactive protein (CRP) level during the initial visit. Conclusion: Perforation is more likely to be suspected in patients aged <24 months presenting together with fever and high CRP level in the initial visit. It is also necessary to keep in mind that it indicates not only a possibility of complicated disease status regardless of its association with stones but also a difficulty of applying a minimal invasive procedure and relatively increased length of hospital stay.

• The Korean Journal of Food And Nutrition
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• v.23 no.1
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• pp.102-113
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• 2010

This study was conducted to investigate the relationship among dietary behavior, meal balance, and clinical symptoms related nutritional status and Attention Deficit Hyperactivity Disorder(ADHD) in preschool children. The survey was conducted using questionnaires and the subjects were 3~6 years old preschool children in Samcheok. Subjects were divided into an ADHD dispositions group(n=88) and a normal group(n=129) based on assessments conducted by the children's mother using the Abbreviated Conners's Parent Rating Scale. There was no significant difference in meal frequency, meal speed, meal regularity or meal balance between children with ADHD dispositions and the normal groups. The ADHD disposition group had a higher proportion of children with picky eating(p<0.05), too much snacking(p<0.05) and over eating (p=0.05) habits than the normal group. In addition, the ADHD dispositions group had a higher frequency of clinical symptoms such as 'breathlessness when going up stairs', 'sleeplessness', 'anxiety' and 'tiredness'. Overall, there was a significant relationship between ADHD disposition and dietary problems and clinical symptoms related to poor nutritional status in preschool children. Therefore, to prevent and treat ADHD in preschool children, proper dietary management such as correcting of picky eating, over snacking and overeating is needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.113-121
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• 2011

Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.356-365
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• 2020

Purpose: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. Methods: We conducted a retrospective chart review of patients between ages of 0-18 years, who were admitted with AP at 2 institutions between 2013-2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. Results: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6-17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). Conclusion: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS.

• Korean Journal of Community Nutrition
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• v.10 no.3
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• pp.319-330
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• 2005

College foodservice (FS) demands highly-developed operation technique which can provide adequate nutrients to their students, as well as to guide better eating habits and to meet students' various desires. The purpose of this study was to provide basic data to improve college FS satisfaction with food items by comparing 2 contract-managed and 2 self-operated college FS in Daejeon and Chungnam area. According to the results, $\59.1%$ of students frequently (over 3 times per week) took meals at college cafeteria and the main reason for using college cafeteria was the low-price of meal, although the students' Satisfaction degree with price of meal was lower in contract-managed FS than in self-operated FS. There were no differences in the food satisfaction degrees with overall appraisal of food items between 2 operating systems of college FS, but the satisfaction degrees with all food items were high in male as compared with female. The higher the negative self-perceived clinical symptoms scores, the lower the satisfaction with foods, which suggests that the health state of students was one of the factors that influenced college FS satisfaction. According to stepwise multiple regression analysis,'taste of boiled rice', 'overall appraisal of boiled rice', 'overall appraisal of soup', and 'variety of side dish', in decreasing order, were the most relatively important attributes for overall customer satis-faction with food taste of college FS. Finally, there should be further studies on important management factors to improve college FS satisfaction according to 2 operating system.

• Journal of Nutrition and Health
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• v.44 no.4
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• pp.312-325
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• 2011

The purpose of this study was to investigate dietary behaviors and nutritional knowledge among immigrant women in multicultural families. In addition, this study reveals a necessity for nutrition education, which is apparent to both immigrant women living in multicultural families as well as nutrition education experts. The survey was conducted with 30 immigrant women within multicultural families in Seoul. The dietary behaviors of the women were significantly different by their period of residence. The longer they had resided in Korea, the higher their dietary behavior score. However, there was no significant difference in nutrition knowledge by their period of residence. This study also conducted in-depth personal interviews with 8 immigrant women who lived in Seoul, and with 4 nutrition education experts. These interviews were performed to provide profound insights regarding the content and means of nutrition education for immigrant women. Nutrition education for immigrant women living in multicultural families should proceed at a basic level in terms of language and content, using bilingual (Korean and their native language) education materials. Education topics and content need to be developed differently according to the level of Korean comprehension and period of residence in Korea. Also, this multicultural approach should be adapted when planning nutrition education since immigrant women have various acculturation levels, and the content and means of education should be adjusted to these acculturation levels. Management after nutrition education is necessary for immigrant women who do not have sufficient understanding of the Korean language. Practical educational methods such as real cooking practices and food purchasing simulations must be developed. Finally, the results suggest that the government needs to establish a systematic plan for nutrition education among immigrant women living in multicultural families. Policy support such as training nutrition educators on multicultural individuals residing in Korea is necessary for active and effective nutritional education.

• Korean Journal of Community Nutrition
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• v.29 no.1
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• pp.1-15
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• 2024

Objectives: This study investigated the need for nutrition education aimed at improving the health of residents and users of social welfare facilities for persons with disability and aimed to provide basic information for developing a nutrition education program that meets the needs of the field. Methods: Altogether, 249 employees working in social welfare facilities for people with disabilities were included in the study. Data on the health status of residents/users, meal management, nutritional education, nutritional education needs, and awareness of nutritional education were obtained through online surveys. A descriptive analysis was conducted to analyze the demographic characteristics, needs, and perceptions of the respondents, and independent t-tests and χ² tests were performed to analyze and compare the differences between residential and daycare facilities. Results: The majority of residents/users of social welfare facilities for persons with disabilities have developmental disabilities. When educating residents with residents/users of social welfare facilities, 'personal hygiene' was the most necessary topic, followed by 'obesity management' education. Regarding the methods of providing education, face-to-face lectures demonstrated a high demand. They responded that when nutrition education experts provide nutrition education to people with disabilities, they must understand 'the physical characteristics of persons with disabilities' and have the ability to determine appropriate nutrition for such people. The most appropriate nutrition program training would be twice a year, lasting 30 min to 1 h per training session. Conclusions: It will present a direction for operating a nutrition education program for persons with disabilities that meets their needs of social welfare facilities and ultimately contribute to the establishment and activation of nutrition education tailored to welfare facilities for such individuals in Korea.

• Nutrition Research and Practice
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• v.3 no.4
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• pp.315-322
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• 2009

This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin $B_2$, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2933-2934
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• 2014

Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.55-60
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• 2017

Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to $Omegaven^{TM}$, a fat emulsion comprised of omega-3 fatty acids. $Omegaven^{TM}$ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with $Omegaven^{TM}$ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of $Omegaven^{TM}$. No current guidelines for the diagnosis and management of hypoganglionosis are available. We recommend a multidisciplinary approach and the use of novel therapies such as fat emulsions composed of omega-3 fatty acids for improved patient outcomes. Appropriate compassionate use protocols should be obtained from the Food and Drug Administration prior to initiation of $Omegaven^{TM}$.