• Clinical and Experimental Pediatrics
• /
• 제65권1호
• /
• pp.10-20
• /
• 2022

The prevalence of developmental disabilities is increasing worldwide over time. Developmental issues in infancy or early childhood may cause learning difficulties or behavioral problem in school age, further adversely affecting adolescent quality of life, which finally lead to low socioeconomic status in family, increase in medical expenses, and other relevant issues in various ways. Early childhood has brain plasticity, which means there is a high chance of recovering from developmental issues by early detection and timely intervention. Pediatricians are placed an ideal position to meet with young children till 6 years of age, of which age range is the time applicable to early intervention. Determining child's developmental status can be made by 2 pathways such as developmental surveillance and developmental screening tests. For better results, pediatricians should update their knowledge about developmental issues, risk factors, and screening techniques through varying educational program or other relevant educating materials. This paper will update reports on the prevalence of developmental disabilities and review the recent results of the Korean developmental screening test and discuss relevant issues. Finally, it will be addressed the pediatrician's role in early detecting developmental issues and timely intervention.

• Clinical and Experimental Pediatrics
• /
• 제51권1호
• /
• pp.1-25
• /
• 2008

목 적 : 1967년 이후로 1998년까지 대한소아과학회와 정부는 매 10년마다 한국 소아청소년 신체발육표준치를 제정하여 왔다. 지난 40년간의 한국 성장도표는 체계적이고 통계학적인 표준화를 거치지 않은 기술적인 도표였다. 전 세계적인 비만의 유행에 대하여 WHO나 CDC와 같은 국제적인 기관들은 이에 대처하기 위하여 성장도표의 제정 원리들을 변경하여 왔다. 본 논문은 고찰과 함께 새로운 2007년 성장도표 개발과정을 요약하였다. 방 법 : 질병관리본부 만성병조사과의 주도로 2005년에 새로운 성장도표 제정을 위한 신체계측 조사를 시행하였고, 그 결과 소아 비만의 급증과 청소년 최종 성장의 세대별 증가 현상이 정체된 것을 확인하였다. 이에 연구진은 혁신적인 방법론을 도입하였으며, 이를 통하여 새로운 성장도표를 제정하였다. 확보 가능한 원자료인 1997년 및 2005년 측정 자료를 표준화고 통합하였으며, LMS 방법을 도입하여 통계적 모델링을 시행하였다. 결 과 : 표준화된 자료로서 연령별 신장, 연령별 체중, 연령별 체질량지수, 연령별 두위, 신장별 체중 도표가 제공되며, 2005년 조사의 표준화되지 않은 자료로 제공되는 연령별 허리둘레, 연령별 가슴둘레, 연령별 상완둘레, 연령별 피부 두겹집기가 제공된다. 임상 지침도 함께 제공된다. 결 론 : 새로운 한국 성장도표의 개발 과정과 결과는 국제적인 기준인 WHO 표준성장도표 및 미국 CDC 성장도표의 방법론을 적용한 것으로서, 비만과 성 발육이 가속화된 현 상황에 적절하다. 이는 특히 한국 국민과 한민족에게 유용하다. 향후 보다 과학적인 표준을 제시하기 위하여 지속적인 연구가 요청된다.

• Neonatal Medicine
• /
• 제15권1호
• /
• pp.94-99
• /
• 2008

저자들은 저혈당증에 의해 발생한 뇌후두엽의 신생아 저혈당 뇌증과 이로 인한 시각유발전위검사 이상을 보인 2례를 경험하였기에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권8호
• /
• pp.3687-3696
• /
• 2016

Cancer registration, an important component of cancer surveillance, is essential to a unified, scientific and public health approach to cancer prevention and control. India has one of the highest cancer incidence and mortality rates in the world. A good surveillance system in the form of cancer registries is important for planning and evaluating cancer-control activities. Cancer registration in India was initiated in 1964 and expanded since 1982, through initiation of the National Cancer Registry Program (NCRP) by the Indian Council of Medical Research. NCRP currently has twenty-six population based registries and seven hospital based registries. Yet, Indian cancer registries, mostly in urban areas, cover less than 15% of the population. Other potential concerns about some Indian registries include accuracy and detail of information on cancer diagnosis, and timeliness in updating the registry databases. It is also important that necessary data collection related quality assurance measures be undertaken rigorously by the registries to ensure reliable and valid information availability. This paper reviews the current status of cancer registration in India and discusses some of the important pitfalls and issues related to cancer registration. Cancer registration in India should be complemented with a nationwide effort to foster systematic investigations of cancer patterns and trends by states, regions and sub populations and allow a continuous cycle of measurement, communication and action.

• 대한유전성대사질환학회지
• /
• 제23권2호
• /
• pp.31-38
• /
• 2023

Maple syrup urine disease (MSUD) is an autosomal recessive metabolic disorder caused by a deficiency in branched chain α-keto acid dehydrogenase (BCKAD). Between 1997, when Korea's MSUD case was first reported, and 2023, 14 cases were reported in the literature. 29% of the cases experienced developmental delay, and 29% expired. The prevalence of MSUD in Korea was estimated to be 1 in 230,000. Of 21 MSUD patients currently being treated at the Korea Genetics Research Center, 19 were detected through newborn screening program, and 2 were diagnosed by the symptoms. 14 MSUD patients had confirmed genetic mutations; 6 (43%) were BCKDHA and 8 (57%) were BCKDHB. In one case, a large deletion was observed. 4 patients had leucine levels above 2,000 (umo/L), and post-dialysis diet therapy was initiated in the newborn period. No patient required further dialysis as diet therapy and regular monitoring proved highly effective. Most MSUD patients were growing normally; weight and height growth were above the 50th percentile in 76% of the cases while BMI values were higher than normal in 71% of cases. Developmental delays were observed only in 2 cases (10%) and anticonvulsant use in 3 cases (14%). With newborn screening available to all Korean infants, early diagnosis and intervention should allow most patients to remain asymptomatic. However, ongoing surveillance, dietary management and continued patient compliance as well as rapid correction of acute metabolic decompensations remain critical to a favorable long-term prognosis.

• 한국발생생물학회지:발생과생식
• /
• 제24권1호
• /
• pp.53-62
• /
• 2020

Natural killer (NK) cells are innate lymphocytes that play an essential role in preventing cancer development by performing immune surveillance to eradicate abnormal cells. Since ex vivo expanded NK cells have cytotoxic activity against various cancers, including breast cancers, their clinical potential as immune-oncogenic therapeutics has been widely investigated. Here, we report that the pyrazole chemical XRP44X, an inhibitor of Ras/ERK activation of ELK3, stimulates NK-92MI cells to enhance cytotoxic activity against breast cancer cells. Under XRP44X stimulation, NK cells did not show notable apoptosis or impaired cell cycle progression. We demonstrated that XRP44X enhanced interferon gamma expression in NK-92MI cells. We also elucidated that potentiation of the cytotoxic activity of NK-92MI cells by XRP44X is induced by activation of the c-JUN N-terminal kinase (JNK) signaling pathway. Our data provide insight into the evaluation of XRP44X as an immune stimulant and that XRP44X is a potential candidate compound for the therapeutic development of NK cells.

• BMB Reports
• /
• 제50권5호
• /
• pp.235-236
• /
• 2017

The circadian clock is an internal system that is synchronized by external stimuli, such as light and temperature, and influences various physiological and developmental processes in living organisms. In the model plant Arabidopsis, transcriptional, translational and post-translational processes are interlocked by feedback loops among morning- and evening-phased genes. In a post-translational loop, plant-specific single-gene encoded GIGANTEA (GI) stabilize the F-box protein ZEITLUPE (ZTL), driving the targeted-proteasomal degradation of TIMING OF CAB EXPRESSION 1 (TOC1) and PSEUDO-RESPONSE REGULATOR 5 (PRR5). Inherent to this, we demonstrate the novel biochemical function of GI as a chaperone and/or co-chaperone of Heat-Shock Protein 90 (HSP90). GI prevents ZTL degradation as a chaperone and facilitates ZTL maturation together with HSP90/HSP70, enhancing ZTL activity in vitro and in planta. GI is known to be involved in a wide range of physiology and development as well as abiotic stress responses in plants, but it could also interact with diverse client proteins to increase protein maturation. Our results provide evidence that GI helps proteostasis of ZTL by acting as a chaperone and a co-chaperone of HSP90 for proper functioning of the Arabidopsis circadian clock.

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

• Clinical and Experimental Pediatrics
• /
• 제53권3호
• /
• pp.300-306
• /
• 2010

목 적 : 최근 우리나라도 선진국형 저출산 고령사회로 변하고 있어 차세대의 건강한 국민 확보를 위하여 국민 개개인의 평생건강의 기초가 되는 영유아 및 소아청소년에 대한 건강증진사업의 필요성이 강조되고 있다. 이에 실효성 있고 표준적인 영유아 및 소아청소년(학교) 건강검진 지침(guideline)의 개발이 필요하다. 방 법 : 국내 검진 현황 파악 및 문제점 도출 후, 영유아 및 소아청소년 시기의 국내 질병부담 정보와 최근에 실시된 국가 역학조사자료를 검토하고, 선진국에서의 검진 체계를 비교 분석하였다. 이후 실효성 있는 영유아 및 청소년(학교) 건강검진 지침 개발을 위한 방안을 모색하였다. 결 과 : 1) 국내 영유아 관련 건강검진제도는 보건소를 중심으로 실시되고 있으나, 사업 대상이 경제적 취약계층으로 제한되어있을 뿐 아니라 빈혈검사, 소변검사, 청각검사, 혈압측정 등 검사중심으로 구성된 질병발견 위주의 검진체계이다. 2) 학교 건강검진제도 또한 성인에서의 검진제도와 유사하게 혈액검사, 소변검사, 방사선학검사 등 검체 검사 중심의 질병발견 위주 검진체계로 구성되어 있어 실효성 있는 건강검진 항목 개발과 검진빈도, 검진방법 등에 대한 근거중심의 체계가 부족한 실정이다. 3) 선진국의 영유아 검진체계에서는 검체 검사를 선별적으로만 실시하는 것을 원칙으로 하고 있다. 4) 선진국의 학교건강검진은 각국의 정책에 따른 차이는 있으나 기본적으로 검체검사나 방사선학검사 등의 질병에 대한 검사보다는 병력 청취와 질병 예방 및 건강한 생활습관과 환경 조성을 위한 상담과 교육에 중점을 두고 있다. 결 론 : 이상의 결과에서 대안으로 다음과 같은 검진 체계를 제시한다. 1) 급격히 성장 발달하는 영유아에서는 성인과는 달리 혈액검사, 소변검사로 유병률이 낮은 질병 발견에 초점을 맞추기보다는 이 시기에 가장 중요한 성장 및 발달을 주기적으로 평가하고, 연령별로 예측 가능한 예방차원의 육아 지침(anticipatory guidance)을 제공하는 질병예방 위주의 검진을 영유아 건강검진 사업의 목표로 설정하여야겠다. 2) 학생검진도 과거의 만성질환이나 성인병 조기 발견을 위한 검사보다는 급격한 신체적, 정신 사회적 성장과 발달 과정에서 흔한 건강 문제와 위해 요소를 파악하여 건강한 생활 습관 및 건강관리 능력을 배양할 수 있도록 지속적인 상담과 교육으로 발전시키는 것을 목표로 하여야겠다.

• Journal of Preventive Medicine and Public Health
• /
• 제51권3호
• /
• pp.163-168
• /
• 2018

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.