• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.379-383
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• 2014

Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of $35-70{\mu}g/kg/day$ should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

• Childhood Kidney Diseases
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• 제13권1호
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• pp.14-20
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• 2009

Growth retardation is a common consequenc of chronic kidney disease (CKD) in childhood. Many recent clinical and experimental data indicate that growth failure in CKD is mainly due to a relative GH insensitivity and functional IGF-I deficiency. Glucocorticoids also glucocorticoids interfere with the integrity of the somatotropic hormone axis at various levels. Over the past 10 years, recombinant growth hormone (rhGH) has been used to help short children with chronic kidney disease. A GH dosage of 0.35 mg/kg/week (28 IU/$m^2$/week) appears efficient and safe. Some clinical trial data show that final height will be within the normal target height range when GH treatment is continued for many years without remarkable adverse events.

• 대한본초학회지
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• 제29권5호
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• pp.31-38
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• 2014

Objectives : Egg yolk is composed of various important chemical substances for human health. A calcium shortage causes the growth retardation on the body growth. In this study, we examined the therapeutic effects of calcium, vitamin D and egg yolk peptide (EYP) treatment on the retardation of the longitudinal bone growth induced by low-calcium diet in adolescent rats. Methods : Low calcium diets were administrated for 15 days. During the last five days, calcium and/or vitamin D and/or EYP were administrated. The body weights, longitudinal bone growth rates, the heights of growth plates, and bone morphogenetic protein (BMP)-2 and insulin-like growth factor (IGF)-1 expressions were measured using histochemical analysis. Results : Low calcium diets caused the significant reduction in body weight gains and the longitudinal bone growth. The heights of growth plates and the expressions of BMP-2 and IGF-1 showed the impairment of body growth as well. Calcium and/or vitamin D administration could not significantly increase the longitudinal bone growth. However, calcium, vitamin D, and EYP administration significantly increased the bone growth, the growth plate height, and BMP-2 and IGF-1 expressions. Conclusions : These results suggest that EYP enhances the longitudinal bone growth in the calcium and/or vitamin D deficiency and it could be a promising agent for the treatment of children suffering from malnutrition.

• Clinical and Experimental Pediatrics
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• 제57권11호
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• pp.465-471
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• 2014

Inflammatory bowel disease (IBD) is a chronic relapsing disorder of unknown etiology, which is believed to be multifactorial. Recently, the incidence of pediatric IBD has steeply increased in Korea since 2000. Poorly controlled disease activity can result in complications such as intestinal fistulae, abscess, and stricture, as well as growth retardation and delayed puberty in children. Because of a lack of confirmative tests, various diagnostic modalities must be used to diagnose IBD. Onset age, location, behavior, and activity are important in selecting treatments. Monogenic IBD must be excluded among infantile and refractory very-early-onset IBD. Early aggressive therapy using biologics has recently been proposed for peripubertal children to prevent growth failure and malnutrition.

• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1019-1025
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• 2006

Motor delay, when present, is usually the first concern brought by the parents of children with developmental delay. Cerebral palsy that is the most common motor delay, is a nonspecific, descriptive term pertaining to disordered motor function that is evident in early infancy and is characterized by changes in muscle tone, muscle weakness, involuntary movements, ataxia, or a combination of these abnormalities. A wide range of causative disorders and risk factors have been identified for cerebral palsy, and broadly classified into 5 groups; perinatal brain injury, brain injury related to prematurity, developmental abnormalities, prenatal risk factors, and postnatal brain injury. Delay in attaining developmental milestones is the most distinctive presenting complaint in children with cerebral palsy. A detailed history and thorough physical and neurologic examinations are crucial in the diagnostic process. The clinician should be cautious about diagnostic pronouncement unless the findings are unequivocal. Several serial examinations and history review are necessary. All children with cerebral palsy should undergo a neuroimaging study, preferably MRI, because an abnormality is documented on head MRI(89%) and CT(77%). The high incidence rates for mental retardation, epilepsy, ophthalmologic defects, speech and language disorders and hearing impairment make it imperative that all children with cerebral palsy be screened for mental retardation, ophthalmologic and hearing impairments, and speech and language disorders; nutrition, growth, and swallowing also should be closely monitored.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.142-151
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• 2006

Purpose : Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy. Methods : We studied 60 children(male 47, female 13) with nephropathy who received rhGH(1 U/kg/week) for more than 0.5 years($1.39{\pm}1.12$). Their mean age was 11.0 years($11.17{\pm}2.62$). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was $4.32{\pm}2.97$ years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch $Sch\ddot{o}nlein$ nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes. Results : Height velocity increased significantly with rhGH therapy from $3.29{\pm}1.95$ to $8.66{\pm}3.75$(cm/yr) and height SDS decreased from $-0.72{\pm}0.93$ to $-1.04{\pm}0.86$ at one year after steroid therapy but increased to $-0.55{\pm}0.96$ at one year after rhGH administration(P<0.05). BMD improved from $0.71{\pm}0.14$ to $0.79{\pm}0.15g/cm^2$(P<0.05). IGF-1 increased from $445.09{\pm}138.01$ to $506.62{\pm}181.31ng/mL$(P<0.05). IGFBP-3 decreased from $4073.75{\pm}700.78$ to $3933.61{\pm}789.25ug/L$ numerically, but there was no statistically significant difference(P=0.533). Conclusion : The administration of rhGH in the short stature patients who received long-term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.

• 대한한방소아과학회지
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• 제25권1호
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• pp.49-62
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• 2011

Objectives: The purpose of this study is to evaluate the effect of the herbal medicine in children's growth. Methods: 67 of the children in the age from 3 to 16 were participated in this study(31 of boys and 36 of girls). Department of the pediatrics, $\bigcirc\bigcirc$ university oriental medical hospital, and the participants were measured their body composition and their bone age, the height percentile of the first and the last visit were measured, and those were compared by the Korean Association of Pediatrics' Growth Statistics Curve. Results: 1. Generally, total children's average height and weight were significantly increased after the herbal medical treatment. The comparison between the height and the average height, the weight and the average weight were significantly decreased after the herbal medical treatment. 2. Total children's average soft lean mass, body fat mass, BMI, basal metabolic rate, abdominal circumference and hip circumference were also significantly increased after the herbal medical treatment. 3. The mean height percentile of the children showed 0.88 percentile upwardly. The mean weight percentile of children showed 1.84 percentile upwardly. 4. The height percentile was increased in the group of boys younger than 13, and a group of girls older than 12 year old. Other than a group of boys older than 14, every group showed increasing weight percentile. Conclusions: The herbal medical treatment helped children with growth retardation.

• 대한한방소아과학회지
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• 제30권4호
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• pp.87-98
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• 2016

Objectives The purpose of this study is to evaluate the effect of herbal medicine in children's growth. Methods 51 children from the age of 5 to 16 were participated in this study (27 of boys and 24 of girls). The participants were from the department of the pediatrics in Daegu hanny university oriental medical hospital. They were measured their body composition and their bone age, the height percentile of their first and the last visit. Then, those were compared by the Korean Association of Pediatrics' Growth Statistics Curve. Results 1. Generally, total children's average height and weight were significantly increased after the herbal medical treatment. The differences between their height and the general populations' average height, their weight and general populations' average weight were significantly decreased after the treatment. 2. Total children's average soft lean mass, body fat mass, BMI were also significantly increased after the herbal medical treatment. 3. The mean height percentiles of the children has increased by 1.47 percentile. The mean weight percentiles of the children decreased 1.08 percentile. 4. The height percentiles were increased in every group except the group of boys younger than 9 and older than 12 year old. Other than the group of boys younger than 9-year-old and the group of 10-11-year-old boys, every group showed decreasing weight percentile. Conclusions The herbal medical treatment helped children with growth retardation.

• 대한한방소아과학회지
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• 제25권2호
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• pp.111-120
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• 2011

Objectives: The purpose of this study is to estimate genetic and environmental factors, which can affect Idiopathic true Precocious puberty, and to evaluate the clinical and endocrinologic characteristics. Methods: Retrospective and Comparative analysis of 76 children (72 girls and 4 boys) has been diagnosed with idiopathic true precocious puberty, and treated with GnRHa from December 2008 to July 2011. Results: 1. The Average chronological age (CA. yr) of children diagnosed with idiopathic true precocious puberty was $8.40{\pm}0.81$ (girls), $9.93{\pm}0.12$ (boys). 2. The Average height & weight percentile (%ile) of the girls diagnosed with idiopathic true precocious puberty was $67.38{\pm}22.04$, $67.69{\pm}23.20$. 3. The girls' mothers have diagnosed with idiopathic true precocious puberty, and they were shorter than the average. This shows that mother's small height and idiopathic true precocious puberty are closely related to each other. 4. BMI percentile (%ile) of girls diagnosed with idiopathic true precocious puberty was $63.26{\pm}24.86$. 23.6% of children were diagnosed with overweight or obesity. This result shows that obesity and idiopathic true precocious puberty are proportionally related. 5. Birth weights (kg) of the children diagnosed with idiopathic true precocious puberty were $3.16{\pm}0.43$ (girls), $3.15{\pm}0.38$ (boys). 8.3% of children were diagnosed with Intrauterine growth retardation. 6. The Average bone ages (BA. yr) of the children diagnosed with idiopathic true precocious puberty were $10.51{\pm}0.99$ (girls), $12.10{\pm}0.97$ (boys). The Average BA-CA was $2.11{\pm}0.81$ (girls), $2.00{\pm}0.87$ (boys). 7. The Average predicted adults' height (PAH. cm) of the children diagnosed with idiopathic true precocious puberty was $151.61{\pm}4.00$ (girls), $163.50{\pm}2.15$ (boys). The Average MPH-PAH was $6.84{\pm}4.91$ (girls), $6.00{\pm}5.35$ (boys). 8. 23.6% of the children treated with GnRHa were co-treated with Growth Hormone. Conclusions: Estimated factors which cause Idiopathic true precocious puberty are mother's small height, obesity, and Intrauterine growth retardation. However, the studies of Oriental Medicine for Idiopathic true precocious puberty were lacking. Further clinical and experimental researches are needed.

• Journal of Nutrition and Health
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• 제24권4호
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• pp.366-377
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• 1991

저소득층 영유아의 식이형태가 linear growth에 미치는 영향에 대하여 연구하기 위하여 1987년 3월부터 1988년 1월까지 대전시, 춘천시, 그리고 춘성군 보건소에서 만 2세 미만의 영유아 679명과 그 어머니들을 대상으로 영양조사를 실시하였다. 조사방법은 어머니들을 대상으로 식이섭취를 중심으로한 설문조사를 실시하였고 대상아들의 체중과 키를 측정 하였으며 보건소 기록을 이용하여 대상아들의 출생시 체중의 키값을 구하였다. 대상아들은 한국 소아 발육표준치를 이용한 표준 편차점수(Z-score)로 볼 때 체중, 신장 모두 월령 7, 8개월부터 성장지체를 보였다. 출생체중/신장과 질병효과를 통계적으로 조정하였을 때, 이유식을 먹는 대상아들이 모유나 우유만 먹는 경우보다 더 크지않았으며 각종 보충식을 자주 먹는 대상아들이 가끔 먹거나 거의 안 먹는 경우보다 더 크지 않았다. 일일 열량섭취량 분석도 같은 결과를 보였다. 즉 식이 형태나 식품섭취 빈도가 열량섭취량으로 연결되지 않았다. 이같은 현상은 월령 8개월 이후의 대상아에게서 더 두드러지게 나타났다. 따라서 이유에 관한 영양교육 내용은 기존의 빠른 보충식 도입의 강조 차원 보다는 이시기의 빠른 성장을 뒷받침할 만한 다양한 식품 및 충분한 열량섭취에 관한 보다 자세한 정보가 growth monitoring 함께 어머니들에게 전달되도록 변화되어야할 것으로 생각된다.