• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.987-994
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• 2007

Purpose : This study investigated the clinical significance of AN in children and adolescents with obesity induced metabolic complications. Methods : Forty-nine patients who had obesity induced metabolic complications were participated in this cross-sectional study. Obesity induced metabolic complications are as follows: hypertension, dyslipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), nonalcoholic steatohepatitis (NASH), homeostasis model assessment of insulin resistance (HOMA-IR)>3.16. Clinical characteristics, such as, age, percentage-weight-for-height (PWH), pubertal status, blood pressure (BP), fasting plasma insulin level, fasting and post-oral glucose tolerance test 2-hour glucose levels, liver function test, lipid profile, HOMA-IR were compared according to the presence of AN. Results : Sixty-five percent of patients had AN, 57.1% NASH, 57.1% dyslipidemia, 55.1% hypertension, 46.9% IFG, 24.5% HOMA-IR>3.16 and 16.2% IGT. The patients who were moderately to severely obese with AN had higher incidence of IGT and HOMA-IR>3.16. The patients with AN had significantly higher diastolic BP ($79.4{\pm}6.9$ vs $75.4{\pm}5.6mmHg$), fasting levels of plasma insulin ($10.6{\pm}6.0$ vs $6.2{\pm}5.4{\mu}IU/mL$), HOMA-IR index ($2.6{\pm}1.4$ vs $1.4{\pm}1.3$) and PWH ($42.4{\pm}13.0$ vs $34.3{\pm}1.8%$). The increasing tendency for the presence of AN was significantly related to the cumulative number of obesity induced metabolic complications. Binary logistic regression analysis revealed that the presence of AN was significantly associated with fasting plasma insulin level, PWH and IFG. Conclusion : AN could be useful as a clinical surrogate of obesity induced metabolic complications.

• The Journal of the Korea Contents Association
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• v.14 no.2
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• pp.355-363
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• 2014

The purpose of this study is to find out the effect of using cellular phone dependence of middle school student based on Agnew's GST. A total of 2,151 questionnaires were used to Korean Children and Youth Panel Survey(KCYPS)2010. Analytical methods of Structural Equation Model(SEM) was verified by AMOS 21.0 Ver. The results were the following. Firstly, The fit of definitive model was $X^2=1398.997$, df=144, GFI=.937, NNFI(TLI)=.902, CFI=.918, RMSEA=.061. Model was proper to verify the use of cellular phone dependence of adolescents. Secondly, The strain factors of middle school student presented statistically significant positive effect to make negative life satisfaction. Finally, The negative life satisfaction of middle school student presented statistically significant positive effect to the use of cellular phone dependence of middle school student. We need to provide as basic data for developing cellular phone dependence intervention programs.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.245-252
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• 1999

Purpose : The aim of this study is to determine the age-specific seropositivity and the level of measles specific IgG in adults and to evaluate herd immunity to measles in Korea, the measles specific IgG were measured from the sera of adults over ages of 20 in Korea. Methods : 156 sera were collected from 156 out-patients over ages 20, who had visited clinical laboratory from June to July in 1997 at Korea University Ansan Hospital. The histories of natural measles or vaccination were not undertaken. Measles specific IgG titers were measured using ELISA method($SIA^{TM}$ Measles IgG Kit Co. St. Louis. Mo). Results : The results obtained from this study were as follows. 1) The seropositivity of measles specific IgG in adults was 94.9%. And there were no significant differences in their age and gender. 2) The mean measles-specific IgG titer was $238{\pm}84AU/mL$. And there were no significant differences in age and gender, except significant lower in 4th decades than other age groups. And there were no significant correlations between age and measles specific IgG level. Conclusion : In conclusion, a seropositivity of in adults was 94.9% which was higher than that of adolescents(91.2% in previous study), and antibody level was similar with adolescents. The herd immunity of the adults were considered to enough for protecting the transmission of measles in the community. For the eradication of measles in Korea, more efforts will be required to increase the vaccine coverage rate in children and adolescents.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.76-82
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• 2003

Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.767-773
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• 2007

Purpose : Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. Methods : Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturityrating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. Results : BMI ($25.3{\pm}2.9kg/m^2$ vs. $26.0{\pm}2.9kg/m^2$) and HOMA-IR ($3.6{\pm}1.8$ vs. $4.7{\pm}1.9$) have increased significantly after one-year follow-up. The serum adiponectin concentration ($17.2{\pm}5.2g/mL$ vs. $12.6{\pm}5.2g/mL$) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. Conclusion : Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.

• Journal of Nutrition and Health
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• v.10 no.2
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• pp.59-70
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• 1977

This study was designed to evaluate the changes and improvements in the Korean diet during the last thirty years (since independence in 1945), and to make recommendations for the improvement of their nutritional status, consequently contributing to the physical and mental welfare of the Korean people. The results and recommendations are as follows: 1. The total calorie and carbohydrate intake decreased by $8{\sim}12%$ in the 1970's, as compared with the 1940's and the 1950's. 2. The intake of calcium and vitamiu A increased $30{\sim}50%$ and $20{\sim}60%$ respectively in the 1960's and 1970's as compared with the 1940,s. But this intake level is still lower than the RDA values. 3. The vitamin C intake was somewhat higher in the mountainous and farming areas than in urban areas. 4. In the 1970's, the decrease of untriend intake due to seasonal variation was marked especially for protein, niacin, vitamin $B_1$, and vitamin C. 5. The consumption of protein foods (meats and legumes) increased in an amount of $15{\sim}36g$ per day. There was a marked increase in the intake of meat in farming areas and of milk in urban areas in the 1970's. This increased intake of animal proteins is a very desirable dietary change. 6. The cereal consumption was lowest in urban areal, but there was a general decrease in the intake of the cereal group in the entire area in the 1970's. For the farmers, the intake of cereal food decreased most, from 750 g to 576 g, but cereals still composed a high proportion of the entire diet. 7. Fruits and vegetables showed the highest intake for the urban people, as expected. For the whole area, this food group showed an increase of 8.7% in the 1970's, as compared with the 1960's. 8. The gradual ihcrease in the intake of the fats and oil group was a desirable dietary change. but the absolute amount was too low. 9. A 7% increase in height and a 9% incrrase in weight for growing children and adolescents was observed in the 1970's as compared with the 1940's, but several kinds of deficiency diseases, such as nutritional anemia and dental caries were still apparent in many areas. 10. To improve cur food life and to cope with food shortages faced in Korea, an efficient and nationwide nutrition education program should be implemented. This would maximize efficiency of intake from the limited food sources for a balanced diet. 11. As it is of utmost importance to provide growing children with a desirable physical, sccial mental, and especially nutritional environment, a well-planned and organized school feeding program should be practiced widely and efficiently. 12. Young mothers and pregnant women should be educated on the importance of their children's nutrition, especially for the critical fetal and infancy periods. 13. More thorough and continuous nutritional survey studies on the changes in dietary patterns for the entire nation should be pursued, evaluated and documented. This would Provide a good information guide for future nutritional study programs. 14. It is the nutritionistist's strong desire that national leaders, especially decision makers recognize the fact that improvement of the nutritional status of the People is one of the most economic and preventative ways of improving their physical and mental health. This is closely related to the economic development and strength of the nation.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.72-81
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• 2018

Purpose: This prospective study aimed to investigate the therapeutic efficacy of lamivudine in children with chronic hepatitis B virus (HBV) infection. Methods: During July 2003 through October 2015, children with chronic hepatitis B who visited our institution were included in this study. Fifty-five patients, who received first-line treatment of lamivudine (3 mg/kg, 100 mg maximum) for over three months, were enrolled. After initiating lamivudine, alanine aminotransferase (ALT), HBV-DNA, and HBV markers were followed up at 1 month, 3 months, and every 3 months, thereafter. The treatment endpoint was determined as 1) normalization of ALT, 2) HBeAg seroconversion, and 3) anti-HBe positivity for twelve consecutive months. Results: Thirty-one male (56.4%) and 24 female (43.6%) patients were included. The mean age at treatment initiation was 8.1 years. The mean duration of treatment was 23.4 months. ALT normalization was found in 98.2% (54 of 55). Anti-HBe seroconversion was found in 70.6% (36/51). Loss of HBsAg was found in 10.9% (6/55). All biochemical responses occurred under age seven. The rate of virologic response (defined as HBV-DNA <2,000 IU/mL) at six months after treatment initiation was 78.7% (37/47). At twelve months after reaching treatment endpoint, 87.2% (34/39) maintained their virologic response. Resistance to lamivudine was found in 16.4% (9/55). Conclusions: Lamivudine treatment in Korean pediatric patients with chronic hepatitis B showed better outcomes compared with other studies that implemented similar protocols in foreign populations. Further studies are needed to investigate the efficacy of newly recommended antiviral drugs on the Korean pediatric population.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.857-864
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• 2005

Purpose : The objectives of this study was to evaluate the correlations between the indices of insulin sensitivity using fasting glucose and insulin level, and the body fat mass measured by bioelectrical impedance analysis(BIA) and dual energy X-ray absorptiometry(DEXA), and to determine the clinical usefulness of insulin sensitivity indices when obese children were followed up. Methods : In this study, 28 simple obese children and adolescents were included. Anthropometric data including body weight, height, obesity degree(OD), body mass index(BMI), and waist-to-hip ratio were collected and then body fat mass was measured by using BIA and DEXA. For metabolic data, 12 hour fasting serum glucose, insulin and lipid profiles were measured and indices for insulin sensitivity(G/I ratio, $log_{insulin}$, HOMA-IR, $log_{HOMA-IR}$, QUICKI) were calculated. Results : BMI had a higher correlation with insulin sensitivity indices than OD(G/I ratio, -0.463 vs -0.209; $log_{insulin}$, 0.417 vs 0.196; HOMA-IR, 0.301 vs 0.238; $log_{HOMA-IR}$, 0.403 vs 0.198; QUICKI, -0.451 vs -0.224). But OD had a higher correlation with body fat mass measured by BIA and DEXA than BMI(BIA, 0.612 vs 0.316; DEXA, 0.667 vs 0.512). The G/I ratio was correlated with body fat mass in BIA(r=-0.420, P<0.05) and DEXA(r=-0.512, P<0.01), percentage of body fat(percentage of fat) in BIA(r=-0.366, P<0.05) and DEXA(r=-0.449, P<0.01). HOMA-IR was only correlated with body fat mass in DEXA(r=0.341, P<0.05). Conclusion : This study revealed that G/I ratios had a statistically significant correlation with anthropometric obesity indices(OD and BMI) and also had a correlation with both body fat mass and percentage of fat. These results suggest that G/I ratios could be used as useful index when obese children and adolescence are followed up.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.2
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• pp.65-75
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• 2018

Objectives : This study aimed to investigate the satisfaction of Korean medicine doctors (KMD) who conducted Korean medicine school doctor program (KMSD). We are going to use study as a foundation for activation KMSD program. Methods : Seoul Korean medicine association and Seoul metropolitan office of education conducted KMSD program for 22 schools in 2017. The program included health lessons, health counseling, and health care programs. After program finished, we carried out self-administered questionnaire survey to KMD who participated in KMSD program and we analysed it. Results : A total of 45 people answered the questionnaire, and 56% of respondents answered as 'Good progress' and 44% answered as 'Bad progress'. The reason for good progress was 'Good cooperation of School' (47.4%). 'Personalized program for participant' (23.68%), 'Support of Seoul Korean Medicine Association' (21.1%). The reason for 'Bad progress' was 'Bad cooperation of School' (37.8%), 'Lack of personal circumstances' (32.4%), 'Lack of motivation' (16.2%). The advantage of KMSD program included 'It is helpful for positive perception of the Korean medicine' and 'Korean medicine can contribute to improving public health, which is the health of schools' was 25%, 'It is helpful in expanding the services of Korean medicines to children and adolescents' was 17.6%, 'Highly satisfaction in participations' was 15.7%. The question of prerequisites for activation KMSD Program included 'Active cooperation of school' was 35.05%, 'Expand teaching materials and programs' was 20.62%, 'Support of Seoul Korean Medicine Association' was 15.46%. Conclusions : We will organize and activate programs of KMSD program and conduct program based on harmony of local community and school support, research of school health program. The program will contribute to improve student health and develop Korean health support program.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.512-517
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• 2008

Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.