• 대한한방소아과학회지
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• 제20권1호
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• pp.151-164
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• 2006

Objective : The objective of this study is to analyze an increasing rate, difference of attack rate in age, relationship between atopic dermatitis and breast-feeding, the relationship between atopic dermatitis and the Sasang constitution, and various treatments of atopic dermatitis. Methods : This clinical study was carried out with 22 theses which are related with diagnosis, treatments, prognosis and control of atopic dermatitis. The 22 theses are carried on J Korean Oriental Pediatrics, J Korean Oriental Ophthalmology, J Korean Oriental Med, J Korean Academy of Pediatric Allergy and Respiratory Disease, J Korean Acad Fam Med and Korean J Food & Nutr. Results : The prevalence rate, attack rate and diagnosis rate of atopic dermatitis are increased in the year of 2000, compared with those of 1995. Comparing age of patient between the year of 1992 and 2002, the attack rate of atopic dermatitis is increased quickly over 7 years old. Specific immunoglobulin E(IgE) antibodies detected in patients under 1 year old was exclusively caused by food. But for the age over 7 years old, food and inhalant allergen are detected in the year of 2002 in compare with that of 1992. Because of breast-feeding, intemperate diet adjustment during the period of maternity of family history of atopic dermatitis, the attack rate of atopic dermatitis is increased in infant. The types of patients are categorized according to Sasang constitution and Soeumin group was largest. The Oriental medicine treatments of atopic dermatitis are bath & skin hydration, avoidance from antigen, dietetic treatment, external treatment, medication and phototherapy. Conclusion : The atopic dermatitis is associated with breast-feeding, Sasang constitution types. More active approach for the treatment and prevention of Atopic dermatitis in children are needed.

• Clinical and Experimental Pediatrics
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• 제61권6호
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• pp.200-204
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• 2018

Atopic dermatitis (AD) is a chronic inflammatory skin disease in children. Patients with AD experience a high rate of colonization of the skin surface by Staphylococcus aureus. Because of a skin barrier defect, there is a potential risk of staphylococcal invasive infection in patients with AD. Here, we present 2 cases of breast abscess caused by S. aureus in 2 adolescent girls with severe AD. Methicillin-sensitive S. aureus was identified from the breast abscess material. They were treated with appropriate antibiotics, however surgical drainage of the abscess was needed in case 1. Identical strains were found from the breast abscess material as well as the lesional and the nonlesional skin of the patients through matrix-assisted laser desorption/ionization time-of-flight analysis. We characterized the differential abundance of Firmicutes phylum in patients' skin in microbiota analysis. In particular, S. aureus, a member of Firmicutes, differed significantly between the lesional and the normal-appearing skin. Our cases demonstrate the potential severity of bacterial deep tissue infection in AD and the dysbiosis of skin microbiota may be involved in inflammation in AD.

• Advances in pediatric surgery
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• 제4권2호
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• pp.149-155
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• 1998

Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(100 %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(18.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases(66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases(62.4 %) and mixed feeding; 37 cases(13.1 %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.1 %), UGI series 27 cases(7.4%) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.

• Clinical and Experimental Pediatrics
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• 제48권11호
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• pp.1166-1171
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• 2005

목 적 : 영아시기의 모유수유가 이후 소아기의 과체중이나 비만의 유병률에 영향을 줄 수 있는지를 알아보고자 하였다. 방 법 : 2004년도 마산 및 창원에 있는 4개의 초등학교 1학년과 2학년 1,275명을 대상으로 하여, 생활기록부로부터 키와 몸무게에 대한 정보를 바탕으로 BMI와 비만도를 구하였고 학부모를 대상으로 설문지를 보낸 후 수집하였다. 설문의 내용은 출생력(재태주수, 출생시 몸무게, 분만방식), 수유의 방법(모유 단독 수유, 분유 단독 수유, 혼합 수유, 모유수유 후 분유로의 전환) 및 그 기간에 대해서 표시하도록 하였다. 결 과 : 1) 과거 수유방식은 모유를 2개월 미만으로 먹고 이후 분유만 먹인 경우가 54.5%로 가장 많았고 모유를 2개월에서 6개월간 먹고 이후 분유 수유한 경우가 12.9% 7개월 이상 모유만 먹인 경우가 18.4%, 모유와 분유를 혼합해 먹인 경우가 14.3%였다. 2) BMI를 기준으로 과체중은 10.3%, 비만은 9.8%로 과체중 이상의 어린이는 전체 조사대상의 어린이 중 20.1%로 나타났다. 비만도를 기준으로 한 경우 경도 비만은 4.5%, 중등도 비만은 2.4%였고 고도비만은 없었다. 3) 수유방식에 따른 BMI를 적용한 과체중 및 비만의 유병률에 차이가 없었으며 이는 비만도를 적용한 경우에도 마찬가지였다. 4) 평균 체질량지수와 평균 비만도 역시 수유방식에 따른 차이가 없었다. 결 론 : 영아기 수유방식은 초기 학동기 어린이의 비만에 특이한 영향을 주지 않는 것으로 보아 모유의 비만예방에 대한 효과를 확인할 수 없었다. 그러나 어린이의 비만에 영향을 줄 수 있는 요인은 아주 많아 이를 고려하고 대상을 보다 광역화, 대량화한 연구가 추가적으로 진행되어야 할 것으로 사료된다.

• 대한소아치과학회지
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• 제32권4호
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• pp.682-686
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• 2005

색소실조증(Incontinentia pigmenti)은 신생아기에 체간과 사지에 소수포가 발생하여 1세경이 되면 수포는 더 이상 생기지 않고 갈색반점이 나타나는 특징을 보이는 아주 드문 질환이다. Bloch-Sulzberger syndrome이라고 불리는 이 질환은 반성 우성 유전질환으로 대부분 여성에게 나타나며, 외배엽, 중배엽 기원 조직들인 눈, 치아, 피부, 손톱, 가슴, 머리카락, 신경계 등에 이상을 동반한다. 본 증례는 유치의 선천적 결손을 주소로 내원한 환아의 문진 중 색소실조증의 사실을 발견하고 검사한 결과, 다수의 유치와 영구치의 선천적 결손과 치아의 형태이상, 상악의 열성장, 치아의 형태이상과 악골 성장의 부조화 등으로 인한 교합불안정을 보이고 있었다. 전신적으로는 망막이상을 보여 수술을 시행한 상태이며, 피부에는 특징적 인 갈색반점을 보였다. 현재 치아결손부의 공간관리와, 심미적, 심리적인 문제의 해결, 그리고 기능의 회복을 위해 가철식 부분의치를 장착해주었으며, 계속적인 관찰을 하고 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.536-544
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• 2019

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.169-178
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• 2008

목 적: 건강한 모유 수유아의 경우 생후 6개월까지는 철분 결핍이 일어나지 않으며 6개월 이전에는 철분을 보충할 필요가 없다고 알려져 있으나, 최근 건강한 모유 수유아에서도 생후 6개월 이전에 철 결핍과 철 결핍성 빈혈이 발생한다는 보고가 있다. 따라서 본 연구에서는 생후 6개월과 12개월 영아들의 철 영양상태를 알아보고, 생후 2개월부터 조기 저용량 철분보충요법을 시행하여 철 결핍과 철 결핍성 빈혈을 예방하는데 효과가 있는지 알아보고자 하였다. 방 법: 2004년 8월부터 2005년 7월까지 만 1년간 충북대학교병원 산부인과에서 만삭으로 출생한 건강한 신생아 87명을 대상으로 하였다. 이들을 생후 2개월에 분유 수유군(A군), 모유 대조군(B군), 모유 보충군(S군, 철분 5 mg/일 보충)으로 나누어 출생 시(제대혈), 생후 6개월, 12개월에 저장철(ferritin), 혈청 철(iron), 총철결합능(total iron binding capacity, TIBC), 트랜스 페린 포화도(transferrin saturation rate, TFSAT)와 헤모글로빈(hemoglobin), 헤마토크릿(hematocrit), 평균적 혈구용적(mean corpuscular volume, MCV), 평균적혈구혈색소량(mean corpuscular hemoglobin, MCH), 적혈구분포폭(red cell distribution width, RDW)을 측정하였다. 결 과: 1) 생후 6개월에 측정한 저장철, 혈청 철, TFSAT, 헤모글로빈은 세 군 중 모유 대조군에서 가장 낮았으며, 총철결합능과 적혈구분포폭은 가장 높았다. 저장철 고갈, 철 결핍, 철 결핍성 빈혈의 빈도는 모유대조군에서 각각 33, 33, 30%로 분유 수유군의 0, 5, 8%나 모유 보충군의 1, 7, 5%보다 높았다. 2) 생후 12 개월의 저장철, TFSAT, 헤모글로빈, MCV, MCH는 세군 중 모유 대조군에서 가장 낮았으며, 총철결합능과 적혈구분포폭은 가장 높았으나, 혈청 철과 헤마토크릿은 세 군 간에 유의한 차이가 없었다. 저장철 고갈, 철결핍, 철 결핍성 빈혈의 빈도는 모유 대조군에서 각각 73, 64, 50%로 분유 수유군의 4, 4, 3%나 모유 보충군의 9, 9, 7%보다 높았다. 결 론: 철 결핍 상태와 철 결핍성 빈혈은 모유 수유아에서 분유 수유아에 비해 높은 빈도를 보였다. 또한, 철분 보충 없이 모유 수유만 했던 영아의 경우 생후 6개월에도 철 결핍과 철 결핍성 빈혈이 발생하였으며, 조기 저용량 철분보충요법은 모유 수유아에서 철 결핍과철 결핍성 빈혈을 예방하는데 효과가 있었다.

• Clinical and Experimental Pediatrics
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• 제54권9호
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• pp.368-372
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• 2011

Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.248-256
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• 2018

Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.124-127
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• 2019

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.