Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.
Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.
Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.
The purpose of this study was to verify the clinical utility of th Korea Child Behavior Checklist 16-18(K-CBCL 6-18) in diagnosing ADHD among children with psychological disorders in child welfare institutions. The participants were 509 elementary school children(309 boys and 200 girls) who lived in child welfare institutions. They were assessed using the Korean ADHD Rating Scale(K-ARS) and K-CBCL 6-18. Only five scales of the K-CBCL 6-18 related with attention were used for analysis: syndrom total, externalizing total, aggressive behavior, attention problems and DSM-oriented ADHD scales. The results were as follows. First, K-ARS and K-CBCL 6-18 had significantly positive correlations with all five scales. Second, as a result of a t-test on the ADHD and the non-ADHD groups, which were divided using K-ARS, the mean scores of ADHD group were significantly higher than the non-ADHD group for all five scales of the K-CBCL 6-18. The hit rate of all five scales of the K-CBCL 6-18 was 60 to 70 percent. The syndrom total and externalizing total scales had high sensitivity, whereas the aggressive behavior, attention problems, and the DSM-oriented ADHD scales had high specificity. In addition, all scales had high positive predictive values. Third, as the result of a t-test on the ADHD group and the emotional disorder group, there were significant difference in the mean scores of the attention problems and the DSM-oriented ADHD scales. The attention problems and the DSM-oriented ADHD scales had a similar percentage of hit rate, high specificity and low sensitivity. Especially, the DSM-oriented ADHD scale revealed higher specificity than the attention problems scale. The results of this study suggested that the five scales related to attention of the K-CBCL 6-18 are useful in diagnosing ADHD in child welfare institutions.
This study has been performed for the purpose of providing the basic pedagogical resources to the specialized and meister high school related educational settings in either constructing educational contents suitable for the students'technological thinking disposition or fortifying the disposition required for the students.. A tool of secured validity and reliability has been used to test technological thinking disposition for the specialized and Meister high school students. Followings are the major results of the survey analysis for the subjects. 1. Technological thinking disposition with the most component ratio for the specialized & meister high school was turned out to be Technological Operating Disposition(TOD). The second most was Technological Planning and Reflecting Disposition(TPRD). Technological Curiosity Disposition(TCD), Technological Problem Identifying and Resolving Disposition (TPIRD), Technological Analyzing Disposition(TAD), Technological Creativity and Expressing Disposition(TCED) were in sequence. 2. In comparing the technological disposition of specialized high school students with that of meister high school students, the statistical test showed no evidence for the difference between the two group. 3. Statistical comparison test for the gender difference in technological thinking disposition has also been performed for the students of specialized and meister high school. The result showed that the magnitude of difference between the component ratio of TCD and TPIRD for the boy students was bigger than that for the girl students. In the TPRD, the component ratio for the disposition of the girl students was bigger than that of the boy students on the other hand. 4. For the comparison test of the technological thinking disposition between boys and girls only for the specialized high school students, the results showed the same different component ratio results as the results of the test for the specialized and meister high school students. 5. For the gender difference of meister high school student for the technological thinking disposition, there was no statistical evidence supporting the difference.
Purpose: The aim of this study was to evaluate the dietary behaviors of preschoolers in Daejeon using the Nutrition Quotient for Preschoolers (NQ-P). Methods: The study subjects were recruited from child-care centers and kindergartens located in Daedeok-gu, Daejeon between August and September 2018. A total of 411 preschoolers aged 3 ~ 6 years were included in the data analyses. A questionnaire of NQ-P, which consisted of 14 checklist items on dietary behaviors, was completed by the parents or guardians of the study subjects. The NQ-P scores and its three factors, including "balance", "moderation", and "environment" factors, were calculated according to sex, age, and weight status. Differences in the NQ-P scores and their factors according to sex, age, and weight status were tested using a student's t-test. Results: The mean NQ-P score of the total subjects was $58.5{\pm}9.2$, which was within the medium-low grade. The NQ-P score was $58.5{\pm}9.4$ in boys and $58.6{\pm}9.0$ in girls (p = 0.955). The NQ-P score was similar regardless of the age groups ($57.8{\pm}9.4$ in 3 ~ 4 years vs. $59.2{\pm}9.0$ in 5 ~ 6 years, p = 0.124), whereas subjects aged 5 ~ 6 years showed a significantly higher scores of environment factors than those aged 3 ~ 4 years ($67.9{\pm}16.8$ vs. $61.7{\pm}17.3$). The mean score of the moderation factor was lower in the overweight/obese children compared to the non-overweight/obese children ($46.6{\pm}13.3$ vs. $51.0{\pm}16.2$, p = 0.012). Compared to children aged 3 ~ 4 years, children aged 5 ~ 6 years had higher intakes of vegetable dishes and processed meat. The overweight/obese group showed a higher consumption of processed beverages than the non-overweight/obese group. Conclusion: The current study indicates that the dietary behaviors of preschoolers residing in Daejeon need to be improved. These findings suggest that nutrition education or health interventions targeting young children is necessary for improving their nutritional health status.
Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.
The evaluation of growth potency can be done with many physiologic indicators. It has been well known that skeletal maturity has a close relation with both sexual maturity and somatic maturity, but the correlation between skeletal maturity and dental maturity was believed to be less certain. But, recent studies show that specific teeth, including lower canines, present close correlations with skeletal maturity. So, in this study, we studied hand-wrist X-ray films and orthopantomograms of 387 Korean boys and girls aged from 7 to 15; the purpose was to determine skeletal and dental maturity, and to find out a new method to estimate individual skeletal maturity using multiple-regression model, without the help of hand-wrist X-ray film. As a result of this study, followings were observed. 1. The following multiple-regression model can estimate skeletal maturity index (SMI) with 84% of accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. SMI = 0.60 x chronologic age - 1.67 x sex$^{**}$ + 0.88 x lower canine$^{*}$ - 0.05 x lower 2nd molar$^{*}$ - 10.3 $^{*}$ : mean age corresponding each developing stage, $^{**}$ : male=1, femal=0 2. The following multiple-regression model can estimate skeletal age with 87% of accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. Skeletal age = 0.75 x chronologic age - 0.55 x sex$^{**}$ + 0.71 x lower canine$^{*}$ - 0.09 x lower 2nd molar* -5.77 $^{*}$ : mean age corresponding each developing stage, $^{**}$ : male=1, femal=0
Purpose: This study examined the frequency of sugar-sweetened beverage consumption in Korean adolescents and the major factors influencing the excessive consumption of sugar-sweetened beverages, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits. Methods: The analysis was performed using the data from the 2017 Korean Youth Risk Behavior Web-based Survey. The subjects included in the analysis were 30,885 middle school students and 31,391 high school students, totaling 62,276. The frequency of sugar-sweetened beverage consumption was calculated by summing the consumption frequencies of soda, high caffeine or energy drinks, and sweet beverages over the last 7 days. The Rao-Scott chi-square test, reflecting information on the sampling design, was used to test the differences in the rate of sugar-sweetened beverage consumption according to each factor. Logistic regression analysis was performed to examine the factors influencing the excessive consumption of sugar-sweetened beverages. Results: The rate of sweetened beverage consumption was higher in boys than in girls, in high school students than in middle school students, in students whose father's education level was lower, in those whose subjective academic performance was lower, and in those who smoked or consumed alcohol. In addition, the rate of sugar-sweetened beverage consumption was higher in those who experienced severe stress, suicidal ideation, sadness, or a sense of despair. The rate of sugar-sweetened beverage consumption was also high in those who skipped breakfast; who frequently consumed fast foods, ramen, or snacks; and who frequently ate meals at convenience stores, supermarkets, or school stores. Conclusion: The rate of sugar-sweetened beverage consumption in Korean adolescents is related to various factors, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits.
Kim, Su Jin;Cho, Joong Bum;Kwak, Min Jung;Paik, Kyung Hoon;Kwon, Eun Kyung;Jin, Dong-Kyu
Clinical and Experimental Pediatrics
/
v.51
no.7
/
pp.742-746
/
2008
Purpose : The objective of this study was to evaluate the effects and adverse side-effects of growth hormone (GH) therapy in children with Prader-Willi syndrome (PWS). Methods : Forty-one patients who had been treated with GH for more than two years (24 boys and 17 girls, mean age $7.3{\pm}3.3$ years during treatment initiation) were enrolled for this study. Results : After 2 years of GH therapy, the height and weight standard deviation scores (SDS) increased significantly ($-1.19{\pm}1.37$ vs. $-0.02{\pm}1.45$, and $1.02{\pm}2.42$ vs. $1.63{\pm}2.22$, P<0.002); however the percentage body fat decreased ($44.6{\pm}9.9%$ vs. $38.1{\pm}10.5%$, P<0.001). Further, no change was observed in the thyroid and serum glucose levels, but the total cholesterol level decreased. GH therapy did not impact glucose control in the patients with diabetes. The most common adverse effects of GH therapy were the progression of scoliosis and adenoid hypertrophy. Conclusion : GH therapy improved the height SDS and body composition in patients with PWS. However, GH should be used with caution in patients with scoliosis and adenoid hypertrophy.
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