• Clinical and Experimental Pediatrics
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• v.53 no.10
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• pp.863-871
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• 2010

The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.219-223
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• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Journal of the Korean Dietetic Association
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• v.17 no.2
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• pp.161-175
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• 2011

This study examined students' menu preferences as well as the job satisfaction and specific considerations concerning foodservice operation of dieticians and nutrition teachers at special schools for the disabled. Semi-structured interview questionnaires were sent to all of the 21 special schools with direct school food service in Gyeonggi-do, and 16 dieticians and nutrition teachers agreed to participate in this study. Among the various menu groups, the subjects perceived the meat group as the most preferred and the vegetable group the least preferred. They were generally satisfactory with their job and duty, and had a strong sense of belonging to the school. However, most of them answered that they needed more time for nutritional education and counseling. While most had pride and pleasure in their job, they expressed a desire to change the system to better fit with their roles as professional nutritionists. The content analysis revealed that the subjects mainly focused on safety issues in planning the food menu and were thus limited in selecting menu items. They also felt difficulty in menu planning due to various tastes and preferences, since special schools tend to consist of a wider grade range. However, most subjects reported little trouble in food distribution and food leftovers owing to practical support from teachers and parents. The necessity for education concerning table manners and obesity prevention was generally a shared opinion, and education programs for parents were also perceived as necessary to better understand the special considerations for developing proper eating habits in their child. The study findings provide useful basic data to improve the foodservice system at special schools.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.1
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• pp.20-29
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• 2015

This study investigated the demand of nutrition education programs among preschooler's parents. Focus group interview was conducted four times with 29 parents of preschool children. Most subjects appeared to have interest in nutrition education; 'very interested' (58.6%), 'somewhat interested' (20.7%). Sources of nutrition information were 'internet' (35.1%), 'books' (21.6%), 'newspaper or magazines' (13.5%), 'family or relatives' (13.5%), 'media' (8.1%), 'preschool' (5.4%) and 'hospital or public health center' (2.7%) in order. The most frequently mentioned health problems related to dietary behavior were atopy and obesity. Major concerns for children's dietary behavior was picky eating habits, and having questions for how to deal with this problem. Most subjects had trouble with obtaining an adequate amount of dietary supplements for their children. Nutrition education for parents about food labeling and information on processed foods was in demand. Preferred methods of nutrition education for children were playing games with stickers, gardening vegetables, and participating in cooking. Attitudes toward computer-assisted education materials, one of the methods of nutrition education, appeared to be ambivalent. Some preschool parents showed negative attitudes towards exposing their children to electronic devices at an early age, whereas others showed positive attitudes. Subjects were interested in meal-planning and ways to balance nutrients for their child. Parents preferred attending professional lectures to receive reading materials or searching websites as an adult nutrition education method. Results of this study have implications on providing basic information for developing nutrition education programs for preschoolers and their parents. Future research should focus on developing nutrition education programs for both preschools and the home.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.1
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• pp.44-51
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• 2012

Purpose: Tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) polymorphism has been suggested to play an important role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) in obese adults, and known to be a mediator of insulin resistance. In this study, we evaluated the role of TNF-${\alpha}$ promoter polymorphisms and insulin resistance in the development of NAFLD in obese children. Methods: A total of 111 obese children (M:F=74:37; mean age, $11.1{\pm}2.0$ yrs) were included. The children were divided into 3 groups: controls (group I, n=61), children with simple steatosis (group II, n=17), and children with non-alcoholic steatohepatitis (group III, n=33). Serum TNF-${\alpha}$ levels, homeostasis model assessment of insulin resistance (HOMA-IR), and TNF-${\alpha}$ -308 and -238 polymorphisms were evaluated. Results: There were no differences in TNF-${\alpha}$ polymorphism at the -308 or the -238 loci between group I and group II + III ($p$=0.134 and $p$=0.133). The medians of HOMA-IR were significantly different between group I and group II + III ($p$=0.001), with significant difference between group II and group III ($p$=0.007). No difference was observed in the HOMA-IR among the genotypes at the -308 locus ($p$=0.061) or the -238 locus ($p$=0.207) in obese children. Conclusion: TNF-${\alpha}$ promoter polymorphisms at the -308 and -238 loci were not significantly associated with the development of NAFLD in children; nevertheless, insulin resistance remains a likely essential factor in the pathogenesis of NAFLD in obese children, especially in the progression to NASH.

• Clinical and Experimental Pediatrics
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• v.62 no.11
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• pp.416-421
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• 2019

Background: The seropositivity rate of hepatitis B surface antigen (anti-HBs) antibodies is known to be ≥95% after hepatitis B virus vaccination during infancy. However, a low level or absence of anti-HBs in healthy children is discovered in many cases. Recent studies in adults reported that a reduced anti-HBs production rate is related to obesity. Purpose: To investigate whether body mass index (BMI) affects anti-HBs levels in healthy children following 3 serial dose vaccinations in infancy. Methods: We recruited 1,200 healthy volunteers aged 3, 5, 7, or 10 years from 4-day care centers and 4 elementary schools. All subjects completed a questionnaire including body weight, height, and vaccine type received. Levels of serum hepatitis B surface antigen (HBsAg) and anti-HBs in all subjects were analyzed using electrochemiluminescence immunoassay. The standardized scores (z score) for each sex and age were obtained using the lambda-mu-sigma method in the 2017 Korean National Growth Charts for children and adolescents. Results: Our subjects (n=1,200) comprised 750 males (62.5%) and 450 females (37.5%). The overall anti-HBs seropositivity rate was 57.9% (695 of 1,200). We identified significant differences in mean BMI values between seronegative and seropositive groups (17.45 vs. 16.62, respectively; P<0.001). The anti-HBs titer was significantly decreased as the BMI z score increased adjusting for age and sex (B=-15.725; standard error=5.494; P=0.004). The probability of anti-HBs seropositivity based on BMI z score was decreased to an OR of 0.820 after the control for confounding variables (95% confidence interval, 0.728-0.923; P=0.001). Conclusion: There was a significant association between anti-HBs titer and BMI z score after adjustment for age and sex. Our results indicate that BMI is a potential factor affecting anti-HBs titer in healthy children.

• Health Policy and Management
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• v.25 no.3
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• pp.149-151
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• 2015

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

• Nutrition Research and Practice
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• v.13 no.2
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• pp.169-177
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• 2019

BACKGROUND/OBJECTIVES: Excessive sugar intake is one of the causes associated with obesity and several chronic diseases prevalent in the modern society. This study was undertaken to investigate the effect of parenting variables based on the theory of planned behavior, on the sweetness preferences and sweets intake of children. SUBJECTS/METHODS: Parents and their children (n = 103, aged 5-7 years) were enrolled to participate in a survey for this study, after providing the required informed consent. Parents were asked to fill out a self-administered questionnaire at their residence. The sweetness preference test for children was conducted at a kindergarten (or daycare center) by applying the one-on-one interview method. RESULTS: The children were divided into two clusters categorized by the K-mean cluster analysis: Cluster 1 had higher sweetness preference (0.42 M sugar, 35%; 0.61 M sugar, 65%); Cluster 2 exhibited lower sweetness preference (0.14 M sugar, 9.5%; 0.20 M sugar, 9.5%; 0.29 M sugar, 81%). Cluster 1 had a higher frequency of sweets intake (P < 0.01), and lower sweets restriction (P < 0.05) and nutrition quotient score (P < 0.05). Sweets intake was negatively correlated with the nutritional quotient (r = -0.204, P < 0.05). The behavioral intention of parents was higher in cluster 2 (P < 0.05), while affective attitude, feeding practice, and reward were higher in cluster 1 (P < 0.001, P < 0.05, and P < 0.01, respectively). Furthermore, behavioral intention of parents showed a negative correlation with affective attitude (r = -0.282, P < 0.01) and feeding practice (r = -0.380, P < 0.01), and a positive correlation with subjective norm (r = 0.203, P < 0.05) and parenting attitude (r = 0.433, P < 0.01). CONCLUSIONS: This study indicates that the sweetness preferences and sweets intake of children is related to the parent's affective attitude, feeding practice and reward. We suggest that to reduce the sugar consumption of children, guidelines for access to sweets and pertinent parenting practices are required.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.59-68
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• 2019

Purpose: This study evaluated the psychometric properties of the Korean version of Yale Food Addiction Scale for Children (YFAS-C). Methods: Participants were 419 young adolescent students (11~15 years old). The content validity of the expert group was calculated as the content validity index (CVI) after the translation and reverse translation process of the 25 items of the YFAS-C. The multitrait-multimethod matrix (MTMM) method was used to verify the construct validity; the generalized linear model (GLM) was used to evaluate the concurrent and incremental validity. Reliability was calculated as Kuder-Richardson-20 (KR-20) and Spearman-Brown coefficients. Results: The CVI of the 25 items was greater than the item-level CVI .80 and the scale-level CVI .90. The Korean version of YFAS-C had verified convergent validity in emotional eating and external eating and discriminant validity in restrained eating. In addition, it had verified concurrent validity in emotional eating and external eating. Finally the incremental validity of the Korean version of YFAS-C was statistically significant on BMI. Reliability was KR-20 ${\alpha}=.69$ and the Spearman-Brown coefficient was .64. Conclusion: The Korean version of YFAS-C is a valid and reliable scale for measuring the severity of food addiction; it can be a useful scale for preventing obesity by predicting food addiction early.

• Nutrition Research and Practice
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• v.16 no.6
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• pp.765-774
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• 2022

BACKGROUND/OBJECTİVES: It is important to determine Dysfunctional eating behaviors such as dietary restraint and overeating tendencies in order to provide weight management and acquire the right habits in children. The purpose of this study was to test the reliability and validity of Dutch Eating Behaviour Questionnaire Children (DEBQ-C) with Turkish preadolescent children. MATERIALS/METHODS: This research included 440 preadolescents (9.3 ± 6.9 years and 235 girls, 205 boys). The instrument is divided into three subscales, each with 20 items. Emotional eating, restrained eating, and external eating are the three subscales. Confirmatory factor analysis (CFA) was used to assess the construct validity of the Turkish version of the DEBQ-C, and Cronbach α values were computed to evaluate the subscale reliabilities. There were 20 observable variables and three latent variables in the hypothesized model. RESULTS: Fit indices for the hypothesized model were good (×2/degree of freedom = 1.96; root mean square error of approximation = 0.05; comparative fit index = 0.95; goodness of fit index = 0.93). These findings revealed that the Turkish version of the DEBQ-C has a factor structure that was identical to the three-factor structure of the original scale. The Turkish version of the DEBQ-C subscales has internal consistency coefficients ranging from 0.72 (external eating) to 0.86. (emotional eating). CONCLUSIONS: The DEBQ-C Turkish version is a viable and reliable tool for measuring overeating tendencies in Turkish preadolescents, according to the findings.