• Journal of Dairy Science and Biotechnology
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• v.27 no.1
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• pp.1-12
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• 2009

In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.29-36
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• 2019

Background: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. Methods: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. Conclusion: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.109-116
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• 2011

Purpose : Pneumococcus is one of the most important causes of invasive infection through the childhood period. In January 2008, the Clinical and Laboratory Standards Institute (CLSI) published revised penicillin breakpoints for Streptococcus pneumoniae and penicillin susceptibility rates of S. pneumoniae increased in Korea. This study was performed to determine the probability of oral amoxicillin for the empirical treatment achieving bactericidal exposure against pneumococcus using pharmacodynamics model. Methods : Twenty-three isolates of pneumococci were subjected to determine minimum inhibitory concentration (MIC) for ${\beta}$-lactams and macrolide. For the ${\beta}$-lactams, exposure of fT >MIC (time that free drug concentrations remain above the MIC) for 50% of the administration interval have determined the probability of target attainment (PTA), and regimens that had a PTA >90% were considered optimal. An analysis was performed by applying MIC of 23 isolates to a 5000-patient Monte Carlo simulation model. Results : Among 23 isolates from healthy children, 7 (30.4%) isolates were MIC ${\leq}$1.0 ${\mu}g$/mL and 19 (82.6%) were MIC ${\leq}$2 ${\mu}g$/mL for amoxicillin. Amoxicillin 40 mg/kg/day achieved PTA >90% at MIC ${\leq}$1.0 ${\mu}g$/mL but PTA decreased to 52% at MIC 2 ${\mu}g$/mL, whereas amoxicillin 90 mg/kg/day can predict 97% of PTA at MIC 2 ${\mu}g$/mL. Overall, oral amoxicillin 90 mg/ kg/day for the empirical treatment against pneumococcus can expect more successful response in Korean children. Conclusion : Considering the resistantce pattern of pneumococci in Korean children, we estimate that oral amoxicillin 90 mg/kg/day will provide a pharmacodynamic advantage for the empirical treatment against pneumococcus. And low dose amoxicillin or macrolide are expected to have higher chance of treatment failure than high dose oral amoxicillin.

• Women's Health Nursing
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• v.29 no.4
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• pp.337-347
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• 2023

Purpose: Despite the health impacts of endocrine-disrupting chemicals (EDCs) beginning in the early stages of life, there is little research on the perception of EDCs among Korean mothers, who are primarily responsible for protecting children. This study aimed to explore how mothers with young children perceived EDCs for their concerns, the issues they faced, and the way they dealt with them. Methods: An exploratory qualitative design was utilized. Twelve mothers who were recruited from snowball sampling participated in voluntary interviews. Individual in-depth interviews lasting approximately 47 to 60 minutes were recorded and transcribed verbatim. The data were analyzed using qualitative content analysis as suggested by Graneheim and Lundman. Results: Four categories, 10 subcategories, and 25 condensed meaning units were identified by interpreting mothers' underlying meanings. The four categories were 'Knowledgeable yet contrasting ideas regarding EDCs,' 'Negative health impact, but more so for children,' 'Inaction or trying to minimize exposure,' and 'Need for early, reliable resources and social change.' Mothers were knowledgeable about EDCs and actively needed further education and support. While they tended to focus more on the health impact of EDCs on their children and were optimistic about their health risks, paying less attention to their preventive behaviors. Conclusion: Healthcare professionals must consider mothers' perceptions of EDCs in future education and interventions regarding EDCs impact on women's life stages such as puberty, pregnancy, and childrearing. Also preventive strategies that can be applied to their daily lives are needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.781-784
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• 2014

Background: Although the cause in most cases of childhood leukemia is not known, the contribution of environmental risk factors in the context of genetic predisposition has been reported with inconsistent results. The aim of this study was to examine association of childhood leukemia with maternal factors especially during pregnancy, to help in avoiding risk factors. Materials and Methods: This case-control study included children younger than 18 years diagnosed with leukemia from 2008 to 2012. Controls were randomly selected and individually matched to cases with respect to age, sex, and residency. All variables were compared between cases and control to determine any significant association with leukemia. Results: Statistically significant associations between risk of childhood leukemia with mother's education (p=0.001), occupation (p=0.0005) and pesticides exposure (p=0.005) during pregnancy were found. However, there were no significant links with maternal age (p=0.090), history of fetal loss (0.85), history of radiography during pregnancy (p=0.400), history of drug intake (p=0.689) and infection (p=0.696) during pregnancy. Conclusions: The results showed increased risk of leukemia in children whose mothers were working in agriculture and were exposed to pesticides during pregnancy. The further study needs to be investigated to know association of various maternal risk factors with leukemia which remained unknown in this study.

• Child Health Nursing Research
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• v.25 no.2
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• pp.175-183
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• 2019

Purpose: This study was conducted to analyze physical symptom-related and life-style factors affecting suicidal ideation of senior grade students in elementary school. Methods: Physical symptom-related and life-style factors were used to investigate suicidal ideation among 663 elementary school students. From February 11 to 15, 2018, data were collected using a structured questionnaire and analyzed using the $x^2$ test, Pearson correlation analysis, and logistic regression analysis in SPSS for Windows version 22.0. Results: The factors affecting suicidal ideation were gender, family structure, economic status, academic performance, exposure to school violence during the past year, physical symptoms, drinking experience, smoking experience, sleeping time, and ramen noodle consumption. The regression analysis showed that exposure to school violence during the past year (odds ratio [OR]: 102.99, 95% confidence interval [CI]: 51.19~207.19, p=.001), number of physical symptoms (OR: 1.25, 95% CI: 1.12~1.41, p=.001), drinking experience (OR: 3.17, 95% CI: 1.66~6.06, p=.001), and game and internet usage time (OR: 2.08, 95% CI: 1.08~4.01, p=.029) affected suicidal ideation. Conclusion: This study revealed that physical symptoms and life-style significantly influenced suicidal ideation. Therefore, interventions to reduce suicidal ideation in children must focus on improving children's physical symptoms and life-style.

• Safety and Health at Work
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• v.4 no.1
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• pp.1-11
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• 2013

This review surveys the recent literature on the neurodevelopmental impacts of chemical exposures during pregnancy. The review focuses primarily on chemicals of recent concern, including phthalates, bisphenol-A, polybrominated diphenyl ethers, and perfluorinated compounds, but also addresses chemicals with longer histories of investigation, including air pollutants, lead, methylmercury, manganese, arsenic, and organophosphate pesticides. For some chemicals of more recent concern, the available literature does not yet afford strong conclusions about neurodevelopment toxicity. In such cases, points of disagreement among studies are identified and suggestions provided for approaches to resolution of the inconsistencies, including greater standardization of methods for expressing exposure and assessing outcomes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.2
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• pp.65-70
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• 2013

Many child actors have appeared in various movies as the Korean film industry continues to evolve. As more children appear in violent and raunchy scenes, there are more concerns about the movie's effect on child actors. In some Western countries, many strategies have been developed for child actors, but for the Korean movie industry, the conditions are still poor for them. Although children who enter the concrete operational period are able to think logically and systematically, they are yet limited by their experiences. Adolescents in the formal operational period try to deal with all of the possibilities and assumptions logically and systematically with freedom from realistic contents and experiences. This period is very important because adolescents become more sensitive to others' feelings and they should develop their ego identity. Several studies have reported the indirect experiences through media including how the movie affected children and adolescents negatively. Depending on the individual's morality, judgment and emotional status, these effects were variable and inconsistent and could be relieved by several interventions. We could anticipate much bigger emotional effect on child actors who are acting directly and then are confronting themselves in the scene. Therefore, we suggest that the emotional effects of the movies on child actors can be managed properly by considering children's cognitive ability and emotional status, and establishing protective strategies before they are exposed to problematic scenes. Of course, it should be followed by evaluating them after the exposure and with follow-up management, if necessary.

• Environmental Analysis Health and Toxicology
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• v.20 no.3 s.50
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• pp.209-213
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• 2005

Due to steady increase of childhood asthma, exposure to air toxics including PAHs have been thought as an etiology for the asthma. PAHs -involvement in airway inflammation, such as IgE production, is the potential mechanism of the PAHs-induced asthma. Cytochrome P450s (CYPs), particularly CYP1A1 is known enzyme to metabolite PAHs and to be induced by PAHs. The CYP1A1 expression has been emphasized as an biomarker for PAHs - exposure. The present study was performed to clarify the etiology of childhood asthma with PAHs-exposure using mRNA expression of CYP1A1 . The study Objects were Korean children who were asthma patients (cases) or other hospital controls (N=20; age,3 $\~$ 16; boys,56$\%$). As result, we detected expression of the CYP1A1 in all peripheral blood specimens which were collected from the subjects. Moreover, we found approx. 300 fold-higher expression of the CYP1A1 in the cases than that in the controls (p(<)0.01). When we considered age which was related to Asthma, the above significant trend was somewhat diluted, however, the relation between asthma and the Cypih i expression waL stronger than that between asthma and age (chi square,7.99 vs. 3.34). Therefore, our study supports that PAHs induce or worse childhood asthma and suggests application of expression of the CYP1A1 as an initiation or progress biomarker for PAHs - induced childhood asthma.

• BioChip Journal
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• v.12 no.4
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• pp.304-308
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• 2018

Atopic disease is caused by a complex combination of environmental factors and genetic factors, and studies on influence of exposure to various environmental factors on atopic diseases are continuously reported. However, the exact cause of atopic dermatitis is not yet known. Our study was conducted to analyse the association of SNPs with the development of atopic disease in a small cohort. Samples were collected from the Mothers' and Children's Environmental Health (MOCEH) study and 192 cord blood DNA samples were used to identify incidence of atopy due to influence of exposure to environmental factors. Genetic elements were analysed using a precision medicine research (PMR) array designed with various SNPs for personalized medicine. Case-control analysis of atopy disease revealed 253 significant variants (p<0.0001) and SNPs on five genes (CARD11, ZNF365, KIF3A, DMRTA1, and SFMBT1) were variants identified in previous atopic studies. These results are important to confirm the genetic mutation that may lead to the onset of foetal atopy due to maternal exposure to harmful environmental factors. Our results also suggest that a small-scale genome-wide association analysis is beneficial to confirm specific variants as direct factors in the development of atopy.