• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.220-226
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• 2009

Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients ($23.9{\pm}2.4$ years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. Results : Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects ($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). Conclusion : Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.298-305
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• 2005

Purpose : We performed this study to evaluate the mean serum levels of insulin-like growth factor (IGF)-I, insulin-like growth factor binding protein(IGFBP)-2 and IGFBP-3 in healthy Korean children according to age and sex. Methods : Ninety two healthy children, consisting of 42 boys and 50 girls, were classified into five groups according to age : neonate; infancy; early childhood; late childhood; and adolescence. We measured serum levels of IGF-I, IGFBP-2 and IGFBP-3 by enzyme-linked immunosorbent assay(ELISA) and analysed the serum levels according to sex and age group. Results : For boys, the mean serum levels of IGF-I(ng/mL) in neonate, infancy, early childhood, late childhood and adolescence were $41.1{\pm}3.6$, $70.9{\pm}33.7$, $103.5{\pm}97.2$, $89.8{\pm}46.5$ and $51.4{\pm}27.8$, respectively. Those of IGFBP-2(ng/mL) were $8.2{\pm}3.4$, $5.8{\pm}0.4$, $9.3{\pm}4.0$, $9.5{\pm}1.1$ and $7.0{\pm}0.5$, respectively. Those of IGFBP-3(ng/mL) were $559.2{\pm}215.2$, $1,333.3{\pm}692.5$, $2,254.6{\pm}1,513.8$, $2,447.1{\pm}1,464.2$, $1,533.6{\pm}807.4$, respectively. For girls, the mean serum levels of IGF-I(ng/mL) according to five age groups were $53.3{\pm}9.5$, $99.3{\pm}45.8$, $69.6{\pm}51.1$, $106.2{\pm}67.0$ and $145.1{\pm}127.8$, respectively. Those of IGFBP-2 (ng/mL) were $9.1{\pm}7.4$, $5.3{\pm}0.9$, $6.9{\pm}2.0$, $10.5{\pm}3.0$ and $7.9{\pm}1.3$, respectively. Those of IGFBP-3(ng/mL) were $858.2{\pm}433.4$, $1,834.8{\pm}851.3$, $1,404.3{\pm}570.2$, $2,203.5{\pm}899.4$ and $2,029.3{\pm}1,316.7$, respectively. There were significant positive correlations observed between IGF-I and IGFBP-3 levels(r=0.589, P=0.000). Conclusion : IGF-I and IGFBP-3 levels increased as children get older. The peak level of IGFBP-3 was observed in late childhood for both boys and girls, suggesting a current trend of children reaching peak growth velocity before adolescence. The IGFBP-2 level was higher in neonates compare to infancy, suggesting that IGFBP-2 is an important substance for fetal growth.

• Journal of the Korean Society of School Health
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• v.31 no.2
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• pp.79-87
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• 2018

Purpose: The purpose of this study was to investigate the relationship between the risk of school bullying victimization and the risk of Internet gaming disorder according to gender in adolescents. Methods: The data of 1,920 middle school students collected at the baseline of the Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence (iCURE) study were analyzed. For statistical analysis, $x^2$ test, t-test and stratified multiple logistic regression analysis were conducted using SAS 9.4. Results: The prevalence rate of Internet gaming disorder of middle school boys was greater than that of girls (Boys: 9.9%, Girls: 6.2%). The greater the risk of school bullying victimization, the greater both the risk of Internet gaming disorder and the average daily time spent on Internet gaming. In girls, the relationship between the experience of being bullied in school and Internet gaming disorder was not statistically significant. However, the boys who had been bullied in school were 3.2 times more vulnerable to the risk of Internet gaming disorder than those without such experience (95% CI: 1.135-8.779). Conclusions: When considering interventions for Internet gaming disorder for adolescents, bullying victimization should be taken into account as well. Particularly, relieving stress related to bullying victimization can be important for boys with Internet gaming disorder.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.99-117
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• 2009

Diabetic nephropathy is a major cause of chronic renal failure in developing countries, and the prevalence rate has markedly increased during the past decade. Diabetic nephropathy shows various specific histological changes not only in the glomeruli but also in the tubulointerstitial region. In the early stage, the effacement of podocyte foot processes and thickened glomerular basement membrane (GBM) is noticed even at the stage of microalbuminuria. Nodular, diffuse, and exudative lesions, so-called diabetic glomerulosclerosis, are well known as glomerular lesions. Interstitial lesions also exhibit fibrosis, edema, and thickened tubular basement membrane. Diabetic nephropathy is considered to be multifactorial in origin with increasing evidence that one of the major pathways involved in the development and progression of diabetic nephropathy as a result of hyperglycemia. Hyperglycemia induces renal damage directly or through hemodynamic alterations, such as, glomerular hyperfiltration, shear stress, and microalbuminuria. Chronic hyperglycemia also induces nonhemodynamic dysregulations, such as, increased production of advanced glycosylation endproducts, oxidative stress, activation of signal pathway, and subsequent various cytokines. Those pathogenic mechanisms resulted in extracellular matrix deposition including mesangial expansion and GBM thickening, glomerular hypertrophy, inflammation, and proteinuria. In this review, recent opinions on the histopathologic changes and pathophysiologic mechanisms leading to initiation and progression of diabetic nephropathy will be introduced.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.133-138
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• 1997

Prader Willi Syndrome(PWS) was first recognized and reported by Prader-Willi. The etiology of the syndrome is not fully understood, but 50-70% of the patients show small deletion in chromosome 15. Manifested symtoms vary according to developmental age. In early life, hypotonia, areflexia, feeding difficulties, hypothermia, microgenitalia, hypoplastic scrotum, cryptochordism were observed. But in several years, hypotonia disappears, and polyphagia, decreased satiety, psychomotor retardation, obesity, hypogonadism and short stature become main problems. Behavioural problems including temper and aggressive outbursts, stealing food, hoarding food, and self excoriating skin picking, trichotillomania are more prominent during adolescence and young adulthood. Also, irritable, depressed mood are described. Lots of psychological and behavioural problems explain the reason why psychiatrists have managed and reported this syndrome. However, there has been no official report of PWS in our country. So authors report the clinical characteristics and issues in management of a patient with PWS.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.334-339
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• 2016

Child abuse often interferes with the normal and healthy development of a child, bringing about various complications and problematic behaviors. Furthermore, such physical, mental abuse or neglect, and sexual abuse on a developing child may have serious effects even until after adolescence. The types of injuries caused by physical abuse vary, but some types of injuries are common. A great number of them can be detected during a routine dental examination because many of these injuries are present in the facial and dental region. Accordingly, in the case of abused children, it is important to find the signs of abuse through regular dental checkups, as many suffer injuries to the face, head and neck area including the oral and perioral area. As a pediatric dentist, it is the legal and social obligation to contribute to preventing and assisting the struggle against child abuse. The authors contemplate ways for all pediatric dental related personnel to find some clinical signs and symptoms of child abuse to help early detection, and to manage the situation properly.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.604-619
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• 1992

This study was designed to investigate the problems facecl by adolescents who have nephrotic syndrome and who have struggled with their disease over a long time. Information obtained from this study can be utilized as basic data in planning nursing care for these adolescents. The subjects in this study were 13 adolescents who were being treated in the pediatric OPD of one general hospital in Seoul. The treatment period ranged from 2 to 15 years. The tool for this study was constructed after asking patients with nephrotic syndrome about their problems using anunstructured questionalire. Problem items which were observed during nursing cared in the pediatric unit. were also inclucled. Ten problem items were constructed on the basis of Moonlcy's problem check list and two additional items related to diet and physical activity were added to the list. The results of this study can be summerized as follows : adolescents with Nephrotic Syndrome. 1) have a vague knowledge about their illness and have distorted concepts. 2) feel social isolation within their peer group because of their changed appearance, limited physical activity and special diet regimen. 3) have problesm in heterosexual relationship because of short height in boys and changes in body propotions in girls. 4) think that their personality has changed due to illness. In most cases(8) changes were in a negative direct ion but in two cases they were positive. 5) have problems with scholastic achievement due to physical weakness and school absence. 6) who are in late adolescentce are more realistic and plan for their future taking into consideration their prognosis much more so than do patients who are in early adolescence. 7) have problems in their peer relationships. 8) have limitation their enjoy ment of leisure time. 9) have some conflict with their siblings. 10) think religion is significant and it has and influence on their life.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.409-417
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• 1998

The 123 left hand-wrist radiographs and menarcheal ages attained by direct questioning to patients or her mothers are used, in order to exploit the relationship between the bone maturity and the menarcheal age of girls in adolescence. The results were as follows, 1. The mean age at menarche was $12.31{\pm}0.99$. 2. The onset of menarche occurred at SMI 7 and SMI 8 ($73.33\%$). The onset of menarche was correlated with skeletal age rather than chronological age. 3. There was statistically significant difference among the time passed from menarche according to skeletal maturity level. 4. The distal epiphyseal union of radius began at about 20 months after menarche. 5. In comparision of the time intervals from menarche to radial epiphyseal fusion among early, average, and late menarcheal age groups, late group had lesser time interval than other two groups.

• Journal of the Korea Furniture Society
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• v.27 no.2
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• pp.111-121
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• 2016

In the structure of modern houses, a living room is the space most frequently used by family members. In a living room, they rest, talk together, watch TV, study, read books and enjoy hobbies. A living room is furnished with a TV cabinet, a storage closet, a sofa, a bookshelf, a desk and etc. depending on the purposes of activities in it, which can be different in each house. Furniture is the required tool for indoor architectural space and humans to lead a life. In most families, a man and a woman marry each other and become man and wife, go through the honeymoon phase, give birth to one or two children and become a family with three or four members. According to the children's growth cycle from birth to infancy, early childhood, childhood, adolescence, youth and adulthood, furniture layout and kinds of furniture in a living room change. Depending on the family life cycle, most parents of young children try to help their children to form good habits of reading books and studying for their future. As for the environmental elements interrupting reading and studying, watching TV and using smart phones excessively are being regarded as problems. As the number of two-income families is increasing in this era when many women are participating in the social activities with the government's encouragement, children are having more time.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.1
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• pp.48-53
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• 2013

Tyrosinemia I (fumarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that produces liver failure in infancy or a more chronic course of liver disease with cirrhosis, often complicated by hepatocellular carcinoma in childhood or early adolescence. We studied a 37-year-old woman with tyrosinemia I whose severe liver disease in infancy and rickets during childhood were resolved with dietary therapy. From 14 years of age, she resumed unrestricted diet with the continued presence of the biochemical features of tyrosinemia, yet maintained normal liver function. In adult years, she accumulated only a small amount of succinylacetone. Despite this evolution to a mild biochemical and clinical phenotype, she eventually developed hepatocellular carcinoma. Her fumarylacetoacetate hydrolase genotype consists of a splice mutation, IVS6-1G>T, and a novel missense mutation, p.Q279R. Studies of resected liver revealed the absence of hydrolytic activity and immunological expression of fumarylacetoacetate hydrolase in tumour. In the non-tumoral areas, however, 53% of normal hydrolytic activity and immunologically present fumarylacetoacetate hydrolase were found. This case demonstrates the high risk of liver cancer in tyrosinemia I even in a seemingly favorable biological environment. In this study of tyrosinemia I, Case 2 with negative succinylacetone accumulation and the recovery of acute liver failure was compared with Case 1. Diet restriction and NTBC treatment are crucial to prevent hepatocellular carcinoma until liver transplant can take place and cure the condition. Further studies are needed to examine cases where liver cancer did not result despite clinical symptoms/signs of tyrosinemia type I.