Kim, Byung Gee;Kwak, Jae Ryoung;Park, Ji Min;Pai, Ki Soo
Clinical and Experimental Pediatrics
/
v.53
no.3
/
pp.408-413
/
2010
Purpose : We aimed to prove the relative limitation of $^{99m}Tc-DMSA$ scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children. Methods : Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan. Results : The 10 DMSA false-negative patients were mostly males (80%) and infants (80%). They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60%) cases and diffuse in 4 (40%) cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions. Conclusion : In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.4
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pp.593-599
/
2001
Recently, tempormandibular disorder(TMD) shows an tendency to increase every year. TMD is a collective term embracing a number of clinical problems that involve the masticatory musculature, temporomandibular joint(TMJ) and associated structures, or both. TMD, viewed in distribution of age, often occurred from late teens to late twenties. But recently, the age of occurrence tends to be lower. Accordingly, early diagnosis of tempormandibular disorder is very important. In this study, we measured the maximum mouth opening which is simple and easy to carry out as a way of TMD diagnosis. In this study, the maximum mouth opening was examined for 1,775 children from 4 to 12 years of age. We compared the relationship between the maximum mouth opening with the age, height, and weight. The results obtained were summarized as follows; 1. The mean maximum mouth openings of 4, 8, and 12 year of age were respectively 40.16mm, 47.32mm, 50.54mm for male, 39.79mm, 44.85mm, 48.09mm for female. 2. The maximum mouth opening increased with age, and the values were greater in male than in female. 3. The maximum mouth opening increased with height, and the values were eater in male than in female except between 105cm and 115cm 4. The maximum mouth opening increased with weight, and the values were eater in male than in female. 5. The correlation between the maximum mouth opening with the age, height, and weight was all significant, and height showed the highest correlation.
Journal of Wellbeing Management and Applied Psychology
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v.1
no.1
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pp.21-26
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2018
Modern society has become an aging society, and the National Statistics Office(NSO) expects that Korea will be also an aging society by 2019, that is, people over the age of 65 will account for 14 percent from the total population. In addition, the increase of labor flexibility is also one of the dramatic features in modern society. However, this social shift have unpredictable results, that is, the advent and increase of grandparent and grandchildren family. Modern medical technology has given Koreans longer expectancies, and structural and economic changes in society have brought early retirement. One of the main reasons that grandparent and grandchildren family increase is below an average of two children per family. There are various services available such as Health support center, Dream start center, Youth support center, Community child center, and Community welfare center. Besides, schools operates various programs for grandparent and grandchildren family with social workers and school counselors. But, most of all, what is necessary is a change of perspective on them. Basically, we need to develop a clear perspective on grandparent and grandchildren family as a not dismantling family type but alternative family type with creating a separate program or service
Biliary atresia is a progressive, idiopathic, obliterative disease of the extrahepatic biliary tree that presents with biliary obstruction in the neonatal period. It is the most common indication for liver transplantation in children. If untreated, progressive liver cirrhosis leads to death by two years of age. Nowadays, more than 90% of biliary atresia patients survive into adulthood with the development of Kasai portoenterostomy and liver transplantation technology. Early diagnosis is critical since the success rate of the Kasai portoenterostomy decreases with time. This study comprehensively reviews the recent advances in the etiology, classification, prevalence, clinical manifestations, treatment, and prognosis of biliary atresia.
Han, Song Yi;Lee, I Re;Park, Se Jin;Kim, Ji Hong;Shin, Jae Il
Clinical and Experimental Pediatrics
/
v.59
no.3
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pp.139-144
/
2016
Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.
Purpose: Although it is well known thatmortality and morbidity due to cardiovascular diseases are higher in salt-sensitive subjects than in salt-resistant subjects, their underlying mechanisms related to obesity remain unclear. Here, we focused on salt-sensitive gene variants unrelated to monogenic obesity that interacted with sodium intake in humans. Methods: This review was written based on the modified $3^rd$ step of Khans' systematic review. Instead of the literature, subject genes were based on candidate genes screened from our preliminary Genome-Wide Association Study (GWAS). Finally, literature related to five genes strongly associated with salt sensitivity were analyzed to elucidate the mechanism of obesity. Results: Salt sensitivity is a measure of how blood pressure responds to salt intake, and people are either salt-sensitive or salt-resistant. Otherwise, dietary sodium restriction may not be beneficial for everyone since salt sensitivity may be associated with inherited susceptibility. According to our previous GWAS studies, 10 candidate genes and 11 single nucleotide polymorphisms (SNPs) associated with salt sensitivity were suggested, including angiotensin converting enzyme (ACE), ${\alpha}$-adducin1 (ADD1), angiotensinogen (AGT), cytochrome P450 family 11-subfamily ${\beta}$-2 ($CYP11{\beta}$-2), epithelial sodium channel (ENaC), G-protein b3 subunit (GNB3), G protein-coupled receptor kinases type 4 (GRK4 A142V, GRK4 A486V), $11{\beta}$-hydroxysteroid dehydrogenase type-2 (HSD $11{\beta}$-2), neural precursor cell-expressed developmentally down regulated 4 like (NEDD4L),and solute carrier family 12(sodium/chloride transporters)-member 3 (SLC 12A3). We found that polymorphisms of salt-sensitive genes such as ACE, $CYP11{\beta}$-2, GRK4, SLC12A3, and GNB3 may be positively associated with human obesity. Conclusion: Despite gender, ethnic, and age differences in genetics studies, hypertensive obese children and adults who are carriers of specific salt-sensitive genes are recommended to reduce their sodium intake. We believe that our findings can contribute to the prevention of early-onset of chronic diseases in obese children by facilitating personalized diet-management of obesity from childhood to adulthood.
Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.
Purpose : To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR). Methods : Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1 year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made. Results : The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 yew, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up. Conclusion : In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.
Journal of the Korean Society of Food Science and Nutrition
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v.4
no.1
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pp.13-17
/
1975
1. A nursery school principal must think over physical stamina and health of his children, and he must make an epoch making changes to nutrition control. I think that authorities concerned must give weight to quality before quantity to manage the nursery school. If the nursery school principal who has aid received from abroad and his native country must manage the nursery school rationally. It is expected that, though the nutrition level is below the level of sports middle school children, it is above the common level of home children. 2. I fear that the calories which the pupils of sports middle school assimilate a day on the average is apt to be more calories as compared with other pupils of their age(weight). This is also true for their level of activity. It is required that the nutritionist must recheck the quantity of the calorie provision. 3. I took no thought about infection with parasites in this thesis. It is because that the pupils of sports middle school have much Hb (hemoglobin), because they have had meals with a settled menu for a year or two. So, that it is expected that it is caused only by the nutritious foods regardless of parasites and that they have little Hb(hemoglobin). Besides though they are little pupils, because they have much Hb. Of taking the level with upper life classes of the the Ewha Girls University students, it will be more reliable. Therefore as we maintain the states of health of the common home children and nursery school children normally, to increase the national power, the managers of nursery schools or the heads of families must pay attention to the control of nutrition, and authorities concerned must pay attention to the control of nutrition, and authorities concerned must take the trouble much more to the management of nursery school.1. We have been undertaking the occupations of the family plannings for more ten years. But we have still failed to realize the anticipated result in the farm villages. Though it is not in this district, I think that we must make efforts in these occupations urgently, and control increases in population, decrease the consumptions of food and salt, and contribute to the increasing of the general income. 2. There is a tendency to take a little more salted foods in the cities than in the farm villages. But we are apt to take more salt in quantity(20g) to be taken in a day both in the cities and in the farm villages than it is necessary to us. So it is required that we must grope for a means of increasing of the general income as early as possible, and that we must improve our diet to be got rid of dietary life in importance. And so we have to study throughly the side effect caused due to too much salt to be taken in, if it is discovered, we must spour on a means of sweep of it.
This study was carried out to collect basic information on the knowledge and attributes and behavior related to the prevention of breast cancer of a Sample Seoul women. Similar studies had dealt with samples of tumor clinic patients and their families and with non-professional hospital welters. The sample for this study was drawn by women out patients from eight centrally located general hospitals, in Seoul where the number of annual out patients exceeded 100,000, and the number of beds exceeded 100. The interview schedule consisted 33 questions related to knowledge, attitude, and behavior related to prevention of breast cancer. It was modified from the previous on cancer studies. The investigator interviewed 665 women over 20 years of age, from those who visited these eight hospitals from 24, June to 20, August 1975. More than half of the respondents were housewives and primarily in the 20 to 29 ages group. They had a mean level of 3.562 pregnancies and 1,986 children. 33.4% were high-school graduates, 32.2% had a monthly family income in the 50,000 to 100,000 won range. 75% of the respondents had heard about breast cancer through mass media or personal media, but the majority of respondents did not have an accurate understanding of it. This varied according to educational, economical income and occupations. The primary reason given for maintaining distance from a patient with breast cancer was not because of cancer but simply because person was a patient. 74.7% of the respondents thought that early cancer of the breast could be cured with early treatment. Only 5.3% of the respondents had ever had a physical examination and only 6.3% practised self examination of the breast.
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