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Aim This study aims to evaluate the extrinsic effects of conditional factors affecting quantitative parameters and to establish the optimization of indocyanine green (ICG) angiography using in vitro experiments and prospective observational study. Method In vitro experiments were performed to evaluate the correlation between conditional factors, such as camera distance, surrounding lighting, fluorescence emission sources, and ICG doses. The fluorescence intensity was measured from the ICG contained test tube in each condition. In the clinical study, ICG angiography was applied to patients with colorectal cancer (n = 164). The quantitative perfusion parameters were included as maximal fluorescence intensity (FMAX ), Slope, T1/2MAX , and perfusion time ratio (TR). Camera position, distance to colon, fluorescence emission source, surrounding lighting, site of angiography, and ICG specific modes were considered as conditional factors and compared with quantitative parameters to identify the optimal condition of ICG angiography. Results The fluorescence intensity had an inverse correlation with distance, and the transitional zone was shown at the distance of 4-5 cm by slope differential. FMAX , T1/2MAX , and Slope were affected significantly by camera distance, site of angiography, fluorescence emission source, ICG modes as conditional factors. On multivariate analysis, FMAX was independently associated with spectral ICG mode with red inversion, Laser mode, and camera distance. Conversely, TR was not related to any conditional factors. Conclusion Since quantitative parameters of ICG angiography are influenced by various conditions, a standardized protocol is required. The application of ICG specific modes with a constant distance of 4-5 cm can provide optimized fluorescence images.

A circular polarizer (CP) film modified by a nanoporous polymer film (NPF) was applied to improve the viewing angle characteristics of a top-emission organic light-emitting diode (TEOLED) without any serious pixel blur phenomenon. From this approach, the angular color shift (Δu′v′) was significantly improved from 0.096 to 0.056, and the angular luminance distribution was also expanded to the Lambertian distribution direction. The black color had a slightly faded tint, however, like the turn-off condition of the plasma display panel (PDP), regardless of the introduction of NPF below or above the CP. Very interestingly, the surface reflectance of the device with NPF-coated CP was not significantly different from that of the device with non-NPF CP. The pixel blur level according to the distance between the scattering medium and the light source was also investigated. As a result, it was found that the pixel blur phenomenon can be greatly suppressed by applying a thinner encapsulation lid with an NPF film.

Purpose This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. Methods We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest. Results Fourteen patients were identified. Of these, 13 were young children (

Purpose Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL-10). We aimed to determine the association of the frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) with the outcomes of KD, as well as to compare FTLR2% to the usefulness of sIL-10. Methods The FTLR2% in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results We found that FTLR2% greater than 92.62% predicted CALs with 80% sensitivity and 68.4% specificity, whereas FTLR2% more than 94.61% predicted IVIG resistance with 66.7% sensitivity and 71.4% specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40% and 66.7% sensitivity, respectively, and 73.7% and 76.2% specificity, respectively. Conclusion We showed that measuring FTLR2% before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2% as a marker of prognosis and severity of KD.

To improve poor viewing angle characteristics of top emission organic light emitting diodes (TEOLEDs) without any serious pixel blur phenomena, we applied a circular polarizer (CP) film modified by nanoporous polymer film (NPF). From this approach, we could improve the color shift significantly (Δu'v’ in CIE 1976 with viewing angle, from 0.0165 to 0.0114), and expand angular light emission distribution of off-axis by applying CP with NPF. We found that black color shift was little associated with NPF position change although black color was slightly faded tint by applying NPF, as like plasma display panel(PDP)’s off condition. Very interestingly, we found that the reflectance was not changed seriously whether NPF exists between glass encapsulation and CP or not. Besides, we investigated the pixel blur level when we applied different condition in encapsulation thickness and morphology of diffusing films. As a result, we found that the pixel blur phenomena can be significantly suppressed by applying thin encapsulation and NPF type diffuser film.

Background and objectives Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents. Methods BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles. Results The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP. Conclusions We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.

We fabricated a randomly distributed micro-lens array (RDMLA) to improve the external quantum efficiency of organic light emitting diodes (OLED). We prepared three different types of RDMLA with different size distribution (L1 pattern: 0.3–0.5 μm, L2 pattern: 1.0–1.2 μm, L3 pattern: 3.0–5.0 μm). To control the average size of RDMLA, we prepared porous polymer film with an average pore size similar to that of RDMLA to utilize it as a template for simple imprinting technology. Especially, the RDMLA having L2 structure showed the best external quantum efficiency which was improved by 28.5% compared to that without RDMLA.

The current efficiency and color purity of organic light-emitting diodes (OLEDs) can be easily improved by means of a microcavity structure, but this improvement is typically accompanied by a deterioration in the characteristics of viewing angle. To minimize the angular dependence of the color characteristics exhibited by these strong microcavity devices, we investigated the changes in the optical properties of the green OLED with a bottom resonant structure. This investigation was based on varying the hole transport layer and semitransparent anode thicknesses. The results of optical simulations revealed that the current efficiency and viewing angle characteristics can be simultaneously improved by adjusting the thickness of the two layers. Furthermore, optical simulations predicted that the angular color dependence could be limited to 0.019 in the International Commission on Illumination (CIE) 1976 coordinate system. This optimum condition yielded a current efficiency of ∼134 cd/A. To further reduce this color shift, a nanosized island array (NIA) was introduced through the dewetting process of cesium chloride. By employing NIAs, the color coordinate shift value was reduced to 0.016 in the CIE 1976 coordinate system, and a current efficiency of 130.7 cd/A was achieved.

In order to suppress the viewing angle dependence of top emission organic emitting diodes (TEOLEDs) with strong microcavity effect, we introduced randomly distributed nano-wrinkle structure beneath highly reflective anode. By applying such nano-wrinkle pattern, viewing angle dependence and color shift could be improved compared with that without nano-structure [e.g. Δ (u’, v’): 0.077 → 0.025]. However, current efficiency reduced more than half. To compensate this problem, we additionally introduced index matching epoxy filler between encapsulation glass and TEOLED device. By this approach, current efficiency drop of device with nano-wrinkle structure could be improved. For example, the efficiency dropped by 7.7% when we filled the epoxy filler between capping layer and glass lid while, it decreased by 30.8% if we don't use epoxy filler. We found that index matching helps to extract more light confined inside TEOLED, so device performance degradation could be minimized. In addition, when we attached a circular polarizer film to these devices, depolarization was observed in most cases, but we were able to achieve a perfect black state from the devices with nano-wrinkle structure underneath reflective anode.

This paper describes problems of the sensorless starting of horizontal axis washing machines with direct drive and suggests solution, which was experimentally verified. Horizontal axis washing machines have very difficult conditions for the drive starting, especially at full load. Inertia of the tub and water, torque from the laundry make load torque at starting higher than rated one and sometimes even higher than the maximum torque of the motor, which makes sensorless starting extremely challenging task. This paper suggests modified open-loop starting, where control system is closed shortly after beginning at low speed and rotates the drum until laundry restructuring. To ensure proper work of the sensorless algorithm at low speed additional measures for increasing of the estimation algorithm performance have been taken. These measures include special algorithm for the drive parameters estimation, which has been developed and verified by the experimental results.

Objective: Obesity in adolescence is associated with increased cardiovascular risk. The patterns of obesity and body composition differ between boys and girls. It is uncertain how body composition correlates with the cardiovascular system and whether such correlations differ by sex in adolescents. Methods: Body composition (fat-free mass (FFM), adipose mass, waist circumference (WC)) and cardiovascular parameters and functions were studied in 676 healthy Korean adolescents aged 12-16 years. Partial correlation and path analyses were done. Results: WC correlated with stroke volume (SV) and cardiac output (CO), systolic blood pressure (SBP) and pulse pressure (PP), cardiac diastolic function (ratio of early to late filling velocity (E/A ratio)), and vascular function (pulse wave velocity (PWV)) in boys. Adipose mass was related to SV, CO, SBP, PP, left ventricular mass (LVM), and PWV in girls - and to E/A ratio in both sexes. FFM affected SV, CO, SBP, and PP in both sexes and LVM in boys. Cardiac systolic functions had no relation with any body composition variable in either sex. Conclusion: In adolescence, the interdependence of the cardiovascular system and the body composition differs between sexes. Understanding of those relations is required to control adolescent obesity and prevent adult cardiovascular disease.

Background White matter (WM) abnormalities associated with prematurity are one of the most important causes of neurological disability that involves spastic motor deficits in preterm newborns. This study aimed to evaluate regional microstructural changes in diffusion tensor imaging (DTI) associated with WM abnormalities. Methods We prospectively studied extremely low birth weight (ELBW

School bullying has become a major social problem in Korea after the emergence of media reports on children who committed suicide after being victimized by bullies. In this article, we review the characteristics of bullying, and investigate the role of the pediatrician in the prevention of and intervention against bullying and school violence. Bullying can take on many forms such as physical threat, verbal humiliation, malicious rumors, and social ostracism. The prevalence of bullying in various countries is approximately 10% to 20%. In Korea, the prevalence of school violence is similar but seems to be more intense because of the highly competitive environment. From our review of literature, we found that children who were bullied had a significantly higher risk of developing psychosomatic and psychosocial problems such as headache, abdominal pain, anxiety, and depression than those who were not bullied. Hence, it is important for health practitioners to detect these signs in a child who was bullied by questioning and examining the child, and to determine whether bullying plays a contributing role when a child exhibits such signs. Pediatricians can play an important role in the prevention of or intervention against school violence along with school authorities, parents, and community leaders. Moreover, guidelines to prevent school violence, such as the Olweus Bullying Prevention Program, KiVa of the Finish Ministry of Education, and Connected Kids: Safe, Strong, Secure of the American Academy Pediatrics, should be implemented.

While there is a growing concern over excessive game playing as a new social psychological phenomenon, some scholars have blamed the media for exaggerating the harmfulness of game playing and creating fear of game ad- diction without sufficient scientific evidence. Against this backdrop, this study analyzes the U.S. press coverage of computer games between 2011 and 2013 mainly in terms of primary themes and overall frames. The findings of the con- tent analysis shows that the U.S. press does not sufficiently address the possible costs, risks, or negative consequences that excessive game playing may cause while overtly emphasizing the economic benefits and consequences of the game industry. In short, the game coverage represents industry perspectives more strongly than consumers' perspectives and their welfare.

Background and Objectives Obesity has reached epidemic proportions globally and affects people of all ages. Recent studies have shown that visceral adipose tissue measured by magnetic resonance imaging and/or computed tomography correlates positively with epicardial adipose tissue. Epicardial fat, which is correlated to several metabolic parameters, can be assessed by echocardiography. The aim of this study was to evaluate epicardial fat thickness and other metabolic parameters in obese adolescents and investigate the correlation between epicardial fat thickness and other metabolic parameters in obese adolescents. Subjects and Methods We selected 99 subjects, between ages 15-17 years of age, to be enrolled in this study. Sixty five obese adolescents with a body mass index (BMI) >95 percentile and 34 control subjects were included in this study. Echocardiographic measurements including epicardial fat thickness as well as anthropometric and blood pressure (BP) measurements were performed. The following parameters were estimated: blood glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, aspartate aminotransferase, alanine aminotransferase, free fatty acid, interleukin-6, tumor necrosis factor-α, leptin, adiponectin and high sensitive C reactive protein. Results The obese group showed a statistically significant correlation with echocardiographic epicardial fat thickness and, BMI, waist circumference, obesity index, fat percentage, systolic BP, insulin level, leptin and adiponectin. Multivariate linear regression analysis showed epicardial fat thickness as the most significant independent parameter to correlate with obese adolescents. Conclusion These data suggest that epicardial fat thickness measured by echocardiography is a practical and accurate parameter for predicting visceral obesity.

In order to suppress the viewing angle dependence of top emission organic light emitting diodes (TEOEDs) on a strong microcavity structure, we prepared multi-layered nano scattering film which was consisted with transparent planarizing layer and hazy crosslinked scattering layer. Through such an approach, we could obtain not only a stable color shift and luminance distribution with viewing angle but also a negligible pixel blur level. Meanwhile, we investigated a black tint level of TEOLEDs after attachment of circular polarizer (CP) on various nano scattering films because nano scattering film deteriorates a black level. We found that the black level could be improved from the black tint by reducing the refractive index difference between planarizing layer and scattering layer.

Purpose Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients. Methods The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients. Results Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement. Conclusion Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations.

In this letter, we propose the transmit power controlled adaptive downlink frequency symbol spreading OFDM (TPC-AMS/FSS-OFDM) system. In the TPC-AMS/FSS-OFDM, each S/P transformed signal is spread by orthogonal spreading codes and combined in the transmitter, so the detected signals obtain the same SINR for each frequency symbol spreading block in the receiver. In this case, we can assign the same modulation level and transmit power for each frequency symbol spreading block for next transmission. Thus, the proposed system not only increases throughput performance but also reduces the total transmit power, FBI and MLI.

Stress Path Search Model of Evolutionary Structural Successive Optimization (SPSMESO) using Triangular Irregular Network(TIN) was developed for improving over burden at initial design of ESO and strict stress direction of strut-and-tie model and truss model. TIN was applied for discretizing structures in flexible stress path and segments of TIN was analyzed as one-dimensional line element for calculating stress. Finally, stress path was searched using ESO algorithm. SPSMESO was efficient to express the direction of stress for 2D structure and time saving.

A male infant, aged 2 month, with Kawasaki disease had a myocardial infarction despite intravenous infusions of gamma globulin and aspirin at high dosage. He developed progressively a thin walled, dilated aneurysm of the apex of the left ventricle which became lined with thrombus despite treatment with warfarin. Another boy, aged 6 years, was noted on the 10th day of the evolution of Kawasaki disease to have developed a giant aneurysm of the main stem of the left coronary artery. Despite infusion of gamma globulin, the aneurysm remained unaltered and developed a thrombus. The thrombus resolved following treatment with warfarin, though the giant aneurysm has persisted. These two cases illustrate the serious consequences that can follow Kawasaki disease despite management optimal by current standards.

Planar spiral inductors on silicon substrates were optimally designed using MATLAB, which is a tool to perform numerical computations with matrices. The equivalent circuit parameters of the spiral inductors were extracted from the data measured from the spiral inductors fabricated using a 0.18 RF CMOS process. The metal width, which is a critical design parameter, was optimized for the maximum quality factor with respect to the operating frequency.

This paper describes problems of the sensorless starting of horizontal axis washing machines with direct drive and proposes solution, which was experimentally verified. H-axis washing machines have very difficult conditions for the drive starting, especially at full load. Inertia of the tub and water, torque from the laundry make load torque at starting higher than rated one and sometimes even higher than the maximum torque of the motor, which makes sensorless starting extremely challenging task. This paper suggests modified open-loop starting, where control system is closed shortly after beginning at low speed and rotates the drum until laundry restructuring. To ensure proper work of the sensorless algorithm at low speed an additional method for the drive parameters estimation has been proposed and verified by the experimental results.

We propose a new fiber-type all-optical switching device based on the optical nonlinearity of Yb(3+) doped fiber and a long-period fiber gratings(LPG) pair. The all-optical ON-OFF switching with the continuous wave laser signal at ~1556nm in the LPG pair including the 25.5cm long Yb(3+) doped fiber was demonstrated up to ~200Hz upon pumping with the modulated square wave pulses at 976nm, where a full optical switching with the ~18dB extinction ratio was obtained at the launched pump power of ~35mW.

Pulmonary artery hypertension is a common cardiovascular complication in preterm infants with bronchopulmonary dysplasia which is associated with increased morbidity and mortality. Inhaled iloprost is used as a therapeutic option in pulmonary hypertension, especially in adults. There have been but a few reports on the use of iloprost for neonates and infants. We report the case of a 5 month-old-male infant who received neonatal intensive care for 4 months due to respiratory distress syndrome and prematurity, during which he developed bronchopulmonary dysplasia. Echocardiography showed severe pulmonary hypertension. The initial treatment included respiratory support with high frequency oscillatory ventilation (HFOV); however, his clinical condition did not improve. Inhaled iloprost with sildenafil, an oral phosphodiesterase-5 inhibitor, was thus used. With the administration of iloprost and sildenafil, his condition improved and he was weaned from oxygen. Our clinical experience suggests that iloprost is a promising therapy for pulmonary hypertension, especially when inhaled nitric oxide is unavailable.

Aims: To shorten the analysis time needed for non-stress testing (NST) without decreasing efficacy in compromised fetuses. Methods: We selected 80 cases with a 5-min Apgar score Results: The sensitivity of criteria D (91.25%) was greater than the other three criteria (P Conclusion: Adding ApEn to the conventional criteria for reactivity shortened NST analysis time without decreasing efficacy, facilitating a decision of reactivity within a single 20-min NST window.

The frequency of sudden cardiac death increases in the morning. The relationship between decreased complexity of heart rate dynamics and sudden cardiac death has been documented. An understanding of circadian variation in the complexity of cardiac dynamics may be important to predict and prevent sudden cardiac death. Dynamic 24-h electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41–50 years, and the digitized data were partitioned into sections of 30 min duration. For each section, four indexes obtained from separate algorithms of non-linear dynamics of the RR interval – modified correlation dimension, Lyapunov exponent, approximate entropy, and fractal dimension – were calculated. Normalized low- (0·04–0·15 hertz) and high-frequency (>0·15 hertz) components were also calculated. All four indexes of non-linear dynamics showed a remarkably similar circadian rhythm: a prominent morning dip preceded by a steep decline during the late night, a recovery during the evening and a peak around midnight. In the morning, the low-frequency component rose rapidly with concomitant reduction in the high-frequency component. The complexity of cardiac dynamics decreases significantly in the morning, and this may contribute to the ominously increased rate of cardiac death in the morning hours.

Purpose Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. Methods In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). Results We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. Conclusion In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.

Background: To validate Omron HEM 907 XL blood pressure monitor (test device) against auscultatory mercury sphygmomanometer in children aged 7–18 years old in accordance with International Protocol of European Society of Hypertension revised in 2010 (ESH-IP2) and British Hypertension Society (BHS) protocol. Methods: Seventy-five children and adolescents were recruited for the study. A validation procedure was performed following the protocol which was prepared on the basis of ESH-IP2 and BHS protocol for children and adolescents. Each underwent 7 sequential blood pressure (BP) measurements alternatively with a mercury sphygmomanometer and the test device. The results were analyzed according to the validation criteria of ESH-IP2. Results: The mean BP (± standard deviation [SD]) difference of absolute value between the test device and mercury sphygmomanometer readings in all the 75 subjects was 3.26 ± 3.08 mm Hg for systolic BP and 4.11 ± 3.50 mm Hg for diastolic BP. These results fulfilled AAMI criterion of mean ± SD below 5 ± 8 mm Hg for both systolic and diastolic BP. The proportion of test device-observer mercury sphygmomanometer BP differences within 5, 10 and 15 mm Hg were 81%, 96%, 99% for SBP and 72%, 93%, 99% for diastolic blood pressure (DBP), respectively, in the part 1 analysis, so both systolic blood pressure (SBP) and DBP passed the part 1 criteria. As for the part 2 analysis, SBP passed the criteria, bur DBP failed. Conclusions: Omron HEM 907 XL BP monitor failed an adapted ESH-IP2, though SBP passed. When comparing the BP readings by oscillometers with mercury sphygmomanometer, the differences between them, particularly in diastolic BP, should be taken into account, because DBP can be underestimated. (J Korean Soc Hypertens 2011;17(3):114-124)

Background and Objectives Obesity is a chronic disease that requires good eating habits and an active life style. Obesity may start in childhood and continue until adulthood. Severely obese children have complications such as diabetes, hypercholesterolemia, hypertension and atherosclerosis. The goal of this study was to determine the effects of exercise programs on anthropometric, metabolic, and cardiovascular parameters in obese children. Subjects and Methods Fifty four obese children were included. Anthropometric data such as blood pressures, body mass index (BMI) and obesity index (OI) were measured. Blood glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), high sensitive-CRP (hs-CRP), brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index (ABI) were measured. Physical fitness measurements were done. Obese children were divided into three groups: an aerobic exercise group (n=16), a combined exercise group (n=20), and a control group (n=18). Obese children exercised in each program for 10 weeks while those in the control group maintained their former lifestyle. After 10 weeks, anthropometric data and cardiovascular parameters were compared with the data obtained before the exercise program. Results LDL-C, waist circumference, and systolic blood pressure decreased significantly in the aerobic exercise group compared to the control group (p

Department of Pediatrics, Ewha Womans University, Department of Pediatrics*, College of Medicine, Inje University, Department of Preventive Medicine, Ewha Womans University, Department of Pediatric, Hong Ik Hospital, Seoul Department of Pediatrics, College of Medicine, Ajou University, Suwon, Department of Pediatrics, College of Medicine, Han Yang University, Seoul Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

for gender, age, and height on ≥three occasions. Knowing that blood pressure values increase in children as they grow older, the purposes of this study were to measure blood pressure by an oscillometric device and to determine normal values and percentile curves for children. Methods :Systolic and diastolic blood pressures were measured twice with an oscillometric device in 3,545 boys and 3,145 girls under six years of age, in Seoul. Using this data, we determined average blood pressure values and percentile curves based on gender and age; we subdivided these values into blood pressures of 50 th , 90 th , 95 th , and 99 th percentiles, by percentile of height. The regression coefficients and standard deviations of the systolic and diastolic blood pressure values were obtained from linear regression models. Results :Older boys and girls had higher systolic and diastolic blood pressure values. Older boys and girls in the same percentile of height for age had higher systolic and diastolic blood pressure values. Taller boys and girls within the same age group had higher systolic and diastolic blood pressure values. Conclusion :Blood pressure standards based on gender, age, and height were obtained via an oscillometric method. Llimitation of this study is that the study population was not from the whole country, but exclusively from Seoul. Nonetheless, the data from this study will be helpful in diagnosing and managing hypertension in Korean children. (Korean J Pediatr 2008;51:998-1006)

Purpose : Since the infant formula milk has been produced in Korea, it has faced a low rate of breast milk feeding, though breast milk feeding is a little increasing. Therefore, the Korean Pediatric Society launched its website for breast-feeding consultation to provide information to the general public and enhance the health of growing infants. The consultation results were analyzed to identify the problems that mothers encounter during breast-feeding. Methods : From August 1, 2004 to July 31, 2007, 1001 mothers who visited the online consultation webpage (www. pediatrics.or.kr) of the Korean Pediatric Society asked 1,021 questions. The questions were divided into 3 major categories and 14 specific categories. Interesting questions asked more than 100 times were retrospectively analyzed. Results : The results for the major categories were as follows: 413 questions (40.3%) were on how to breast-feed, 315 (30.8%) on problems of feeding mothers, and 293 (28.8%) on problems of the fed babies. In the specific categories, 22.2% of the questions were on how to breast-feed. With the increasing number of working couples and working mothers, many questions were asked on the problems of breast-feeding after returning from work. Conclusion : The author expects that analyses of these consultations will contribute to the enhancement of information on the consultation website, thus enabling to provide clearer answers to people's increased interest in and concerns on breast-feeding. Furthermore, this research will help to establish correct breast-feeding practice.

Background and Objectives：This study was designed to examine whether the multifractal Hurst exponents of heart rate can estimate activating and deactivating spontaneous baroreflex sensitivity (SBRS). Subjects and Methods： Age and sex matched 24 healthy volunteers were placed in the supine position and head-up tilt position for 30 minutes, and the systolic blood pressure and heart rate were measured in an noninvasive manner. When the RR interval (RRI) sequence and systolic pressure sequence simultaneously increased or decreased for more than three successive beats, the slope of the linear regression line of systolic blood pressure and RR interval sequence was defined as the value of spontaneous baroreflex sensitivity (SBRS). From the RR intervals, very short-term (α range, ≤12 heartbeats), short-term (β range, ≥12 heartbeats), and the multrifractal Hurst exponents were calculated to determine the linear correlation.coefficients for SBRS. Results：In the supine position, the linear correlation coefficients (p) of SBRS and H-5α, H-4α, H-3α, H-2α, H-1α, H1α, H2α, H3α, H4α, H5α were -0.195 (NS), -0.207 (NS), -0.232 (NS), -0.282 (NS), -0.355 (NS), -0.621 (0.003), -0.650 (0.001), -0.677 (0.001), -0.699 (0.0006) and -0.708 (0.0005), respectively. In the tilting position, the linear correlation coefficients of SBRS and H-5β, H-4β, H-3β, H-2β, H-1β, H1β, H2β, H3β, H4β, H5β were 0.024 (NS), 0.020 (NS), 0.010 (NS), -0.028 (NS), -0.193 (NS), -0.627 (0.0034), -0.607 (0.0045), -0.598 (0.0053), -0.572 (0.0084) and -0.539 (0.0141), respectively. Conclusion：Some of the very short-term and short-term generalized Hurst exponents, such as H5α and H1β, can be used for the estimation of spontaneous baroreflex sensitivity during patient placement in the supine and head-up tilt position, respectively. (Korean Circulation J 2007;37:443-448)

Background and Objectives:The prevalence of pediatric hypertension appears to be increasing, and secondary hypertension is more common in children than in adults. Essential hypertension is increasing in obese adolescents. An elevated blood pressure (BP) during childhood is associated with premature cardiovascular morbidity and mortality in adulthood. Oscillometric devices are convenient and minimize observer error. The purposes of this study were to measure the BP, using an oscillometric device, in relation to age, sex, weight, height and body mass index (BMI), in normal school aged children, and to identify the 95 and 99 percentile values for the diagnosis of hypertension by age group. Subjects and Methods:Between May and June 2005, the oscillometric blood pressure was measured, using a Dinamap monitor (Procare-200, GE, USA), in 9,499 Seoul school children (male 4,993, female 4,506), aged 7-18 years. The BP was measured on the right arm, in the sitting position, using a BP cuff having a width of 40-50% of the arm circumference. The mean and 5, 10, 25, 50, 75, 90, 95 and 99 percentile values and percentile curves of the systolic and diastolic BP were obtained in relation to age, sex, height, weight and BMI. Results:The systolic and diastolic BP levels were significantly increased in relation to age, height, weight and BMI. A correlation analysis showed that the BP levels were significantly correlated with weight (r=0.553), followed by height (r=0.491), BMI (r=0.470) and age (r=0.445) in males, and significantly correlated with weight (r=0.332), followed by height (r=0.317), BMI (r=0.286) and age (r=0.213) in females. Conclusion:Percentile values and percentile curves for the systolic and diastolic BP were obtained in normal children. These data will be useful in the diagnosis and treatment of pediatric hypertension. (Korean Circulation J 2006;36:744-752)

Purpose:Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods:The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results:There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion:The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.