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BACKGROUND/OBJECTIVES To evaluate the nutritional status and prevalence of malnutrition in hospitalized children at admission and during hospitalization in South Korea. SUBJECTS/METHODS This first cross-sectional nationwide "Pediatric Nutrition Day (pNday)" survey was conducted among 872 hospitalized children (504 boys, 368 girls; 686 medical, 186 surgical) from 23 hospitals in South Korea. Malnutrition risk was screened using the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool Risk on Nutritional status and Growth. Nutritional status was assessed by z-scores of weight-for-age for underweight, weight-for-height for wasting, and height-for-age for stunting as well as laboratory tests. RESULTS At admission, of the 872 hospitalized children, 17.2% were underweight, and the prevalence of wasting and stunting was 20.2% and 17.3%, respectively. During hospitalization till pNday, 10.8% and 19.6% experienced weight loss and decreased oral intake, respectively. During the aforementioned period, fasting was more prevalent in surgical patients (7.5%) than in medical patients (1.6%) (P < 0.001). According to the PYMS, 34.3% and 30% of the children at admission and on pNday, respectively, had a high-risk of malnutrition, requiring consultation with the nutritional support team (NST). However, only 4% were actually referred to the NST during hospitalization. CONCLUSIONS Malnutrition was prevalent at admission and during hospitalization in pediatric patients, with many children experiencing weight loss and poor oral intake. To improve the nutritional status of hospitalized children, it is important to screen and identify all children at risk of malnutrition and refer malnourished patients to the multidisciplinary NST for proper nutritional interventions.

Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.

The purpose of this paper is to examine the effects of practicing Hatha Yoga on the elderly. I have focused on the changes in subjective pain and a feeling of helplessness in their daily lives of elderly people over 65 who are suffering from chronic back pain. We looked at both men and women over 65, who were not working during the period, all of whom had been experiencing back pain over 6 months. All the subjects have never practiced Hatha Yoga or any other specialized and/or systematic workouts at that time. Among them, the men and women over age 65 with chronic back pain were selected as a group and practiced Hatha Yoga three times a week for eight weeks. In conclusion, the study proves that Hatha Yoga is an effective way for the old over 65 with chronic back pain by acquiring muscular strength and flexibility at the same time.

Zizania latifola has used for folk medicine in Korea. It is effective in treating skin trouble and sensitivity skins. The purpose of this study was to develop high valuable types of bath preparation of Zizania latifolia. The natural materials were manufactured by the mixed ratio of Zizania latifolia. Product was manufactured by the mixed ratio of Zizania latifolia and 3 natural materials. Green tea was highest in sensory evaluation as similar with Zizania latifolia. optimum condition of mixed ratio was adaptive 50% Houttuynia cordata, 30% green tea with 20% Artemisia vularis. Product's sensory evaluation was showed best in mixing 40% and Zizania latifolia extract 60%. There were optimal condition for manufacturing of cleansing. Therefore, The development of a bath preparation used by Zizania latifolia is very useful for manufacturing cleansing. We suggest that it help for improve skin trouble and make healthy skin.

Internet addiction is a social problem occurring by overuse of internet. And internet addiction is associated with pathologic personality but clinic study about Internet addiction disorder is lack. This study was designed to evaluate the relationship between internet addiction and pattern of internet utilization. We conducted a questionnaire survey on 1,984 middle school students in Gwang -Ju. We questioned about internet addiction, general characteristics, pattern of internet utilization. 11.8% of total number were internet addiction. Sex, religion, duration, time, place, obscene sites, most frequent using service is associated with internet addiction. Family number, occupation of parents, using internet in home, use of parents isn't associated with internet addiction. We show interest in general characteristics and pattern of internet utilization about internet addiction. So we council youths about internet problem in accordance with this study results. Then internet addiction and other psychologic problem are decreased.

Schools where adolescents spend most of their time should develop a variety of activity programs to encourage them to participate in more physical activities in physical education time, break time, lunch time, and after-school time. To support the direction, educational policy and students and parents` perception on physical education should be changed, and organized plans should be developed through cooperation with experts of communities.

�� ���?¥ � � � Purpose: This study aimed to identify the predictors of failure in medical students. Methods: We conducted a 10-year follow-up survey of 231 medical students. The students' general characteristics, study-related factors, health-related behavior, and self-perceived health were examined using questionnaires that were given late in the first year of a premedical course. We evaluated the failure incidence of students using school records from the second year of a premedical course to the fourth year of medical school. The statistical analyses that were used were χ 2 -test, student t-test, and multiple logistic regression analysis. Results: Sixty-five students experienced failure. Thirty-seven (56.9%) had 1 failure, 11 (16.9%) had 2 failures, 8 (12.3%) had 3 failures, 4 (6.2%) had 4 failures, and 5 (7.7%) had 5 failures. From the results of multiple logistic regression, the rates of failure were significantly higher for those whose grade point average (GPA) in the first year of a premedical course was below 2.5 (Relative Risk [RR]=6.52, 95% Confidence Interval [CI]: 1.42~29.8), who smoked more than 1 pack of cigarettes per day (RR=7.37, 95% CI: 1.23~44.07), who drank more (RR=1.16, 95% CI: 1.02~1.33), and exercised less (RR=0.997, 95% CI: 0.995~0.999). Conclusion: It was demonstrated that the incidence of failure in medical students was reflected in their academic records in the first year of a premedical course and by unhealthy lifestyles. This study suggests that students who have poor academic marks and unhealthy lifestyles in the first year of a premedical course should be properly guided to reduce the incidence of failure.

Purpose This study aimed to evaluate the utility of acanthosis nigricans (AN) severity as an index for predicting insulin resistance in obese children. Methods The subjects comprised 74 obese pediatric patients who attended the Department of Pediatrics at Chosun University Hospital between January 2013 and March 2016. Waist circumference; body mass index; blood pressure; fasting glucose and fasting insulin levels; lipid profile; aspartate transaminase, alanine transaminase, glycated hemoglobin, C-peptide, and uric acid levels; and homeostatic model assessment insulin resistance (HOMA-IR) and quantitative insulin check sensitivity index (QUICKI) scores were compared between subjects with AN and those without AN. Receiver operating characteristic curves were used to investigate the utility of the AN score in predicting insulin resistance. HOMA-IR and QUICKI were compared according to AN severity. Results The With AN group had higher fasting insulin levels (24.1±21.0 mU/L vs. 9.8±3.6 mU/L, p

Detection rates of cholelithiasis and choledocholithiasis in infants and children have increased since the introduction of ultrasonography, and surgical treatment is gradually tending to increase. However, for cholelithiasis and choledocholithiasis, controversies over etiology, diagnostic means, operation time, and operating method remain. Using ultrasonogram and magnetic resonance cholangiopancreatography (MRCP), we diagnosed cholelithiasis and choledocholithiasis in a premature and low birth weight infant who was admitted to the hospital with complaints of obstructive jaundice and alcoholic feces. We report the successful treatment of this infant by cholecystectomy and T-tube drainage.

Gilbert syndrome is the most common inherited disorder of bilirubin glucuronidation. It is characterized by intermittent episodes of jaundice in the absence of hepatocellular disease or hemolysis. Hereditary spherocytosis is the most common inherited hemolytic anemia and is characterized by spherical, osmotically fragile erythrocytes that are selectively trapped by the spleen. The patients have variable degrees of anemia, jaundice, and splenomegaly. Hereditary spherocytosis usually leads to mild-to-moderate elevation of serum bilirubin levels. Severe hyperbilirubinemia compared with the degree of hemolysis should be lead to suspicion of additional clinical conditions such as Gilbert syndrome or thalassemia. We present the case of a 12-year-old boy with extreme jaundice and nausea. The diagnosis of hereditary spherocytosis was confirmed by osmotic fragility test results and that of Gilbert syndrome by genetic analysis findings.

Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1∼5 years old, 51.1% among individuals 5∼10 years old, 12.9% for individuals 10∼15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1∼5 years old, 60.2% and 33.9% among children 5∼10 years old, 14.1% and 9.7% for children 10∼15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 67∼73)

With an uncontrollable amount of energy dense food engulfing children’s life today, no child is completely protected against being overweight or obese. An inordinate intake of energy dense food and lack of physical activity have resulted in a higher rate of obesity in children. In order to combat the seemingly intractable problem, various preventive measures against childhood obesity have been suggested and are currently in effect. It is imperative to evaluate the methodology and potential impact of published obesity-prevention programs, that focus primarily on home, school, and health care environments. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 325∼333)

3and the total lgE concentration was 2,317 IU/dL. Chest and abdominal computed tomography (CT) scans demonstrated multiple, poorly-defined, small, nodular lesions scattered in the liver and lung parenchyma. Toxocara ELISA and Western blot tests were positive in the patient, and her father and brother. A liver biopsy revealed extensive eosinophilic infiltrations in the portal and lobular areas. She took albendazole for 5 days and was discharged in good condition. These results suggest that clinicians should consider foodborne toxocariasis in patients with multiple, small nodules in the liver and lung parenchyma with eosinophilia and a history of raw meat ingestion. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 70∼ 74)

An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is ＞l centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 66∼69)

Purpose : Recently, complementary and alternative medicine (CAM) has been increasingly used in children. Studies have shown that 34% of adults and 11% of children use CAM in the USA and Canada. The purpose of this study was to investigate the prevalence and patterns of CAM use in elementary children in Korea. Methods : From July to August 2007, parents of elementary children completed a questionnaire survey at Gwang-ju. In all, 794 questionnaires were analyzed. Results : Of the 794 respondents, 278 answered that their pupils (35%) had experienced CAM. The following types of CAM therapy were used: herbal medicine, 62.5% dietary supplements, 31.2% vitamins, 30.2% and acupuncture, 11.1%. CAM therapies were used for the following diseases: nutritional deficiency, 33.3% atopic dermatitis, 31.3% arthralgia, 31.3% allergic rhinitis, 28.8% obesity, 26.3% and asthma. The following were the motives to use CAM: prevention of diseases (33.5%), dissatisfaction with modern medicine (21.2%), and complementary therapy to modern medicine (20.5 %). People gained information about CAM through neighbors (65%) and mass media (21%). Moreover, 83 parents (30 %) were satisfied with CAM because of its effectiveness. Conclusion : Many parents have advocated the use of CAM in their children. However, most of them used CAM without any prescription or adequate knowledge. Further studies are required to determine the efficacy of CAM. (Korean J Pediatr

Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months

Prevalence of obesity in Korean children and adolescents has dramatically increased since the last 10–20 years. It is important to initiate prevention efforts early in childhood because prevalence of obesity in adolescence is the strongest predictor of its prevalence in adulthood. Intrauterine life, infancy, and preschool years may comprise the critical periods that are essential for the long-term regulation of energy balance therefore, obesity-prevention strategies should be initiated in utero and continued throughout childhood and adolescence. Families with high-risk children should be provided early education about maintaining normal weight. Encouraging physical activity and, especially, avoiding inactivity, are key challenges in the prevention of future obesity. Schools should be primarily involved in educating parents to discourage their children from excessively watching TV or playing computer games and eating unhealthy snacks and food. The involvement of medical practitioners is also important, especially, in the case of obese parents, obesity prevention strategies should be promoted from the first visit of pregnant women to the physicians. Health professionals can also be involved in obesity prevention because they are ideally equipped to identify young children at risk of obesity. Community and nation-wide efforts to increase awareness and promote environments that encourage physical activity and healthy nutrition are required. (Korean J Pediatr 2009;52:1321-1326)

Purpose : The purpose of this study was to determine the incidence and potential predictors of weight gain in older children and teens treated with valproate (VPA) for epilepsy. Methods : Sixty-five subjects aged 8 to 17 years of age, who began VPA treatment between January 1, 2001, and December 31, 2004, and who had documented weight and height measurements at medication initiation and at least one follow-up visit were retrospectively identified. Exclusion criteria were follow-up

Purpose : Post-lumbar puncture headache is common complaint. A study of post-diagnostic lumbar puncture headache in children is rare. Various factors that might influence the occurrence of postdiagnostic lumbar puncture headache in children exist. The purpose of this prospective study was to assess the frequency and risk factors for post-diagnostic lumbar puncture headache in children. Methods : From March 2005 to February 2006, 44 patients with suspected meningitis were enrolled. Patients were received diagnostic lumbar puncture at the Chosun University Hospital, Gwangju, Korea. We evaluated age, sex, previous headache history, number of puncture attempts, volume of cerebrospinal fluid (CSF), pressure of CSF, cell count in CSF, final diagnosis, and the frequency and duration of headaches. Results : Of the 44 patients (mean age 7.36±2.04, range 4-13 years), 16 patients (36.4%, male 13/33, 39.4%, female 3/11, 27.2%) had headache. The frequency of headaches was significantly higher in patients with previous headache history compare to those without previous headache history (P= 0.037). The mean of cell count of CSF was significantly higher in patients with post-lumbar puncture headache (P=0.012). The other factors did not influence the post-diagnostic lumbar puncture headache. Conclusion : Post-diagnostic lumbar puncture headache in children was more common than other studies. The factors that influence post-diagnostic lumbar puncture headache in children are previous headache history and cell count in CSF.

목적: 소아에서 변비는 흔한 소화기 증상 중 하나로써, 그 유병률에 대한 보고가 다양하고,원인은 대부분 기능적인 원인으로 정신적 성향, 식이습관, 신체의 활동성, 그리고 배변 훈련 등이 관련이 있다고 알려져 있다. 그러나 우리나라에서는 아직 변비에 대한 체계적인 연구가 이루어지지 않고 있다. 이 연구에서 저자들은 일부 초등학교 아동의 변비의 유병률, 원인, 특징 및 관련 요인을 알아보고자 본 연구를 시행하였다. 방법: 2000년 7월 1일부터 7월 31일까지 광주광역시 소재 2개 초등학교 1학년, 6학년 학생 1793명 (남아 830명, 여아 963명)을 대상으로 설문지를 배부하여 학부모의 지도하에 응답하게 하였다. 결과의 분석은 변비의 유병률, 원인, 배변 특징, 관련요인, 그리고 치료 방법에 대해 빈도 분석과 다변량분석을 실시하였다. 결과 : 1) 변비의 유병률은 전체 15.4%이고 남아 14.2%, 여아 16.5%였고, 1학년 13.9%, 6학년 17.6%로 남녀의 성비, 연령 사이에는 유의한 차이가 없었다. 2) 변비의 원인은 야채를 적게 먹는 식이 습관 24.8%, 불규칙한 식이 습관 14.6%, 편식 12.5%, 운동부족 11.5%, 학교 화장실을 가기 무서워서 7%, 식욕이 없어서 6.6%, 생우유를 많이 먹어서 6.3%, 물을 적게 마시기 때문 5.9%순이었다. 3) 변비와 연관성을 보이는 관련 인자로는 운동량이 적은 경우 87.0%, 습관적으로 인스턴트 식품이나 기호식품을 먹는 경우 62.5%, 장시간 TV를 시청하는 경우 40.4%, 편식을 하는 경우 30%, 과거력에서 유뇨증이 있는 경우 2.9% 순으로 유의한 차이를 보이고 있었다. 4) 변비와 유의한 연관성을 보이는 관련 인자 중에서 운동량이 적은 경우, 장시간 TV를 시청하는 경우, 편식을 하는 경우, 과거에 유뇨증이 있는 경우가 변비를 일으키는 유의한 위험인자로 작용하였다. 5) 변비의 치료는 27.1%에서 받고 있었고, 그 중 변비약을 이용하여 15.5%, 관장을 이용하여 11.6%로 변비약을 이용한 경우가 더 많았으며, 대다수인 72.9%는 치료를 전혀 받지 않고 있었다. 결론: 학동기 아동에서 변비의 유병률은 높았으나 치료를 받지 않은 경우가 대부분이었다. 변비의 관련 인자들을 파악하여 변비의 예방에 힘쓰고, 적절한 치료를 받도록 지속적인 교육이 필요할 것으로 생각된다. 【Purpose: Constipation in childhood is a significant problem, however, understanding of its epidemiology has been limited in Korea. The aim of this study was to investigate the prevalence and risk factors of constipation in school-aged children, helping to manage and prevent it. Methods: This cross-sectional, descripsive observational prevalence study included children (2grade, 1st and 6th grade) who were attending two elementary schools in Gwangju. The prevalence of constipation, associated symptoms, and risk factors were evaluated by questionnaire. A child was considered to be constipated when he or she defecated two or less times per week. Results: The prevalence of constipation was 15.4%. There is no significant difference between both sexes and grades. Of the causes of constipation, there was statistically significant difference in exercise deficiency, frequent intake of convenience food, long-time watching TV, unbalanced diet and enuresis history between constipation and normal group. Especially, long-time watching TV, exercise deficiency, and enuresis history were risk factors for development of constipation. Only 27.1% of children with constipation were treated by laxative and enema. Conclusion: Even though the prevalence of constipation was high, more than half of them was not treated at all. We should endeavor to educate the children and their parents to prevent constipation by evaluating the feeding and behavioral habit completely, and treating them properly.】