Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

Purpose: Hypothalamic damage may increase the risk of adulthood obesity and cardiovascular disease in patients with craniopharyngioma. We evaluated the effects of hypothalamic involvement (HI) and growth hormone (GH) discontinuation on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma. Methods: Thirty-three patients (17 males, 16 females) underwent retesting for adult GH deficiency (GHD) between 2005 and 2020 at Seoul National University Children's Hospital. Postoperative HI was graded by Puget's criteria and data regarding GH replacement were collected. At retesting, body mass index (BMI), fasting blood glucose, insulin, high-density lipoprotein cholesterol (HDL-C), triglycerides, and blood pressure were assessed. Results: The mean age of commencement and discontinuation of GH replacement for childhood GHD was 10.0±3.6 and 15.3±3.1 years, respectively. The mean age at retesting for adult GHD was 17.7±2.5 years. When patients were categorized by post-GH discontinuation duration, those with durations >6 months (n=27) showed lower HDL-C levels than those with <6 months (P=0.037). Patients with extensive HI (n=16) had higher BMI z-scores than did those with no HI or mild HI (P=0.020). Both the extent of HI and longer post-GH discontinuation duration were significantly predictive for decreased HDL-C levels (P<0.05, for both). Conclusion The extent of HI and GH discontinuation duration during the transition period can increase cardiovascular risks in patients with childhood-onset craniopharyngioma.

The authors experienced a case of myoglobinuria accompanied by generalized myalgia and mild fever that developed 3 hours 30 minutes after general anesthesia. Tracheal intubation was done smoothly 5 minutes after injection of thiopental sodium(275 mg) and pancuronium bromide(6 mg), and anesthesia was maintained with ethrane/N2O/O2(1.5-2%/21/21/min). There was no specific event except tachycardia and fluctuation of blood pressure throughout operation. In this case, we assume that the myoglobinuria is a presentation of the sign of an abortive type of malignant hyperthermia. However, it was not confirmed. We had good patient outeome with the supportive measures of hydration and diuresis. The patient was discharged twenty three days after operation without any complication.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Diuresis ; Fever ; Humans ; Intubation ; Malignant Hyperthermia ; Myalgia ; Myoglobinuria* ; Pancuronium ; Tachycardia ; Thiopental

PURPOSE: Recently, there has been a marked increase in childhood obesity, and that has aroused social concern. Obesity increases several metabolic disease such as hypertension, diabetes, fatty liver, heart disease and the mortality rate. Complications of obesity are more closely related with the accumulation of visceral fat. Therefore, fundamental treatment of obesity Should be the reduction of body fat. Exercise is the best way to reduce body fat, especially to consume the free fatty acid released from adipocytes. However, it is anticipated that children's response to exercise could differ from adult's. This research was done to find the difference adaptations of energy metabolisms in exercises between children and adults. METHODS: Sprague-Dawley male rats were divided into a young group(two-three months old), adult group(six months old) and an old group(fifteen months old). At fed ad libitum, O2 consumption and CO2 production were measured before and after the exercise. Before and after fasting for 24 hours, O2 consumption and CO2 production were measured. After fasting for 24 hours, the blood was taken to analyse the plasma glucose and free fatty acid. RESULTS: The fasting oxygen consumption decreased only in young rats compared with that of the fed state. The fasting respiratory quotient was decreased in the young and adult rats compared with those of the fed state. The post exercise oxygen consumption was increased in the young and adult rats but not in the old rats. The post-exercise respiratory quotient was decreased only in the young rats. There was no significant change of plasma glucose and free fatty acid between fed and fasting state in the young rats, while the fasting glucose levels were increased in the adult and old rats. CONCLUSION: These results mean that the responses to fasting and exercise differ among rats of different age groups and young rats can burn fat more easily during exercise and fasting than those of the adult and old rats because of the better metabolic flexibility of young rats.
Adipocytes ; Adipose Tissue ; Adult ; Animals ; Blood Glucose ; Burns ; Child ; Energy Metabolism ; Exercise ; Fasting* ; Fatty Liver ; Glucose ; Heart Diseases ; Humans ; Hypertension ; Intra-Abdominal Fat ; Male ; Metabolic Diseases ; Mortality ; Obesity ; Oxygen Consumption ; Pediatric Obesity ; Pliability ; Rats* ; Rats, Sprague-Dawley

The objective of this study was conducted to investigate growth and development status of infants fed soy-based formulas over 3 months. The height and weight were measured and Z-scores were calculated by using standard of the same age groups. Their mothers were interviewed using questionnaires including general and environmental characteristics, total food intakes, soy based formula intakes and Ewha infant development screening test. Main results were as follows: 1) Nutrient intake levels of subjects were similar to or more than the level of Korean Recommended Dietary Allowances except for intakes of vitamin E (79.89% RDA), and the average status of nutrient intakes of infants were fairly good. 2) Z-scores of height for age (HAZ) and Z-scores of weight for age (WAZ), Kaup index, WLI and Ewha Infant Developmental Screening Test score of subjects were in the normal growth range. 3) There were no significant differences among soy based formula intake percentile groups in HAZ, WAZ, Kaup index, WLI and Ewha Infant Developmental Screening Test score. 4) Total energy intake was positively correlated with HAZ (p < 0.01), WAZ (p < 0.01), and WLI (p < 0.05) in infants less than 12 month. Also, soy based formula energy intake was positively correlated with HAZ (p < 0.05) in infants less than 12 month. However, energy and soy based formula intake levels of infants over 12 month were not significant among variables. Considering results of this study, infants fed soy-based formulas over 3 months showed normal growth and development status. Further studies are needed to evaluate long-term growth and development in infants fed soy based formulas.
Child ; Child Development ; Energy Intake ; Growth and Development* ; Humans ; Infant* ; Mass Screening ; Mothers ; Recommended Dietary Allowances ; Vitamin E ; Vitamins

We herein report two patients with epidermolysis bullosa acquisita(EBA), who had showed the atypical clinical features. A 25-year-old male presented with multiple pruritic vesicles, erosion and crusts which occurred more severely on the face than any other sites of the skin and healed with atrophic scar formation. Histopathologically, there was a subepidermal neutrophilic blister with moderate perivascular lymphohistiocytic infiltrates in the dermis, and the diagnosis of EBA was confirmed by means of direct immunofluorescence and salt-split direct immunofluorescence test performed on the perilesional skin. The other patient was a 24-year-old female who had had multiple painful ulcerative lesions on the oral mucosa for 4 months. After then, vesicles and bullae developed to progressively generalize to the anterior neck, chest and lower leg. Histolopathologic examination of peribullous skin showed a subepidermal bulla with neutrophils and eosinophils. The salt-split skin direct immunofluence test showed IgG and IgM binding to the dermal side only. We diagnosed this patient as nonscarring inflammatory EBA. Both patients were treated with prednisolone, colchicine, and dapsone resulting in clinical improvement, but their skin lesions recurred several months after discontinuing medication.
Adult ; Blister ; Cicatrix ; Colchicine ; Dapsone ; Dermis ; Diagnosis ; Eosinophils ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Male ; Mouth Mucosa ; Neck ; Neutrophils ; Prednisolone ; Skin ; Thorax ; Ulcer ; Young Adult