Purpose: Childhood obesity has become a social problem due to the social distancing necessitated by the coronavirus disease 2019 pandemic. This study aimed to identify the dietary problems of obese children through various dietary assessment methods and to confirm the usefulness of each method. Methods: The subjects were 88 students in the 4th to 6th grade of elementary school who participated in the nutrition camp organised by the Busan Metropolitan Office of Education, 2020. To evaluate dietary problems and assess diet quality, 24-hour meal records, monthly food intake frequency, and Dietary Screening Test (DST) data were analyzed. Results: Of the subjects, 15.7%, 30.3%, and 53.9% were normal weight, overweight, and obese, respectively. The average age was 11.77 ± 0.77 years and the average body mass index was 23.96 ± 3.01 kg/m 2 . It was observed from the 24-hour meal record method that the overweight and obese subject groups consumed fewer green vegetables (p < 0.001) and white vegetables (p < 0.01) than the normal weight group. In the monthly food intake frequency method, the consumption of ramen (p < 0.01), snacks (p < 0.05), and sausages (p < 0.05) were high in the obese group, and that of anchovies, broccoli, and sweet pumpkin was high in the normal group (p < 0.05). The comparative data from the DST revealed that the overweight and obese groups had less vegetable intake than the normal weight group (p < 0.01) and had higher intakes of dairy products, fast food, and sweet snacks (p < 0.05). Conclusion The usefulness of each method in the dietary evaluation of obese children was confirmed. To address the problem of obesity, it is necessary to evaluate the dietary problem and approach it with a customized solution tailor-made for the individual subject.

As the coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, there are growing concerns about patients' mental health. We investigated psychological problems in COVID-19 patients assessed with self-reported questionnaires including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, and Impact of Event ScaleRevised Korean version. Ten patients who recovered from COVID-19 pneumonia without complications underwent self-reported questionnaires about 1 month after discharge. Of them, 10% reported depression and posttraumatic stress disorder (PTSD) while 50% had depression during the treatment. Perceived stigma and history of psychiatric treatment affected PTSD symptom severity, consistent with previous emerging infectious diseases. Survivors also reported that they were concerned about infecting others and being discriminated and that they chose to avoid others after discharge. Further support and strategy to minimize their psychosocial difficulties after discharge should be considered.

BACKGROUND/AIMS: Differentiation of an extraluminal compression from a true subepithelial tumor (SET) in the esophagus by using endoscopy alone is often difficult. EUS is known as the best method for differentiating an extraluminal compression from a true SET. Extraluminal compression in the esophagus is occasionally observed, but its clinical significance has been rarely reported. Therefore, we aimed to evaluate the clinical significance of extraluminal compression in the esophagus according to the location of the lesion. MATERIALS AND METHODS: Sixty-one patients were diagnosed as having an extraluminal compression in the esophagus by using EUS between January 2006 and March 2014. Some patients underwent chest computed tomography for accurate diagnosis. RESULTS: The extraluminal compression was located at the mid-esophagus in 26 cases, lower esophagus in 22 cases, and upper esophagus in 13 cases. Of the 61 cases, 55 were caused by normal structures and 6 were caused by pathological lesions. The causes of the normal structures were the aorta, vertebra, trachea, left main bronchus, azygos vein, and diaphragm. The causes of the pathological lesions were engorged vessels and calcified lymph nodes. The posterior wall was the most frequent location of the extraluminal compression. However, the lesions in the anterior and right walls showed a higher frequency of pathological lesions than those in other sites. CONCLUSIONS: If the extraluminal compression is found in the anterior and right walls of the esophagus, more careful evaluation should be performed considering the high frequency of pathological lesions in the site.
Aorta ; Azygos Vein ; Bronchi ; Diagnosis ; Diaphragm ; Endoscopy ; Endosonography ; Esophagus* ; Humans ; Lymph Nodes ; Methods ; Spine ; Thorax ; Trachea

Objective: To identify the clinical characteristics of patients with myasthenia gravis (MG) according to age at onset. Methods: We retrospectively recruited 227 non-thymomatous MG patients with adult onset who had been followed up for more than one year. The patients were classified based on the age of symptom onset as “early-onset MG” (EOMG,18–50 years; N=135), “late-onset MG” (LOMG, 50–64 years; N=53), and “very late-onset MG” (VLOMG, 65 years; N=39). Clinical features and serological findings were compared between these groups. Results: LOMG patients showed more frequent ocular MG (55%) and less frequent thymic hyperplasia (9%) compared to EOMG patients (31% and 38%; p=0.006 and p<0.001, respectively), and no female preponderance compared to VLOMG patients (female, 49% vs.77%; p=0.014). However, there were no significant differences between VLOMG and EOMG patients, except for more frequent thymic hyperplasia (p<0.001) in EOMG patients. When analyzing female patients only, less frequent secondary generalization (10%) were additionally found in LOMG patients, compared to EOMG (47%, p= 0.008) and VLOMG (59%, p=0.004) patients. Anti-acetylcholine receptor antibody (HR, 5.48; 95% CI, 1.73–17.37; p=0.004) was independently associated with secondary generalization in female EOMG patients. Conclusion: Our study suggests that LOMG patients, especially female, were characterized by frequent ocular MG and less frequent secondary generalization, distinguished from EOMG and VLOMG patients. Further large epidemiologic studies in Korea are needed to determine the characteristics of MG patients according to the age at onset and gender.

PURPOSE: To investigate the prevalence of ADHD (attention-deficit hyperactivity disorder) in children with epilepsy and to determine the difference of characteristics in patients with epilepsy and concomitant ADHD as opposed to the patients without ADHD for better management. METHODS: We retrospectively reviewed 184 patients diagnosed as epilepsy and treated with antiepileptic drugs in pediatric neurology department of Seoul St. Mary's hospital from March, 2009 to May, 2012. Their ages ranged from 6 to 18 years. The subjects were included in the study those who made a regular visit for more than a year. RESULTS: 1) Out of 184 patients, 69 patients (37.5%) had both ADHD and epilepsy. 2) In epilepsy children with ADHD, male outnumbered female by almost two fold (male 67: female 33) (P=0.022). 3) In epilepsy children with ADHD, epileptiform discharges on EEG was focused in central regions in 39% of them (P=0.014). 4) In 56% of patients without ADHD, their seizures remained under the control with single anticonvulsant, as opposed to 36% of patients with both ADHD and epilepsy (P=0.001). Therefore, the presence of ADHD in patients with epilepsy might be related to the therapeutic response to anticonvulsants, and be a useful predictive factor for the response to early treatment. CONCLUSION: Patients with epilepsy and concomitant ADHD showed a significant difference and poor response to epilepsy treatment, as opposed to patients without ADHD. Therefore, early detection and establishment of countermeasures for ADHD is necessary.
Anticonvulsants ; Child* ; Electroencephalography ; Epilepsy* ; Female ; Humans ; Male ; Neurology ; Prevalence ; Retrospective Studies ; Seizures ; Seoul

PURPOSE: L-asparaginase is a crucial chemotherapeutic agent for the treatment of acute lymphoblastic leukemia. However, hypersensitivity to L-asparaginase is common which limits its clinical use. METHODS: We performed 44 cases of premedication and 3 cases of desensitization in 16 patients with hypersensitivity to L-asparaginase. RESULTS: With premedication, 33 cases completed L-asparaginase injection with no hypersensitivity reactions. Eleven cases showed mild hypersensitivity reactions, such as urticaria. Desensitization was performed in 3 cases: in 2 cases, desensitization was successful, and in 1 case the medication was switched to Erwinia asparaginase. CONCLUSION: Premedication and desensitization appear to be useful in helping patients receive desired doses of L-asparaginase in pediatric patients with acute lymphoblastic leukemia.
Asparaginase ; Desensitization, Immunologic ; Drug Hypersensitivity ; Erwinia ; Humans ; Hypersensitivity* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Premedication* ; Urticaria

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population. METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors. RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001). CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult* ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity* ; Socioeconomic Factors ; Wrist

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population.METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors.RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001).CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity ; Socioeconomic Factors ; Wrist

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population. METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors. RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001). CONCLUSION We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.

BACKGROUND AND OBJECTIVES: Cardiovascular complications are the leading cause of morbidity and mortality in childhood cancer survivors. Hematopoietic stem cell transplantation (HSCT) is a curable therapy for pediatric cancer. However, changes in cardiac function in children after HSCT are not well known. We assessed left ventricular (LV) function in children after HSCT using speckle tracking echocardiography (STE). SUBJECTS AND METHODS: Forty consecutive patients with median age of 11.9 years (range, 1.5-16 years) who received HSCT for acute leukemia and had comprehensive echocardiography before and after (median 9.2 month) HSCT were included in this study. The LV function parameters including conventional tissue Doppler imaging (TDI) and STE data were collected from pre- and post-HSCT echocardiography. These data were compared to those of 39 age-matched normal controls. RESULTS: Compared to normal controls, post HSCT patients had similar (p=0.06) LV ejection fraction. However, the following three LV function parameters were significantly decreased in post HSCT patients: rate-corrected velocity of circumferential fiber shortening (p=0.04), mitral inflow E velocity (p<0.001), and mitral septal annular E' velocity (p=0.03). The following four STE parameters were also significantly decreased in post HSCT patients: LV global circumferential systolic strain (p<0.01), strain rate (SR, p=0.01), circumferential diastolic SR (p<0.01), and longitudinal diastolic SR (p<0.001). There was no significant change in TDI or STE parameters after HSCT compared to pre-HSCT. Patients with anthracycline cumulative dose >400 mg/m2 showed significantly (p<0.05) lower circumferential systolic strain and circumferential diastolic SR. CONCLUSION: Subclinical cardiac dysfunction is evident in children after HSCT. It might be associated with pre-HSCT anthracycline exposure with little effect of conditioning regimens. Serial monitoring of cardiac function is mandatory for all children following HSCT.
Case-Control Studies* ; Child* ; Echocardiography* ; Hematopoietic Stem Cell Transplantation* ; Humans ; Leukemia* ; Mortality ; Stem Cell Transplantation ; Survivors ; Ventricular Dysfunction, Left*