PURPOSE: This study was performed to evaluate the dietary nutrient intake status and hair mineral content of Korean young children. METHODS: Fifty-five children who visited Seoul National University Bundang Hospital were divided into three groups by age: infants, toddlers, and preschoolers. The 24-hour recall method was used to collect the food intake data of the subjects. Hair mineral analysis was conducted using a Mass Spectrometer. Serum iron, ferritin, and calcium were also measured. RESULTS: The mean energy intakes of the subjects were 730.3 kcal, 994.3 kcal, and 1,482.9 kcal for each age group. The mean percentage of energy intake compared to recommendation was 101.4% and was not different by age group. Toddlers of 37.8% and preschoolers of 54.5% consumed less than the Estimated Average Requirement (EAR) of calcium. Infants of 28.6%, toddlers of 10.8% and preschoolers of 9.1% consumed less than the EAR of iron. In the case of zinc, copper, and selenium, only 0% to 5% of toddlers and none of the preschoolers consumed less than the EAR of those minerals. The hair calcium, iron and copper concentrations were lower in toddlers and preschoolers than those in infants. Serum calcium levels of preschoolers were significantly lower than those of infants, whereas serum iron and ferritin levels were not. CONCLUSION: Hair calcium, iron, and copper concentrations were significantly lower in toddlers and preschoolers than in infants. Insufficient dietary intake of calcium and iron seems to be related with decreased hair mineral contents in young children.
Calcium ; Child* ; Copper ; Ear ; Eating ; Energy Intake ; Ferritins ; Hair* ; Humans ; Infant ; Iron ; Methods ; Minerals ; Miners* ; Selenium ; Seoul ; Zinc

Purpose: This was a nationwide population-based study conducted to investigate the epidemiology, treatment, disease outcomes, and associated factors of childhood intussusception in South Korea. Methods: Data from the Korean National Health Insurance Service database on all patients <18 years old diagnosed with intussusception from 2007 to 2017 were analyzed. Results: A total of 34,688 cases were identified among 30,444 patients. The overall incidence was 28.3/100,000 person-years with a male predominance. Most cases (83.1%) occurred in children <3 years old, with an annual incidence of 195.2, 200.1, and 118.6 cases per 100,000 children in their first, second, and third year of life, respectively. The median age at the first occurrence was 18.7 months, and it was higher in boys than in girls. The post-discharge recurrence rate was 10.6% (3,226/30,444) and the in-hospital recurrence rate was 6.1% (1,842/30,444). The total recurrence rate (post-discharge recurrence and/or in-hospital recurrence) was 15.0% (4,580/30,444). Enema reduction was successful in 90.0% of cases. Enema reduction was more successful in girls than in boys. A total of 3,296 (10.8%) patients underwent 3,481 surgeries, including 735 (21.1%) laparoscopic surgeries. Post-discharge recurrence and surgery were significantly affected by age, sex, and hospital type. Mortality was noted in nine cases (0.03%). Conclusion Our study provides accurate epidemiologic data on the treatment and outcomes of intussusception through complete enumeration during an 11-year-period.

BACKGROUND/AIMS: Although functional abdominal pain disorders (FAPDs) are common in children, the accurate pathogenesis of FAPDs is not known yet. Micro-inflammation, particularly tissue eosinophilia of gastrointestinal (GI) tract, has been suggested as the pathophysiology observed in several GI disorders. We aimed to evaluate eosinophilic infiltration throughout the entire GI tract in children with FAPDs, compared to those with inflammatory bowel diseases (IBD) and to normal reference values. METHODS: We included 56 children with FAPDs, 52 children with Crohn’s disease, and 23 children with ulcerative colitis. All subjects underwent esophagogastroduodenoscopic and colonoscopic examination with biopsies. Tissue eosinophil counts were assessed in 10 regions throughout the GI tract. RESULTS: Eosinophil counts of the gastric antrum, duodenum, terminal ileum, cecum, and ascending colon were significantly higher in children with FAPDs compared to normal reference values. Eosinophil counts of the stomach and the entire colon were observed to be significantly higher in children with IBD than in those with FAPDs. Even after selecting macroscopically uninvolved GI segments on endoscopy in children with IBD, eosinophil counts of the gastric body, cecum, descending colon, sigmoid colon, and the rectum were also significantly higher in children with IBD than those with FAPDs. CONCLUSIONS: Significantly high eosinophil counts of the stomach and colon were observed in the order of IBD, followed by FAPDs, and normal controls, regardless of endoscopically detected macroscopic IBD lesions in children. This suggests some contribution of GI tract eosinophils in the intrinsic pathogenesis of FAPDs in children.
Abdominal Pain ; Biopsy ; Cecum ; Child ; Colitis, Ulcerative ; Colon ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Duodenum ; Endoscopy ; Eosinophilia ; Eosinophils ; Gastrointestinal Diseases ; Gastrointestinal Tract ; Humans ; Ileum ; Inflammatory Bowel Diseases ; Pyloric Antrum ; Rectum ; Reference Values ; Stomach

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.
Academies and Institutes ; Adult ; Child ; Child, Hospitalized* ; Electronic Mail ; Enteral Nutrition ; Gastroenterology ; Hospitals, General ; Humans ; Inpatients ; Korea* ; Malnutrition ; Mass Screening ; Nutrition Assessment ; Nutritional Support* ; Nutritionists ; Parenteral Nutrition ; Pharmacists ; Prevalence ; Serum Albumin ; Tertiary Care Centers

Chronic recurrent abdominal pain is a common manifestation in children. Functional abdominal pain is the most common cause of chronic abdominal pain and can be diagnosed properly by the physician without the requirement of specific evaluation when there are no alarm symptoms or signs. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia, according to the Rome II criteria for pediatric functional gastrointestinal disorders. New concepts on the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, gastrointestinal dysmotility, inflammation, autonomic dysfunction, genetic predisposition, and triggering factors including psycho-social stress.
Abdominal Pain* ; Child* ; Dyspepsia ; Gastrointestinal Diseases ; Genetic Predisposition to Disease ; Humans ; Hypersensitivity ; Inflammation ; Irritable Bowel Syndrome ; Migraine Disorders

PURPOSE: The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children. METHODS: We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment. RESULTS: Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group. CONCLUSION: This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.
Amoxicillin ; Bismuth ; Child ; Clarithromycin ; Disease Eradication ; Helicobacter ; Helicobacter pylori ; Humans ; Metronidazole ; Omeprazole ; Proton Pumps ; Protons ; Retrospective Studies ; Salts

Helicobacter pylori (H. pylori) infection is mainly acquired in childhood. Although the majority of H. pylori-infected individual remain asymptomatic, it may cause some diseases including peptic ulcer disease, MALT lymphoma, subnormal growth, and iron deficiency anemia in children. H. pylori infection in children differs from that in adults in many aspects including clinical manifestations, pathologic features, diagnosis, and treatment. In this article, characteristic features of H. pylori infection in children were presented with special emphasis on different features from adult infection.decreased to 59.6% from 66.9% in the adult (16-79 yrs) over the period of 7 years, especially, in young subjects less than 50 years, Seoul and Gyeonggi suggesting that this decrease may be due to the improvement of socioeconomic status and hygiene.
Adult ; Anemia, Iron-Deficiency ; Child* ; Diagnosis ; Gyeonggi-do ; Helicobacter pylori ; Humans ; Hygiene ; Lymphoma, B-Cell, Marginal Zone ; Peptic Ulcer ; Seoul ; Social Class

Low vitamin D has been implicated in reduced bone mineral density (BMD) in children with inflammatory bowel disease (IBD). Our study aimed to evaluate differences in serum 25-hydroxyvitamin D (25[OH]D) and total body less head (TBLH) BMD z-scores in children with Crohn's disease (CD), ulcerative colitis (UC), and those with abdominal pain-related functional gastrointestinal disorder (AP-FGID) as the control group. We also examined the correlation between serum 25(OH)D and TBLH BMD z-score, and factors that affect each of these parameters. A total of 105 children were included and divided into 3 groups: AP-FGID (n = 45), CD (n = 43), and UC (n = 17). Among the 3 study groups, TBLH BMD z-scores were found to be significantly different (0.5 ± 0.8 in CD vs. 0.1 ± 0.8 in UC vs. −0.1 ± 1.1 in FGID; P = 0.037), despite similar levels of serum 25(OH)D. Within each study group, correlation between serum 25(OH)D and TBLH BMD z-score was not observed. Factors found to affect the TBLH BMD z-score were sex (P = 0.018), age (P = 0.005) and serum hemoglobin (P = 0.041), while factors influencing serum 25(OH)D were sex (P = 0.018), CD with reference to AP-FGID (P = 0.020), and serum phosphorus (P = 0.018). Based on our results, vitamin D is a relatively small contributor to bone loss in pediatric IBD and clinicians should consider female sex, older age, and low hemoglobin as risk factors for low BMD in children with IBD.
Abdominal Pain* ; Asian Continental Ancestry Group ; Bone Density* ; Child* ; Colitis, Ulcerative ; Crohn Disease ; Female ; Gastrointestinal Diseases ; Head ; Hemoglobin A ; Humans ; Inflammatory Bowel Diseases* ; Phosphorus ; Risk Factors ; Vitamin D* ; Vitamins*

No abstract available.
Trigeminal Nerve*

Chronic gastrointestinal diseases such as inflammatory bowel disease, malabsorption syndromes (e.g., intestinal lymphangiectasia, celiac disease, congenital chloride diarrhea, cystic fibrosis), and postsubtotal gastrectomy state or short-bowel syndrome after extensive bowel resection are related to poor bone health in pediatric patients due to increased risks of low bone mineral density, osteoporosis, and fractures. The pathophysiology of abnormal bone health in pediatric gastrointestinal diseases may present from inflammation to malabsorption. In children with chronic gastrointestinal diseases at high risk of poor bone health, routine evaluation using dual-energy X-ray absorptiometry and appropriate prevention or treatment strategies are needed.