PURPOSE:Idiopathic ketotic hypoglycemia (IKH) is an important cause of hypoglycemia in children. The purpose of this study was to determine the prevalence of ketotic hypoglycemia and to describe the clinical manifestation. METHODS:We conducted a retrospective chart review of children presenting hypoglycemia to the emergency department (ED) of Ewha Womans University Hospital between January 1995 and June 2004. Information recorded for subject included age, gender, weight, time of presentation, presenting symptoms, and laboratory data. RESULTS:Eighty two children were identified for hypoglycemia during the study period. IKH was the ultimate diagnosis for 66 patients (80.5%). Other diagnoses included hyperinsulinism (2.4%), drug adverse event (1.2%), sepsis (1.2%), and other disorder. The mean age for presentation of IKH was 37.9+/-18.6 months. Thirty eight boys and twenty eight girls were identified. The median time of presentation was 9:48 a.m. Of the 66 subjects, body weight of 46.9% patients was below 25th percentile for age. The average blood glucose was 41.4+/-14.2 mg/dL. Symptoms at presentation included lethargy (24.2%), mental change (16.7%) and vomiting (16.7%). 49 patients (74.2%) were described as having a concomitant illness. CONCLUSION: IKH was responsible for 80.4% of cases of hypoglycemia in pediatric ED and it had usually concomitant intercurrent illness which resulting in poor oral intake. Awareness of IKH, and its presenting characteristics, will be helpful in the ED when taking care of hypoglycemic children.
Blood Glucose ; Body Weight ; Child ; Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia* ; Lethargy ; Prevalence* ; Retrospective Studies ; Sepsis ; Vomiting

Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. METHOD: 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program. RESULTS: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breast-feeding and breast-feeding in the hospital after delivery (P<0.01). 2) The duration of breast-feeding was 5.2+/-4.4 months. It was significantly longer in the first successful breast-feeding (P<0.01). The earlier the first breast-feeding, the longer the breast-feeding duration (P<0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery (46.5%) and the rooming-in (57.4%) than in Cesarean section (37.1%) and the nursery (39.1%) (P<0.01). 4) The first time of breast-feeding was 64.8+/-62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery (P<0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education (P<0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk (37.1%), the physician' s recommendation (18.8%), the inverted nipple (12.1%), the baby's poor suckling power (10.5%) and thin breast-milk (7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work (25.1%), the convenience of formula-feeding (17.4%), the excellency of formula (10.0%) and maternal conveniency (6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying (38.7%) and poor sleeping with irritability (19.0%). The reasons to consider the breast milk thin were the loose stool (51.1%) and watery nature of breast milk (48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake (67.6%) instead of the frequent baby' s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis (11.1%), hepatitis B (4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby' s diseases such as jaundice (29.9%), loose stool (22.2%) and vomiting (2.8%) were inappropriate. CONCLUSIONS: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.
Breast Feeding ; Cesarean Section ; Crying ; Female ; Hepatitis B ; Hospitals, University ; Humans ; Jaundice ; Korea ; Logistic Models ; Mastitis ; Milk ; Milk, Human ; Mothers ; Nipples ; Nurseries ; Pregnancy ; Prenatal Education ; Return to Work ; Seoul ; Tuberculosis ; Vomiting

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin<10.5g/dL) and iron deficiency(serum ferritin<10ng/mL) were 5%(3/60), 11.7%(7/60) in 9-month-old healthy babies and 2.9%(2/70), 18.6%(18/70) in 15-month-old healthy babies, respectively. The incidence of hypercholesterolemia(serum cholesterol>200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.
Alkaline Phosphatase ; Calcium ; Cholesterol ; Diet ; Ferritins ; Hematocrit ; Hospitals, General ; Humans ; Incidence ; Infant ; Inpatients ; Iron ; Nutritional Status ; Phosphorus ; Prealbumin ; Reference Values* ; Weaning*

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin<10.5g/dL) and iron deficiency(serum ferritin<10ng/mL) were 5%(3/60), 11.7%(7/60) in 9-month-old healthy babies and 2.9%(2/70), 18.6%(18/70) in 15-month-old healthy babies, respectively. The incidence of hypercholesterolemia(serum cholesterol>200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.
Alkaline Phosphatase ; Calcium ; Cholesterol ; Diet ; Ferritins ; Hematocrit ; Hospitals, General ; Humans ; Incidence ; Infant ; Inpatients ; Iron ; Nutritional Status ; Phosphorus ; Prealbumin ; Reference Values* ; Weaning*

Sjogren's syndrome is a chronic inflammatory disorder that is characterized by lymphocytic infiltration of exocrine glands, especially the lacrimal and salivary glands. Although primarily characterized by a particular form of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia), this condition may affect a wide variety of organs and systems, including the skin, lungs, heart, kidneys, and nervous and hematopoietic systems. Optic neuritis is inflammation of the optic nerve and causes loss of vision, usually because of swelling and destruction of the myelin sheath that covers the optic nerve. The most common etiology is multiple sclerosis. Some other causes include infections, tumors, granuloma, autoimmune disorders (e.g., lupus and Sjogren's syndrome) and the inflammation of vessels (vasculitis) that nourish the optic nerve. In this report, we describe a 16-year-old girl with optic nerve atrophy caused by optic neuritis, which can be a presenting feature of Sjogren's syndrome.
Adolescent ; Atrophy ; Exocrine Glands ; Eye ; Granuloma ; Heart ; Hematopoietic System ; Humans ; Inflammation ; Kidney ; Lung ; Mouth ; Multiple Sclerosis ; Myelin Sheath ; Optic Nerve ; Optic Neuritis ; Salivary Glands ; Sjogren's Syndrome ; Skin ; Vision, Ocular

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: The effect of breastfeeding on the development of allergic disease has been assessed in many studies but remains controversial. Thus, we evaluated the prevalence of allergic disease and its association with breastfeeding among preschool children. METHODS: A questionnaire survey was conducted in 604 kindergarten children from 5 different kindergartens in Seoul between May and June, 2004. Parents or guardians were asked to answer the duration of breast-feeding and the time of weaning diet. RESULTS: For the question, "Have you been treated for allergic disease during the past 12 months?" showed 4.5% of in asthma, 11.3% and 19.0% were in allergic rhinitis and atopic dermatitis, respectively. Exclusive breast-feeding for the first 4 months was noted in 21.8% of the children, compared with 55%, partial breast-feeding or only formula milk feeding in 23.2%. The prevalence of wheezing during the past 12 months was significantly lower in children with prolonged breast-feeding than in those with short-term breast feeding infants. There was a significant reduction in risk for atopic dermatitis in breastfeeding compared with formula milk feeding. CONCLUSION: Breastfeeding seems to have a preventive effect on the development of atopic dermatitis. The risk for wheezing, during the past 12 months was higher for in children with formula milk feeding.
Aged ; Asthma ; Breast Feeding ; Child ; Child, Preschool ; Dermatitis, Atopic ; Humans ; Infant ; Milk ; Parents ; Prevalence ; Surveys and Questionnaires ; Respiratory Sounds ; Rhinitis ; Rhinitis, Allergic, Perennial ; Weaning

PURPOSE: The effect of breastfeeding on the development of allergic disease has been assessed in many studies but remains controversial. Thus, we evaluated the prevalence of allergic disease and its association with breastfeeding among preschool children. METHODS: A questionnaire survey was conducted in 604 kindergarten children from 5 different kindergartens in Seoul between May and June, 2004. Parents or guardians were asked to answer the duration of breast-feeding and the time of weaning diet. RESULTS: For the question, "Have you been treated for allergic disease during the past 12 months?" showed 4.5% of in asthma, 11.3% and 19.0% were in allergic rhinitis and atopic dermatitis, respectively. Exclusive breast-feeding for the first 4 months was noted in 21.8% of the children, compared with 55%, partial breast-feeding or only formula milk feeding in 23.2%. The prevalence of wheezing during the past 12 months was significantly lower in children with prolonged breast-feeding than in those with short-term breast feeding infants. There was a significant reduction in risk for atopic dermatitis in breastfeeding compared with formula milk feeding. CONCLUSION: Breastfeeding seems to have a preventive effect on the development of atopic dermatitis. The risk for wheezing, during the past 12 months was higher for in children with formula milk feeding.
Aged ; Asthma ; Breast Feeding ; Child ; Child, Preschool ; Dermatitis, Atopic ; Humans ; Infant ; Milk ; Parents ; Prevalence ; Surveys and Questionnaires ; Respiratory Sounds ; Rhinitis ; Rhinitis, Allergic, Perennial ; Weaning