This study was conducted in order to compare weight control behaviors, eating disorder risk, and depression in female adolescents according to dieting experience during the last year. The subjects were 707 students attending a girls' high school in Seoul, and all the information was collected by self-administered questionnaire. Eating disorder risk and depression were determined by using EAT-26 (Eating Attitude Test-26) and PHQ-9 (Patient Health Questionnaire-9), respectively. Data were compared between subjects with experience of dieting (320) and those without (387). More of the subjects with dieting experience were unsatisfied with their own body weights (76.9% vs. 44.2%, P<0.01) and weighed themselves frequently (P<0.01) compared to those without diet experience. EAT-26 (11.63±8.3 vs. 5.99±4.7, P<0.01) and PHQ-9 scores (7.05±4.6 vs. 6.00±4.4, P<0.01) were higher in subjects with dieting experience compared to their counterparts. Therefore, we concluded that dieting is associated with several undesirable psychological aspects such as eating disorder risk and depression in adolescent girls, and thus providing proper education is urgently needed to emphasizing importance of healthy weight and the danger of unnecessary dieting.
Adolescent ; Body Image* ; Body Mass Index ; Body Weight ; Depression* ; Diet* ; Eating* ; Education ; Feeding Behavior ; Female* ; Humans ; Seoul*

Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

Angiogenesis is a series of processes that include endothelial proliferation, migration and tube formation. Vascular endothelial growth factor (VEGF) is regarded as a potent mediator of angiogenesis, vascular permeability and tumor cell growth in renal cell carcinoma. This study was designed to evaluate the expression of VEGF and the microvessel count (MVC) and to determine their prediction efficacies for prognosis in renal cell carcinoma. The relationship between the expression of VEGF and MVC were evaluated immunohistochemically in 50 patients with renal cell carcinoma who received a radical nephrectomy at Wonju Christian Hospital between 1989 and 1997. Microvessels were identified by immunostaining endothelial cells for CD-31 antigen. The mean follow-up was 96 months (3 - 133 months). Overall 5-year survival rate was 71.5%. VEGF was expressed in the tumor cell cytoplasm. Of the 50 tumors, 23 (46%) were weak to strongly positive for VEGF but 27 (54%) were unreactive. The respective 5-year survival rates for patients with positive and negative expressions of VEGF were 70% and 73% (p > 0.05). The overall mean MVC was 13.4 in a 400x field. Mean MVCs were significantly higher in VEGF-positive tumors (17.6 +/- 12.1) than in VEGF-negative tumors (9.9 +/- 5.4), and the MVCs of the high vascular density group and the low ascular density groups were significantly different. The 5-year survival rates of patients with high vascular density and low vascular density were 59% and 86%. The median survival period for patients with MVCs higher than or equal to 10 vessels/field was 85 months, whereas for those with MVCs lower than 10 vessels/field the median survival time was 102 months. These results suggest that MVC may be a better prognostic factor in renal cell carcinoma than the expression of VEGF.
Adult ; Aged ; Carcinoma, Renal Cell/*blood supply/*metabolism ; Endothelial Growth Factors/*metabolism ; Female ; Human ; Kidney Neoplasms/*blood supply/*metabolism ; Lymphokines/*metabolism ; Male ; Middle Age ; Neovascularization, Pathologic/*pathology ; Prognosis

Purpose: Food sensitization to egg white (EW) peaks during early childhood, after which some children with sensitization to EW outgrow food sensitization, while others develop an increased degree of sensitization to EW. We investigated factors determining changes in EW-specific IgE in children under 2 years of age. Methods: Among children under 2 years of age with atopic dermatitis or food allergy who visited Asan Medical Center from March 2018 to September 2021, a total of 172 sensitized to EW were enrolled. Serum specific IgE to EW, ovalbumin and ovomucoid, and specific IgG4 to EW and ovomucoid were measured at 0, 6, and 12 months. An increase in EW-specific IgE was defined as an increased level of EW-specific IgE after 12 months from baseline. Multiple logistic regression analysis was performed to identify factors determining an increase in EW-specific IgE. Results: Of the 172 children, 85 had complete data on serum specific IgE and specific IgG4 during a period of 12 months. The levels of EW-specific IgE were decreased in 51 subjects (60.0%), while they were increased in 34 subjects (40.0%). Introduction of baked eggs had a protective effect against an increase in EW-specific IgE levels during a period of 12 months (adjusted odds ratio, 0.148; 95% confidence interval, 0.022–0.983). Conclusion Introduction of the baked egg can prevent an increase in EW-specific IgE during early childhood. Further studies are needed for the long-term effect of baked egg on the natural course of EW sensitization.

The aim of this study was to evaluate the antibacterial effect on Enterococcus Faecalis and physical properties of chitosan added calcium hydroxide canal filling material.
Low, medium, high molecular weights of chitosan powder were mixed with calcium hydroxide canal filling material. Also, for each molecular weight group, 1.0, 2.0, 5.0 wt% of chitosan powder were added. An overnight culture of E. faecalis was adjusted to 1 × 106 CFU/ml. For test of antibacterial effect, three different molecular weights of 2.0 wt% chitosan and three different concentrations of high molecular weight chitosan were mixed with calcium hydroxide canal filling material. The absorbance of plates was analyzed using spectrophotometer at 570 nm with a reference wavelength of 600 nm. Physical properties such as flow, film thickness and radiopacity were examined according to ISO 6876 : 2012.
All molecular weight type of chitosan containing material showed inhibitory effect against E. faecalis growth compared to non-chitosan added calcium hydroxide canal filling material group (p < 0.05). High molecular weight chitosan containing material showed the most antibacterial effect. Also, the antibacterial effect decreased as the incorporated amount of chitosan decreased (p < 0.05). Every molecular weight group of material containing chitosan had a tendency for reduced flow and radiopacity, increased film thickness according to amount of chitosan. Low molecular weight of 1.0 wt% chitosan addition did not show any significant difference of physical properties compared to conventional calcium hydroxide canal filling material.
In conclusion, for reinforcement of antibacterial effect against E. faecalis and for favorable physical properties, 2.0 wt% of chitosan adding is recommended. Considering its antibacterial effect of chitosan, further studies are required for clinical application of chitosan in endodontics and pediatric dentistry.

Purpose: Sixty to eighty percent of children with egg allergy are able to tolerate eggs in baked form. The purpose of this study was to evaluate the clinical usefulness and diagnostic value of measurements of IgE specific to egg white, ovalbumin, and ovomucoid for reactivity to baked egg in children with sensitivity to egg. Methods: Two hundred seventeen children with suspected egg allergy underwent open food challenges with baked egg (in the form of muffins). The outcomes of the challenges were compared to the serum concentrations of IgE specific to egg white, ovalbumin, and ovomucoid by using ImmunoCAP. Results: There were no statistically significant differences in levels of IgE specific to egg white, ovalbumin, and ovomucoid between the baked egg challenge positive and negative groups younger than 2 years (n = 163). However, significant differences were observed between the challenge positive and negative groups in 54 subjects aged 2 to 5 years (all P < 0.05). The optimal cutoff points of egg white, ovalbumin, and ovomucoid specific IgE levels among children aged 2 to 5 years were 12.40 kU A/L (sensitivity 79%, specificity 66%), 4.07 kU A/L (sensitivity 88%, specificity 58%), and 3.65 kU A/L (sensitivity 77%, specificity 62%), respectively. Conclusion The level of IgE specific to egg white and its components can predict the reactivity to baked egg in children aged 2 to 5years.

PURPOSE: Children with asthma frequently have allergic rhinitis (AR) as a comorbidity. Asthmatic children with AR have a higher exhaled nitric oxide (eNO) level and bronchial hyperresponsiveness (BHR) than those without. The purpose of this study is to investigate the difference in lung function, eNO, and BHR between atopic asthma with and without AR, and the association of eNO and BHR with atopic intensity in total asthmatics. METHODS: We recruited 69 atopic asthmatic children with AR, 19 atopic asthmatic children without AR, 38 children with AR, and 43 nonatopic controls. We measured forced expiratory volume in one second (FEV1) and forced expiratory flow at 25% to 75% of forced vital capacity (FEF(25%-75%)), dose response slope (DRS) of bronchial challenge with methacholine and adenosine 5'-monophosphate (AMP), the levels of eNO, and the ratio of sum of allergen wheal diameter to histamine using skin prick tests. RESULTS: Atopic asthmatic children with AR had a higher eNO level compared to those without AR (P<0.05). However, there was no difference in FEV1 %predicted, FEF(25%-75%) %predicted, methacholine DRS, and AMP DRS between asthmatic children with and without AR. In total asthmatics, methacholine DRS and AMP DRS significantly correlated with eNO levels (r=0.338, P<0.001; r=0.365, P<0.001), but not with total IgE levels. However, eNO significantly correlated with total IgE levels (r=0.479, P<0.001). CONCLUSION: These results suggest that AR may enhance airway inflammation but may not lead to enhanced BHR in children with asthma.
Adenosine ; Asthma ; Bronchial Hyperreactivity ; Child* ; Comorbidity ; Forced Expiratory Volume ; Histamine ; Humans ; Immunoglobulin E ; Inflammation ; Lung ; Methacholine Chloride ; Nitric Oxide* ; Rhinitis* ; Skin ; Vital Capacity

PURPOSE: Asthma is a chronic airway inflammatory disease characterized by bronchial hyperresponsiveness and reversible airway obstruction. Bronchial challenge with methacholine or adenosine-5'-monophosphate (AMP) has been used to diagnose asthma. Recently, measurement of exhaled nitric oxide (eNO) can also be used for the diagnosis of asthma. The aim of this study was to compare the diagnostic value for asthma between challenge with methacholine or AMP and eNO in children with chronic nonspecific respiratory symptoms. METHODS: One hundred thirty-three children who have chronic nonspecific respiratory symptoms were enrolled. Bronchial challenge with methacholin and AMP were performed, and eNO was measured in all subjects. Subjects were defined as asthma based on the clinical symptoms and bronchodilator response during follow-up of at least 3 months after test. RESULTS: Thirty-three subjects (34%) were finally diagnosed as asthma among 97 patients after 3-month follow-up. The area under the receiver operating characteristic curves for the diagnosis of asthma were 0.903 (95% confidence interval [CI], 0.838-0.969; P<0.001) for methacholline challenge, 0.867 (95% CI, 0.783-0.950; P<0.001) for AMP challenge, and 0.588 (95% CI, 0.467-0.709, P=0.156) for eNO measurement. The cutoff values of these tests were methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second) 12.0 mg/mL (sensitivity, 87.9%; specificity, 82.8%), AMP PC20 566.2 mg/mL (sensitivity, 84.8%; specificity, 85.9%), and eNO 18.5 ppb (sensitivity, 45.5%; specificity, 71.9%). CONCLUSION: Measurement of eNO may be inferior to challenge with methacholine and AMP for the diagnosis of asthma in children.
Airway Obstruction ; Asthma* ; Bronchial Provocation Tests ; Child ; Diagnosis* ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Methacholine Chloride* ; Nitric Oxide* ; ROC Curve ; Sensitivity and Specificity

Cystic fibrosis (CF) is an autosomal recessive inherited multisystem disorder caused by mutations of the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Respiratory failure remains the most frequent cause of morbidity and mortality. Lung transplantation is the only option to treat end-stage lung disease. Very few cases of CF occur in Koreans. We report the case of a 12-year-old girl with respiratory failure due to CF who underwent lung transplantation. She had been diagnosed with CF 8 years previously after being treated for recurrent Pseudomonas aeruginosa pneumonia and malnutrition based on sweat chloride concentrations and the CFTR protein gene mutation test. Progression to end-stage lung disease and respiratory failure led to registration with the Korean Network for Organ Sharing. She underwent successful double lung transplantation in 2014. Although she has diabetes mellitus and chronic kidney disease, she has a better quality of life and a prolonged life expectancy.
Child* ; Cystic Fibrosis Transmembrane Conductance Regulator ; Cystic Fibrosis* ; Diabetes Mellitus ; Female ; Humans ; Korea ; Life Expectancy ; Lung Diseases ; Lung Transplantation* ; Lung* ; Malnutrition ; Mortality ; Pneumonia ; Pseudomonas aeruginosa ; Quality of Life ; Renal Insufficiency, Chronic ; Respiratory Insufficiency ; Sweat

PURPOSE: Drug provocation tests (DPT) are the gold standard for confirming the diagnosis of drug hypersensitivity reactions (DHRs). However, there are little studies of DPT in children. The purpose of this study was to evaluate DPT results and safety as diagnostic methods of DHR in Korean children. METHODS: We reviewed the medical records of 39 children under 18 years of age with a suspected DHR and performed DPT between January 2010 and May 2016 at Asan Medical Center. RESULTS: Total 110 DPT were performed in 39 children (20 boys and 19 girls) with a history of DHR. Clinical presentation of DHR included skin rash (n=7), pruritus (n=3), urticaria (n=18), angioedema (n=19), dyspnea (n=5), hoarseness (n=1), hypothermia (n=1), and anaphylaxis (n=5). The median age at the time of DPT was 9 years. Positive DPT were observed in 21 of 39 children (53.8%) and 28 of 110 cases (25.5%). Drugs causing positive reactions were acetaminophen in 50% (9 of 18), nonsteroidal anti-inflammatory drugs in 29.2% (14 of 48), cephalosporin in 9.1% (1 of 11), trimethoprim/sulfamethoxazole in 50% (1 of 2), local anesthetics in 10% (1 of 10), and others (levodropropizine and idursulfase) in 15.4% (2 of 13). There was no statistical difference between children who had positive and negative results in sex, age, personal and parental history of allergic disease, eosinophil count, or total IgE level. Children with positive DPT did not develop anaphylaxis during the DPT procedure. CONCLUSION: Drug provocation test is safe, and it can be considered in children with suspected DHRs.
Acetaminophen ; Anaphylaxis ; Anesthetics, Local ; Angioedema ; Child ; Chungcheongnam-do ; Diagnosis ; Drug Hypersensitivity ; Dyspnea ; Eosinophils ; Exanthema ; Hoarseness ; Humans ; Hypothermia ; Immunoglobulin E ; Medical Records ; Parents ; Pruritus ; Urticaria