There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

OBJECTIVES: The purpose of this study was to investigate effects of nutrition education providing school lunch by personalized daily needed food exchange units using Food Exchange System for adolescent athletes. METHODS: The subjects were 60 sports high school students (educated group, 30 vs. non-educated group 30). Nutrition education was provided for 4 weeks (40 min/lesson/week). In addition, personalized school lunch was served for 4 weeks, nutrition education period. The personalized lunch were provided Food Exchange Units according to personalized daily needed energy. The lessons were '5 Major nutrients, functions and foods', 'My daily needed energy and food exchange units by Food Exchange System', 'My meal plan by food exchange units according to my daily needed energy' and 'Smart choice of healthy snacks and eating outs'. After nutrition education, we examined the differences in anthropometric characteristics, nutrition knowledge, dietary attitude and dietary intake between the educated and the non-educated group. RESULTS: We observed improvements in lean body mass in the educated group. With regard to nutrition knowledge, there were improvements in 'Functions of vitamins', 'Functions of minerals', 'Foods of fat', 'Foods of vitamin', and 'Foods of mineral' in the educated group. In relation to dietary attitude, there were improvements in 'Taking a meal with family and friend', 'Taking a meal at ease', 'Taking a meal with kimchi and vegetables', 'Taking a meal with three kinds of side dishes', 'Priority of choosing snacks' and 'Type of snacks' in the educated group. With regard to dietary intakes according to Dietary Reference Intakes for Koreans, there were improvements in intakes levels of fiber, vitamin A, vitamin C, folate, calcium, iron and zinc. The index of nutrition quality, as indicated by nutrition adequacy ratio also improved in the educated group. CONCLUSIONS: These results showed that a nutrition education program providing education lessons and personalized school lunch by food exchange units according to daily needed energy showed positive changes in nutrition knowledge, dietary attitude and dietary intake of adolescent athletes. Nutrition education program providing personalized school lunch by Food Exchange Units may improve dietary behaviors and dietary intakes of adolescents.
Adolescent* ; Ascorbic Acid ; Athletes* ; Calcium ; Eating ; Education* ; Folic Acid ; Humans ; Iron ; Jeollabuk-do* ; Lunch* ; Meals ; Recommended Dietary Allowances ; Snacks ; Sports ; Vitamin A ; Zinc

We reviewed the clinical features, histrologic patterns and clinical courses of 30 children with lupus nephritis retrospectively, and the results were summerized as follows; 1) The male to female ratio was 1:2.8, and the mean age at the onset was 10 8/12 years. 2) The clinical symptoms were diverse, and malaise, weight loss, anorexia, fever and malar rash were the most frequent findings. 3) Among the immunologic tests, FANA and anti-ds-DNA test revealed the highest sensitivity with positive rates of 97% and 87%, respectively. 4) Clinically, 57% of patients had active nephrotic syndrome at the onset, and 33% showed (?) was the most common findings (70%). 5) During the follow-up period, one children with Class IV lupus nephritis expired. And 8 out of 9 cases with renal insufficiency at the onset showed improvement of renal function after treatment with corticosteroid and cytotoxic agents. In conclusion, the clinical features and histologic findings of lupus nephritis in children were diverse. Early diagnosis and proper treatment can prevent rapid deterioration of renal function and improve long-term survival rate.
Anorexia ; Child* ; Cytotoxins ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Immunologic Tests ; Lupus Nephritis* ; Male ; Nephrotic Syndrome ; Renal Insufficiency ; Retrospective Studies ; Survival Rate ; Weight Loss

The use of self-expanding metal stent has been widely reported that its utility can make a palliative decompression treatment and one stage operation without doing colostomy in the patient with unresectable and resectable obstructive colorectal cancer, respectively. It, however, can sometimes cause complications such as intestinal perforation. We report that the conservative treantment could be possible without removing stent or performing laparotomy in case of intestinal perforation during chemoradiotheraphy after insert of stent for relieving colonic obstruction in the 53 years old female patient with stage IV rectal cancer.
Colon ; Colorectal Neoplasms ; Colostomy ; Decompression ; Female ; Humans ; Intestinal Perforation ; Laparotomy ; Middle Aged ; Rectal Neoplasms* ; Stents*

OBJECTIVES: The physical activity paradox suggests that occupational physical activity (OPA), unlike leisure-time physical activity (LTPA), may detrimentally impact health. We explored the relationships of OPA and LTPA with work ability (WA) and health-related productivity loss (HRPL). METHODS: This study included 5,501 workers in Korea who were recruited in 2021 through a web-based cross-sectional questionnaire. The questionnaire was utilized to quantify OPA and LTPA in metabolic equivalents, while WA and HRPL were also measured. Non-parametric regression, using a generalized additive model (GAM), was employed to visualize the relationships of LTPA and OPA with WA and HRPL. Mean differences in WA and HRPL, in relation to OPA and LTPA, were examined using linear regression models. These models were adjusted for covariates including sex, age, body mass index, education level, alcohol consumption, smoking history, insomnia, occupation, hours worked, and income. RESULTS: The GAM and linear regression analyses revealed that higher LTPA corresponded with higher WA and lower HRPL. In contrast, as OPA increased, WA decreased and HRPL increased. However, within the group with high OPA, HRPL was not significantly lower in the high-LTPA subgroup relative to the low-LTPA subgroup (mean difference=1.92%, p=0.343). This pattern was especially pronounced among workers aged 60 years and older, with an increase in HRPL observed with increasing LTPA among the respondents with high OPA. CONCLUSIONS High LTPA levels were associated with elevated WA and diminished HRPL. In contrast, higher levels of OPA were associated with lower WA and higher HRPL.

Ludwig’s angina is a rapidly progressive and gangrenous cellulitis in the submandibular, sublingual spaces, and neck. It is characterized by an elevated tongue and laryngeal edema, resulting in airway compromise and, rarely, in sudden death. The most common cause is an odontogenic infection of a molar tooth. Infection can spread to the superior mediastinum and buccal area through anatomical structures. Herein, we report the sudden death of a 45-year-old male who was not diagnosed with Ludwig’s angina. He died in the emergency room 20 minutes after loss of consciousness. Intubation was impossible owing to severe laryngeal edema. The C-reactive protein level was 33.81 mg/dL. On autopsy, a diffuse light green abscess of the submandibular space was detected, along with severe edema of the epiglottis, aryepiglottic fold, and vocal cords. Subsequently, we confirmed that the airway obstruction was caused by Ludwig’s angina based on a literature review. In conclusion, this report emphasizes the need to identify the infection source and perform a detailed dissection according to the anatomical structure in the autopsy procedure for Ludwig’s angina.

Thirty - five cases of coarctation of aorta, diagnosed by cardiac catheterization and angiography during the period of 1980-1984, at the department of Pediatrics of Seoul National University Hospital, were studied on the clinical features and management. The followoing results were obtained : 1) The incidence of coartation of aorta was 1.2% of congenital heart disease and sex ratio of male to female was 2.2 : 1. 2) The anatomical type of coarctation was preductal in 19 cases, juxtaductal in 15 cases and postductal in 1 case. Most of preductal coarctation (89.5%) were associated with aortic arch or isthmus hypoplasia. 3) All of these patients had various type of additional cardiac anomalies and among them, PDA was the most common associated lesion and followed by VSD. 4) Significant BP gradient between upper and lower extremies and weak femoral pulsation were noticed in 15 cases(42.8%). 5) Congestive heart failure was present in all but one patient less than 1 year old, while only 3 cases(15%) had congestive heat failure in patients older than one year. 6) Overall surgical mortality was 31.8%, but significant decrease in surgical mortality was found since 1983.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Cardiac Catheterization ; Cardiac Catheters ; Estrogens, Conjugated (USP) ; Female ; Heart Defects, Congenital ; Heart Failure ; Hot Temperature ; Humans ; Incidence ; Male ; Mortality ; Pediatrics ; Seoul ; Sex Ratio

PURPOSE: With development of socioeconomic status, the prevelance of adolesecnt obesity, which is a risk factor for cardiovascular disease, is increasing. Skinfold and body mass index are indirectly used measurement of obesity in clinical and epidemiologic studies. Triceps skinfold, subscapular skinfold and body mass index were measured in adolescents aged 12 to 17. Percentile values by age and sex and correlation between skinfold and body mass index were determined. METHODS: We examined 2114 adolescents aged 12 to 17 in Seoul between 1992 and 1993. Triceps skinfold and subscapular skinfold were measured. Body mass index was calculated by dividing weight in kilograms by square of height in meters. RESULTS: 1) The 50th percentile of triceps skinfold in males was 10.8mm at 12 year, 9.3mm at 17 year and decreased with age. The 50th percentile of triceps skinfold in females was 14.0mm at 12 year, 19.9mm at 17 year and increased with age. Females had greater values than males. 2) The 50th percentile of subscapular skinfold in males was 7.8mm at 12year, 10.4mm at 17 year and increased with age. The 50th percentile of subscapular skinfold in females was 11.8mm at 12 year, 19.0mm at 17 year and increased with age. Females had greater values than males. 3) The 50th percentile of body mass index in males was 18.5 at 12 year and 21.1 at 17 year. The 50th percentile of body mass index was 18.5 at 12 year and 20.3 at 17 year. 4) Pearson correlations between body mass index and triceps skinfold were 0.76 in males and females. Pearson correlations between body mass index and subscapualar skinfold were 0.80 in males and 0.81 in females. In females, correlations decreased with age. 5) Our data exceeded triceps skinfold in 1982 and body mass index of USA in 1974. CONCLUSIONS: Percentiles of skinfold thickness and body mass index may be used to monitor skinfold and body mass index of adolescents longitudinally and for comparing an individual with others of the same sex and age. Body mass index correlated highly with skinfold thickness.
Adolescent* ; Body Mass Index* ; Cardiovascular Diseases ; Epidemiologic Studies ; Female ; Humans ; Male ; Obesity ; Risk Factors ; Seoul* ; Skinfold Thickness* ; Social Class

Estimation of the minimum post-mortem interval (PMI-min) by means of forensic entomology is mainly based on the results of the growth rate studies on necrophagous flies. However, results of these studies are difficult to use because these studies have only been undertaken for a select few necrophagous flies, and experimental methods and results processing have not been standardized. In this review, we have summarized the current state of growth rate studies on necrophagous fly species that are frequently found in human cadavers. Criteria have been suggested in order to select reliable data, and the accumulated degree hours and base temperatures to be used in the calculation of PMI-min for each species have been tabulated.

Congenital absence of the pericardium, also known as pericardial agenesis, is an extremely rare anomaly. Although most cases are asymptomatic, some experience chest pain, dyspnea, dizziness, and syncope. A few sudden death cases have been reported. We report a case of congenital complete left-sided absence of the pericardium that is not related to the cause of death. In the autopsy of a skinny 45-year-old deceased man, there was no left pericardium, and the heart had direct contact with the left lung. Inflammation and adhesion around the heart, torsion of great vessels, structure abnormality of the heart, and histologic lesion of the myocardium were absent. Due to the chemical analysis result and morphology, we suspected that the cause of death was related to starvation. The congenital absence of the pericardium is usually accompanied by myocardial infarction, aortic dissection, and variable congenital anomalies in the heart and other organs. Additionally, both complete and partial defects can cause myocardial infarction. Therefore, we suggest that precise gross examination should be performed to determine the ischemic lesions in the heart and other anomalies if congenital absence of the pericardium is noted in the autopsy.