Obesity is a disease that decreases life span. Childhood obesity leads to the higher prevalence of obesity in adulthood, which increases the risk of metabolic syndrome. Recently, the prevalence of obesity and metabolic syndrome is rapidly increasing among children and adolescents in Korea. The percentage of affected individuals was 17.9% among 10 to 14 year-old boys at its highest or 9.7% (boys 11.3%, girls 8.0%) on average, according to KNHANES III (The Third Korea National Health and Nutrition Examination Survey, 2005) and 2005 Korean children and adolescents' growth standard program, respectively. The incidence of metabolic syndrome was 30 to 40% in obese children and adolescents in Korea. Intervention program to prevent and reduce childhood obesity on a national scale is required.
Adolescent ; Child ; Humans ; Incidence ; Korea ; Nutrition Surveys ; Obesity ; Prevalence

The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose- containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.
Child ; Diarrhea ; Diet ; Electrolytes ; Fluid Therapy ; Gastroenteritis ; Humans ; Infant ; Lactose ; Malnutrition ; Milk ; Nutritional Support ; Organization and Administration

PURPOSE: The ability to perform chromosome analysis of cryopreserved cord blood mononuclear cells is important for future retrospective studies. We compared the karyotypes of cryopreserved cells with cells before cryopreservation. METHODS: One cord blood (CB) sample was obtained from normal healthy volunteer. Karyotype analysis was performed before cryopreservation. After mononuclear cell separation with Ficoll-Hypaque, the mononuclear cells were cryopreserved by programmed controlled-rate freezer and then transferred into the liquid nitrogen (-196 degrees C) for 3 days. After rapid thawing, cytogenetic analysis was performed as the same method for each sample by different conditions. The samples were divided by three groups. The first group was no culture before cryopreservation, the second group was 72 hours culture before cryopreservation, but no 24 hours culture after thawing and the third group was 72 hours culture before cryopreservation and 24 hours culture after thawing. RESULTS: The chromosome analysis was successful in the second and third groups of CB sample. CONCLUSION: The successful result from CB samples may suggest the usefulness of long-term cryopreservation for retrospective study in various clinical settings including hematologic malignancies.
Cell Separation ; Cryopreservation ; Cytogenetic Analysis ; Fetal Blood ; Karyotype ; Nitrogen ; Retrospective Studies

BACKGROUND/AIMS: The aim of this study was to establish the characteristics of children with hepatitis B e antigens (HBeAg) positive chronic hepatitis B who were cleared of hepatitis B surface antigens (HBsAg) as a result of lamivudine treatment. METHODS: Seventy-six children with chronic hepatitis B who were seropositive for HBeAg were treated with lamivudine for at least 6 months. HBeAg seroconversion occurred during treatment in 49 of these children, who were then followed up to assess their clearance of serum HBsAg. Various clinical variables were compared between those patients who were cleared of HBsAg and those who were not, including age, pretreatment serum levels of alanine aminotransferase (ALT) and hepatitis B virus (HBV) DNA, treatment duration, the time elapsed between initiation of treatment and ALT normalization, HBV DNA negativization, HBeAg seroconversion, and HBsAg clearance. RESULTS: HBsAg disappeared in 13 of the 49 (26.5%) patients who experienced lamivudine-induced HBeAg seroconversion; HBsAg did not reappear during follow-up period (1-86 months). The time that elapsed between initiation of lamivudine treatment and total HBsAg clearance was 25.9+/-27.1 months (mean+/-SD; range: 5-104 months). The age at which treatment was initiated was the only factor associated with HBsAg clearance. Children who were cleared of HBsAg were significantly younger than those who were not (5.1+/-4.3 years vs. 7.9+/-4.9 years, respectively; P=0.006). All 13 of these patients eventually produced antibodies to HBsAg. CONCLUSIONS: Younger children (age <7 years old) have a higher chance of HBsAg clearance than older children after the treatment of HBeAg-positive chronic hepatitis B with lamivudine.
Adolescent ; Age Factors ; Antiviral Agents/*therapeutic use ; Child ; Child, Preschool ; Drug Resistance, Viral ; Female ; Hepatitis B Surface Antigens/*blood ; Hepatitis B e Antigens/blood ; Hepatitis B, Chronic/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Retrospective Studies

PURPOSE: To estimate the viral suppressive effect of entecavir monotherapy in Korean children and adolescents with lamivudine-resistant chronic hepatitis B (CHB). METHODS: One milligram of entecavir was administered once daily to 6 patients (4 boys; mean age, 17.5 years; range, 15.10~24.6 years) with lamivudine-resistant CHB for a mean duration of therapy of 13.4 months (range, 1~21.1 months). The therapeutic results were compared with 11 patients who received adefovir (0.3 mg/kg/day [maximal dose 10 mg]) for at least 12 months (mean, 33.4 months; range, 12.4~58.3 months). The serum HBV DNA level and serologic markers were measured every 2 months. RESULTS: The interval to a HBV DNA titer decrement (>1 log(10)) was 1.2+/-0.2 and 4.4+/-5.2 months (p=0.185) for the entecavir and adefovir groups, respectively. The interval to a HBV DNA titer decrement (>2 log(10)) was 2.4+/-2.3 and 9.2+/-7.3 months (p=0.025), for the entecavir and adefovir groups, respectively. CONCLUSION: The therapeutic efficacy of entecavir was favorable in children and adolescents, especially in shortening the interval to a >2 log(10) decrement in the HBV DNA titer. Long-term follow up is needed to determine the therapeutic efficacy of entecavir for lamivudine-resistant CHB in children and adolescents.
Adenine ; Adolescent ; Child ; DNA ; Follow-Up Studies ; Guanine ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Lamivudine ; Organophosphonates

CNS infection due to Listeria monocytogenes is a rare condition that occurs primarily in immunocompromised patients. A predilection for the brainstem has been proposed but definite abscess formation is extremely rare. We report a case of necrotizing meningoencephalitis with diffuse extensive abscesses caused by Listeria monocytogenes in a chronic diabetic patient, whose diagnosis was based on blood culture and MRI findings.
Abscess ; Brain Abscess* ; Brain Stem ; Brain* ; Diagnosis ; Humans ; Immunocompromised Host ; Listeria monocytogenes* ; Listeria* ; Magnetic Resonance Imaging ; Meningoencephalitis

PURPOSE: The spontaneous seroconversion rate of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) virus infection in children is lower than that in adults. However, few studies have investigated the rate of transition from the immune-tolerant to the early immune-clearance phase in children. METHODS: From February 2000 to August 2011, we enrolled 133 children aged <18 years who had visited the Department of Pediatrics, Kyungpook National University Hospital. All subjects were in the immune-tolerant phase of HBeAg-positive CHB virus infection. The estimated transition rate into the early immune-clearance phase was calculated using the Kaplan-Meier method. RESULTS: Among the 133 enrolled pediatric CHB virus infection patients in the HBeAg-positive immune-tolerant phase, only 21 children (15.8%) had converted to the early immune-clearance phase. The average age at entry into active hepatitis was 10.6+/-4.8 years. The incidence of transition from the immune-tolerant to the early immune-clearance phase in these children was 1.7 episodes/100 patient-years. When analyzed by age, the estimated transition rate was 4.6%, 7.1%, and 28.0% for patients aged <6, 6-12, >12 years, respectively. CONCLUSION: In children with CHB virus infection, the estimated rate of entry into the early immune-clearance phase was 28.0% for patients aged 12-18 years, which was significantly higher than that observed for children aged <12 years (11.7%; p=0.001).
Adult ; Child* ; Gyeongsangbuk-do ; Hepatitis ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Incidence ; Natural History ; Pediatrics ; Phase Transition

BACKGROUND: Recently, the commercial kits for measurement of the absolute number of CD34+ cells have been introduced as a standard method. The aims of this study was to investigated optimal timing of peripheral blood progenitor cell(PBPC) collection and optimal CD34+ cells dose transplanted by measurement of the absolute CD34+ cells. METHODS: We measured total leukocyte count, mononuclear cell count and the absolute number of CD34+ cells using ProCOUNT(Becton Dickinson, USA) in peripheral blood from 54 patients and 7 normal donors who underwent 101 leukapheresis for PBPC collection. We studied correlations among the absolute number of circulating CD34+ cells, other predictors and harvesting yields. We investigated relationships between the posttransplant hematopoietic recovery and CD34+ cells dose in 30 patients. RESULTS: The total number of CD34+ cells in harvesting products could be mostly predicted from the absolute number of circulating CD34+ cells. From 4 to 6 day after G-CSF mobilization, the absolute number of circulating CD34+ cells was peaked. A number of circulating CD34+ cells more than 20/microliter ensured 2.5x106 CD34+ cells/Kg in harvesting products. The patients received CD34+ cells dose >3.5x106/Kg led to a significantly faster recovery of platelets, compared with the patients receiving <3.5x106 CD34+ cells/Kg(P<0.05). CONCLUSIONS: These results suggest that PBPC collection should be started at day of circulating CD34+ cells more than 20/microliter or 4-6 days after G-CSF mobilization for successful leukapheresis and the CD34+ cell dose more than 3.5x106/Kg for PBPC transplantation could predicted rapid hematopoietic recovery.
Cell Count ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukapheresis ; Leukocyte Count ; Stem Cells* ; Tissue Donors

Coronavirus disease 2019 (COVID-19) in patients with underlying diseases, is associated with high infection and mortality rates, which may result in acute respiratory distress syndrome and death. Mucopolysaccharidosis (MPS) type II is a progressive metabolic disorder that stems from cellular accumulation of the glycosaminoglycans, heparan, and dermatan sulfate. Upper and lower airway obstruction and restrictive pulmonary diseases are common complaints of patients with MPS, and respiratory infections of bacterial or viral origin could result in fatal outcomes. We report a case of COVID-19 in a 16-year-old adolescent with MPS type II, who had been treated with idursulfase since 5 years of age. Prior to infection, the patient’s clinical history included developmental delays, abdominal distension, snoring, and facial dysmorphism. His primary complaints at the time of admission included rhinorrhea, cough, and sputum without fever or increased oxygen demand. His heart rate, respiratory rate, and oxygen saturation were within the normal biological reference intervals, and chest radiography revealed no signs of pneumonia. Consequently, supportive therapy and quarantine were recommended. The patient experienced an uneventful course of COVID-19 despite underlying MPS type II, which may be the result of an unfavorable host cell environment and changes in expression patterns of proteins involved in interactions with viral proteins. Moreover, elevated serum heparan sulfate in patients with MPS may compete with cell surface heparan sulfate, which is essential for successful interaction between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and the host cell surface, thereby protecting against intracellular penetration by SARS-CoV-2.

PURPOSE: The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. METHODS: Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0per thousand for children aged > or =6 years and 7per thousand for children aged <6 years. RESULTS: A total of 2,530 children (1,191 boys) with a mean age of 10.0+/-3.0 years (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and > or =12 years of age (p=0.018). CONCLUSION: The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those > or =12 years old.
Abdominal Pain* ; Ambulatory Care Facilities ; Breath Tests ; Child* ; Endoscopy ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori* ; Humans ; Prevalence* ; Urea