PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work

PURPOSE: Body mass index(BMI), skinfold thickness and arm circumference are commonly used to evaluate obesity in children. There is a need for new standards of these items on Korean children. We performed this study to provide up-to-date reference percentile values and percentile charts for these three items. METHODS: Standardized measurements of height, weight, skinfold thickness(triceps, subscapular) and arm circumference on a total of 31,188 infants and children from age 1 to 18 years during January to December 1998 were used to calculate percentile values and to develop smoothed percentile charts. RESULTS: The mean BMI increased with age and showed similar values in both sexes, but 95th percentile values were slightly higher for boys than girls. The percentile values of BMI were consistently higher than those reported previously in Korea, particularly for the 95th percetile values. Triceps and subscapular skinfold thickness showed significant increase compared with previous studies and significantly higher for females than males. Arm circumference also showed significant increase compared with the previous studies. It was significantly higher for males than females. BMI was more closely related with arm circumference than skinfold thickness. CONCLUSION: The percentile values and percentile charts of BMI, skinfold thickness and arm circumference will allow pediatricians to evaluate obesity in Korean children.
Arm* ; Body Mass Index* ; Child* ; Female ; Humans ; Infant ; Korea ; Male ; Obesity ; Skinfold Thickness*

BACKGROUND AND OBJECTIVES: Chronic rhinosinusitis (CRS) frequently coexists with allergic rhinitis (AR) and nasal polyp. The eosinophil is known to play a pivotal role in allergic reaction and chronic inflammation of respiratory epithelium in paranasal sinus. Therefore, we evaluated the peripheral eosinophilia (PE) in patients with CRS and then investigated its relationship with the AR. We also investigated the correlation of the prevalence of nasal polyp with the incidence of nasal polyp and the severity of PNS CT scoring. SUBJECTS AND METHOD: One hundred and three CRS patients who had persisting symptoms more than 3 months and were refractory to medical management were enrolled. Thirty-six patients with AR only were selected on the basis of allergy rhinitis workup and PNS CT. PE was defined as eosinophil count of more than 4% of the peripheral differential blood count. The scoring system of PNS CT imaging was adopted from Ikeda, et al. RESULTS: CRS with AR had the higher prevalence of PE and nasal polyp (p=0.005 and p=0.046, respectively) than non-AR. CRS with AR had the higher prevalence rate of PE than AR (p=0.001). PE was not related with the prevalence of nasal polyp in the presence of CRS with AR. Peripheral eosinophil partition rate also did not correlate with severity of PNS CT score, irrespective of AR. There was no statistical difference in PNS CT score between AR group and non-AR group, either. CONCLUSION: CRS with AR may be associated with nasal polyp and PE but PE itself had no relationship with the disease severity on PNS CT and prevalence of nasal polyp in the presence of CRS.
Eosinophilia ; Eosinophils ; Humans ; Hypersensitivity ; Incidence ; Inflammation ; Nasal Polyps ; Prevalence ; Respiratory Mucosa ; Rhinitis ; Rhinitis, Allergic, Perennial

BACKGROUND: Bacterial extract consisting of immuno-stimulating components derived from 18 Escherichia coli (E. coli) strains has been used for the prophylaxis of recurrent cystitis. Catechin, extract of green tea, has antimicrobial effect against uropathogens. To evaluate the anti-inflammatory effect of E. coli extract and green tea, we measured the cytokine levels from bladder tissue after oral administration and analyzed bladder inflammation by histopathologic examination in a model of lipopolysaccharide (LPS)-induced cystitis in mice. MATERIALS AND METHODS: After 10-day administration of E. coli extract or catechin, cytokine [interleukin-6 (IL-6), IL-10, monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-gamma), Tumor necrosis factor-alpha (TNF-alpha), IL-12p70] levels in the bladder of female BALB/c mice were measured using cytometric bead array. Bladder macrophage inflammatory protein-2 (MIP-2) level was also measured using sandwich enzyme immunoassay. After immunization with E. coli extract and catechin E. coli LPS was instilled into the bladders. Twenty-four hours later, mice were sacrificed and inflammation of the bladder were quantified using the bladder inflammatory index (BII). RESULTS: Significant increases of IL-6 and IFN-gamma in bladder tissue were observed after treatment with E. coli extract and catechin. IL-12p70 level was only elevated in bladder tissue of the catechin group. Bladder instilled with LPS showed high inflammation scores for edema, leukocyte infiltration, and hemorrhage in saline treated control mice. In contrast, E. coli extract and catechin treated mice exhibited mild inflammation with significant reduction of BII scores compared to controls. CONCLUSION: These results demonstrate that immunization using oral E. coli extract and green tea provides protection from inflammatory responses in a mouse model of LPS-induced cystitis.
Administration, Oral ; Animals ; Catechin ; Chemokine CCL2 ; Cystitis* ; Edema ; Escherichia coli* ; Escherichia* ; Female ; Hemorrhage ; Humans ; Immunization ; Immunoenzyme Techniques ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Interleukin-6 ; Leukocytes ; Macrophages ; Mice* ; Tea* ; Tumor Necrosis Factor-alpha ; Urinary Bladder

BACKGROUND: Bacterial extract consisting of immuno-stimulating components derived from 18 Escherichia coli (E. coli) strains has been used for the prophylaxis of recurrent cystitis. Catechin, extract of green tea, has antimicrobial effect against uropathogens. To evaluate the anti-inflammatory effect of E. coli extract and green tea, we measured the cytokine levels from bladder tissue after oral administration and analyzed bladder inflammation by histopathologic examination in a model of lipopolysaccharide (LPS)-induced cystitis in mice. MATERIALS AND METHODS: After 10-day administration of E. coli extract or catechin, cytokine [interleukin-6 (IL-6), IL-10, monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-gamma), Tumor necrosis factor-alpha (TNF-alpha), IL-12p70] levels in the bladder of female BALB/c mice were measured using cytometric bead array. Bladder macrophage inflammatory protein-2 (MIP-2) level was also measured using sandwich enzyme immunoassay. After immunization with E. coli extract and catechin E. coli LPS was instilled into the bladders. Twenty-four hours later, mice were sacrificed and inflammation of the bladder were quantified using the bladder inflammatory index (BII). RESULTS: Significant increases of IL-6 and IFN-gamma in bladder tissue were observed after treatment with E. coli extract and catechin. IL-12p70 level was only elevated in bladder tissue of the catechin group. Bladder instilled with LPS showed high inflammation scores for edema, leukocyte infiltration, and hemorrhage in saline treated control mice. In contrast, E. coli extract and catechin treated mice exhibited mild inflammation with significant reduction of BII scores compared to controls. CONCLUSION: These results demonstrate that immunization using oral E. coli extract and green tea provides protection from inflammatory responses in a mouse model of LPS-induced cystitis.
Administration, Oral ; Animals ; Catechin ; Chemokine CCL2 ; Cystitis* ; Edema ; Escherichia coli* ; Escherichia* ; Female ; Hemorrhage ; Humans ; Immunization ; Immunoenzyme Techniques ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Interleukin-6 ; Leukocytes ; Macrophages ; Mice* ; Tea* ; Tumor Necrosis Factor-alpha ; Urinary Bladder

Objective: This study aimed to investigate the changing seasonal pattern of suicides in Korea between 2000 and 2019. Methods: We calculated a seasonal pattern of suicides between 2000 and 2019 using a non-stationary cosinor model. In addition, we estimated the effect of each month on the suicide incidence compared to a reference month, using a generalized linear model with a categorical variable of the month. Then, we visualized the rate ratio curves of suicides by gender, age group, and subperiod. Results: We observed a seasonal pattern of suicides in Korea with a spring peak and a winter trough. The seasonal ups and downs were most pronounced in suicides among the elderly ≥65 years. However, the seasonal pattern has not been consistent over the past two decades, with lowering seasonal peaks since 2012. The amplitude of seasonality was also lower in 2010–2019 than in 2000–2009. Conclusion The seasonal pattern of suicides seems to have diminished in Korea in recent years. Thus, we need further studies to investigate climatic and non-climatic factors influencing the seasonality of suicides and the consequence of the change.

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is performed to provide enteral nutrition to patients who require tube-feeding support due to impaired oral intake. As life expectancy increases, the need for, and use of PEG also tend to increase. We aimed to evaluate the indications and complications of PEG insertion, and to investigate any differences in the complication group. MATERIALS AND METHODS: We conducted a retrospective analysis of 109 patients who received a PEG procedure between April 2011 and April 2016 in the Korea University Ansan Hospital. We reviewed the indications and complications related to PEG insertion and time interval of tube change. RESULTS: Among 109 patients who underwent a PEG procedure, 71.6% were male, and the mean age was 68.2 years. The most common indications for PEG were central nervous system diseases, including stroke (33.9%), cerebral hemorrhage (29.4%), and hypoxic brain damage (8.3%). The overall complication rate was 14.7%, and the most common complication was peristomal infection (7.3%). Most of the complications occurred within 10 days in 14 of 16 patients (87.5%). The patients with complications were older than those without complications (74.6±11.1 vs. 67.1±14.0 years, P=0.043). The mean time interval for gastrostomy tube change was 7.3 months. CONCLUSIONS: The most common indication of PEG was brain disease, and the complication rate cannot be ignored. Careful attention is needed after a PEG procedure especially in elderly patients.
Aged ; Brain Diseases ; Central Nervous System Diseases ; Cerebral Hemorrhage ; Endoscopy ; Enteral Nutrition ; Gastrostomy* ; Gyeonggi-do ; Humans ; Hypoxia, Brain ; Korea ; Life Expectancy ; Male ; Retrospective Studies* ; Stroke

OBJECTIVE: Attention deficit hyperactivity disorder is known to be a disorder with high genetic trait. Recently the relationship between alleles frequency distribution and ADHD, has been actively researched. In Korea, the relationship between the genetic type and alleles for COMT (Catechol-O-methyltransferase) gene, has been studied in ADHD patients. METHODS: Thirty three patients diagnosed with ADHD according to the DSM-IV diagnostic criteria were selected for the study. The diagnosis and clinical features were confirmed by Korean version Child behavior check list, Korean version Conner's parent rating scale, Attention deficit Diagnostic System, Korean version Spielberger state-trait anxiety scale etc. For the control group, the parents of patients were chosen. Blood samples were taken from the 99 subjects. DNA was extracted from blood lymphocytes, PCR was performed for COMT NlaIII VNTR Polymorphism. Allele and genotype frequencies were compared using the Chi-square test. For the family-based analyses, we used the TDT and HHRR method. RESULTS AND CONCLUSION: In comparing the ADHD transmitted group and the not transmitted group, No significant difference was seen between the COMT genetic type and alleles distribution. As a result, it is viewed that there is not relationship between ADHD and the dopamine transporter gene, but final decision is indefinite. Follow up studies with larger patient or pure subgroups are expected.
Alleles ; Anxiety ; Attention Deficit Disorder with Hyperactivity ; Catechol O-Methyltransferase* ; Child ; Child Behavior ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Dopamine Plasma Membrane Transport Proteins ; Genotype ; Humans ; Korea ; Lymphocytes ; Parents ; Polymerase Chain Reaction

Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin D in humans therefore, the lack of sunlight can easily cause vitamin D deficiency in children and adolescents. Vitamin D deficiency can be diagnosed on the basis ofits typical clinical manifestation, laboratory tests, and radiologic findings. Detection of vitamin D deficiency in children or adolescents necessitates the simultaneous administration of vitamin D and calcium supplements. To prevent vitamin D deficiency, 200 IU of daily vitamin D intake is recommended in infants, and 400 IU of daily vitamin D intake is recommended in Korean children and adolescents.
Adolescent ; Calcification, Physiologic ; Calcium ; Child ; Homeostasis ; Humans ; Infant ; Rickets ; Sunlight ; Vitamin D ; Vitamin D Deficiency ; Vitamins

OBJECTIVES: Alpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation. METHODS: Forty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II. RESULTS: At baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II. CONCLUSION: The increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation.
Antibodies ; Dermatophagoides pteronyssinus ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin A ; Inflammation ; Leukocyte Elastase ; Nasal Lavage Fluid ; Nasal Mucosa ; Nasal Provocation Tests ; Pancreatic Elastase ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing